COVID-19 Mortality and Therapeutics in Nebraska and Southwest Iowa during Early Pandemic
Abstract: BACKGROUND
1. Background
2. Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- WHO Coronavirus (COVID-19) Dashboard. Available online: https://covid19.who.int/region/amro/country/us (accessed on 14 June 2022).
- Jackson, J.; Nelson, R.; Weiss, M.; Schwarzenberg, A.B.; Nelson, R.M.; Sutter, K.M.; Sutherland, M.D. Global Economic Effects of COVID-19. 2021. Available online: https://sgp.fas.org/crs/row/R46270.pdf (accessed on 14 June 2022).
- Chen, Y.; Li, L. SARS-CoV-2: Virus Dynamics and Host Response. Lancet Infect. Dis. 2020, 20, 515–516. [Google Scholar] [CrossRef] [Green Version]
- Wang, M.; Cao, R.; Zhang, L.; Yang, X.; Liu, J.; Xu, M.; Shi, Z.; Hu, Z.; Zhong, W.; Xiao, G. Remdesivir and Chloroquine Effectively Inhibit the Recently Emerged Novel Coronavirus (2019-NCoV) In Vitro. Cell Res. 2020, 30, 269–271. [Google Scholar] [CrossRef] [PubMed]
- Elfiky, A.A. Anti-HCV, Nucleotide Inhibitors, Repurposing against COVID-19. Life Sci. 2020, 248, 117477. [Google Scholar] [CrossRef] [PubMed]
- Morse, J.S.; Lalonde, T.; Xu, S.; Liu, W.R. Learning from the Past: Possible Urgent Prevention and Treatment Options for Severe Acute Respiratory Infections Caused by 2019-NCoV. Chembiochem 2020, 21, 730–738. [Google Scholar] [CrossRef] [PubMed]
- Dong, L.; Hu, S.; Gao, J. Discovering Drugs to Treat Coronavirus Disease 2019 (COVID-19). Drug Discov. Ther. 2020, 14, 58–60. [Google Scholar] [CrossRef] [Green Version]
- RECOVERY Collaborative Group; Horby, P.; Lim, W.S.; Emberson, J.R.; Mafham, M.; Bell, J.L.; Linsell, L.; Staplin, N.; Brightling, C.; Ustianowski, A.; et al. Dexamethasone in Hospitalized Patients with COVID-19. N. Engl. J. Med. 2021, 384, 693–704. [Google Scholar] [CrossRef]
- Hu, B.; Guo, H.; Zhou, P.; Shi, Z.-L. Characteristics of SARS-CoV-2 and COVID-19. Nat. Rev. Microbiol. 2021, 19, 141–154. [Google Scholar] [CrossRef]
- To, K.K.-W.; Tsang, O.T.-Y.; Leung, W.-S.; Tam, A.R.; Wu, T.-C.; Lung, D.C.; Yip, C.C.-Y.; Cai, J.-P.; Chan, J.M.-C.; Chik, T.S.-H.; et al. Temporal Profiles of Viral Load in Posterior Oropharyngeal Saliva Samples and Serum Antibody Responses during Infection by SARS-CoV-2: An Observational Cohort Study. Lancet Infect. Dis. 2020, 20, 565–574. [Google Scholar] [CrossRef] [Green Version]
- Laurencin, C.T.; McClinton, A. The COVID-19 Pandemic: A Call to Action to Identify and Address Racial and Ethnic Disparities. J. Racial Ethn. Health Disparities 2020, 7, 398–402. [Google Scholar] [CrossRef]
- Moore, J.T.; Ricaldi, J.N.; Rose, C.E.; Fuld, J.; Parise, M.; Kang, G.J.; Driscoll, A.K.; Norris, T.; Wilson, N.; Rainisch, G.; et al. Disparities in Incidence of COVID-19 Among Underrepresented Racial/Ethnic Groups in Counties Identified as Hotspots During June 5–18, 2020–22 States, February–June 2020. MMWR. Morb. Mortal. Wkly. Rep. 2020, 69, 1122–1126. [Google Scholar] [CrossRef]
- Vahidy, F.S.; Nicolas, J.C.; Meeks, J.R.; Khan, O.; Pan, A.; Jones, S.L.; Masud, F.; Sostman, H.D.; Phillips, R.; Andrieni, J.D.; et al. Racial and Ethnic Disparities in SARS-CoV-2 Pandemic: Analysis of a COVID-19 Observational Registry for a Diverse US Metropolitan Population. BMJ Open 2020, 10, e039849. [Google Scholar] [CrossRef] [PubMed]
