Risk factors for COVID infection, death noted in group home residents
A study of adults with intellectual and developmental disabilities (IDD) living in New York City group homes has identified older age, larger residential settings, Down syndrome, and chronic kidney disease as risk factors for COVID-19 infection, with heart disease as a risk factor for related death.
Led by a Syracuse University researcher, the study was published yesterday in JAMA Network Open. The team tracked COVID-19 outcomes for 543 residents of homes operated by a single nonprofit organization in all five city boroughs from Mar 1 to Oct 1, 2020.
Of the 543 residents, 91 (16.8%) were diagnosed as having COVID-19, and 35 (6.4%) died from their infections. Infection risks were increased for older residents (odds ratio [OR], 1.04), those with Down syndrome (OR, 2.91) or chronic kidney disease (OR, 4.17), and those living in a facility with more residents (OR, 1.07). Residents with heart disease were at dramatically higher risk of death from COVID-19 (OR, 10.60).
Among those with IDD, 56 residents (10.3%) also had Down syndrome, while 50 (9.2%) had cerebral palsy. The most common underlying medical conditions were obesity (29.1%), type 2 diabetes (19.0%), and heart disease (17.5%).
Median resident age was 57.0 years, 40.0% were women, and 50.5% were Black, Asian/Pacific Islander, American Indian, Alaskan Native, or Hispanic.
“The fact that the case rate, case-fatality rate, and mortality rate were substantially higher for people with IDD living in residential settings than for New York City overall is consistent with results from prior studies documenting increased COVID-19 risk for people with IDD and emphasizes the urgent need to prioritize vaccination allocation for this population,” the authors wrote.
In addition, they said, “Results underscore that COVID-19 diagnosis should prompt close monitoring and consideration of hospitalization if respiratory symptoms develop for all people with IDD, but especially for those who are older, have preexisting medical conditions and/or Down syndrome, or live in settings with more residents.”
Jun 8 JAMA Netw Open study
Real-world study finds 2 doses of Pfizer COVID-19 vaccine 89% effective
An Israeli population-based study found 89% vaccine effectiveness (VE) 7 or more days after the second dose, according to a study today in Open Forum Infectious Diseases.
The researchers followed 6,286 people, of whom 30.2% weren’t vaccinated, 23.0% received one dose, and 46.8% received two doses (mean ages, 36, 41, and 52 years, respectively). The follow-up period was from Jan 1 to Feb 11, during which the country’s new daily infections peaked at more than 8,000 cases per day from Jan 14 to 20 and then subsided to 5,822 by the study’s end.
Pre-vaccination infection rate was measured as well as VE 14 days after the first dose up to second dose administration, 1 to 6 days after the second dose, and 7 days or more after the second dose.
The researchers found that, for those unvaccinated, the incidence rate was 53 cases per 10,000 person-days. Therefore, the data showed that VE was 61% (95% confidence interval [CI], 49% to 71%) 14 days or more after one dose, which the researchers note is in alignment with a JAMA Network Open study yesterday that found 51.4% in days 13 to 24 after the first dose. For those who received two doses of the vaccine, VE was 82% (95% CI, 71% to 89%) 1 to 6 days post-vaccination and 89% (95% CI, 82% to 94%) 7 or more days post-vaccination.
The researchers write, “The frequent PCR [polymerase chain reaction] testing in our cohort enabled estimation of infections, whether symptomatic or asymptomatic. The reduction ratio remained constant between the individuals in ultra-orthodox Jewish towns, which had higher incidence of COVID-19 infection, and the other cohort participants. The large cohort with its large age variance suggests that these results may be applicable in different population groups.”
Jun 9 Open Forum Infect Dis study
H5N6 avian flu infects another person in China
China has reported another human H5N6 avian flu case, which involves a 49-year-old woman from Sichuan province, according to a statement yesterday from Hong Kong’s Centre for Health Protection (CHP). Sichuan province is in the country’s southwest.
The patient’s symptoms began on May 13, and she was hospitalized on May 16, where she is listed in serious condition. The report did not say how she was exposed to the virus.
China and a few other countries have reported H5N6 outbreaks in poultry since 2014, but China and Laos are the only ones that have reported human cases, which can often be serious or fatal. The latest case would raise the global total to 33, all but 1 in China.
Jun 8 CHP statement