- Gross, C.P.; Essien, U.R.; Pasha, S.; Gross, J.R.; Wang, S.-Y.; Nunez-Smith, M. Racial and Ethnic Disparities in Population-Level COVID-19 Mortality. J. Gen. Intern. Med. 2020, 35, 3097–3099. [Google Scholar] [CrossRef] [PubMed]
- Milner, A.; Jumbe, S. Using the Right Words to Address Racial Disparities in COVID-19. Lancet Public Health 2020, 5, e419–e420. [Google Scholar] [CrossRef]
- Woolf, S.H.; Chapman, D.A.; Sabo, R.T.; Weinberger, D.M.; Hill, L.; Taylor, D.D.H. Excess Deaths from COVID-19 and Other Causes, March–July 2020. JAMA 2020, 324, 1562–1564. [Google Scholar] [CrossRef]
- Rogers, T.N.; Rogers, C.R.; Van Sant-Webb, E.; Gu, L.Y.; Yan, B.; Qeadan, F. Racial Disparities in COVID-19 Mortality among Essential Workers in the United States. World Med. Health Policy 2020, 12, 311–327. [Google Scholar] [CrossRef]
- Selden, T.M.; Berdahl, T.A. COVID-19 And Racial/Ethnic Disparities in Health Risk, Employment, and Household Composition. Health Aff. Millwood 2020, 39, 1624–1632. [Google Scholar] [CrossRef]
- Abbasi, J. “Abandoned” Nursing Homes Continue to Face Critical Supply and Staff Shortages as COVID-19 Toll Has Mounted. JAMA 2020, 324, 123–125. [Google Scholar] [CrossRef]
- Abrams, H.R.; Loomer, L.; Gandhi, A.; Grabowski, D.C. Characteristics of U.S. Nursing Homes with COVID-19 Cases. J. Am. Geriatr. Soc. 2020, 68, 1653–1656. [Google Scholar] [CrossRef]
- Behrens, L.L.; Naylor, M.D. “We Are Alone in This Battle”: A Framework for a Coordinated Response to COVID-19 in Nursing Homes. J. Aging Soc. Policy 2020, 32, 316–322. [Google Scholar] [CrossRef]
- Donnelly, S.C. Elderly Nursing Homes Residents—Are They a Priority in National COVID-19 Strategies? QJM 2020, 113, 387. [Google Scholar] [CrossRef]
- Bivona, G.; Agnello, L.; Ciaccio, M. Biomarkers for Prognosis and Treatment Response in COVID-19 Patients. Ann. Lab. Med. 2021, 41, 540–548. [Google Scholar] [CrossRef] [PubMed]
- Zeng, F.; Huang, Y.; Guo, Y.; Yin, M.; Chen, X.; Xiao, L.; Deng, G. Association of Inflammatory Markers with the Severity of COVID-19: A Meta-Analysis. Int. J. Infect. Dis. 2020, 96, 467–474. [Google Scholar] [CrossRef] [PubMed]
- Luo, H.-C.; You, C.-Y.; Lu, S.-W.; Fu, Y.-Q. Characteristics of Coagulation Alteration in Patients with COVID-19. Ann. Hematol. 2021, 100, 45–52. [Google Scholar] [CrossRef] [PubMed]
- Gao, Y.; Li, T.; Han, M.; Li, X.; Wu, D.; Xu, Y.; Zhu, Y.; Liu, Y.; Wang, X.; Wang, L. Diagnostic Utility of Clinical Laboratory Data Determinations for Patients with the Severe COVID-19. J. Med. Virol. 2020, 92, 791–796. [Google Scholar] [CrossRef] [PubMed]
- Malik, P.; Patel, U.; Mehta, D.; Patel, N.; Kelkar, R.; Akrmah, M.; Gabrilove, J.L.; Sacks, H. Biomarkers and Outcomes of COVID-19 Hospitalisations: Systematic Review and Meta-Analysis. BMJ Evid. Based Med. 2021, 26, 107–108. [Google Scholar] [CrossRef]
- Guan, W.-J.; Ni, Z.-Y.; Hu, Y.; Liang, W.-H.; Ou, C.-Q.; He, J.-X.; Liu, L.; Shan, H.; Lei, C.-L.; Hui, D.S.C.; et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N. Engl. J. Med. 2020, 382, 1708–1720. [Google Scholar] [CrossRef]
- Xiong, Y.; Sun, D.; Liu, Y.; Fan, Y.; Zhao, L.; Li, X.; Zhu, W. Clinical and High-Resolution CT Features of the COVID-19 Infection: Comparison of the Initial and Follow-up Changes. Investig. Radiol. 2020, 55, 332–339. [Google Scholar] [CrossRef]
- Beigel, J.H.; Tomashek, K.M.; Dodd, L.E.; Mehta, A.K.; Zingman, B.S.; Kalil, A.C.; Hohmann, E.; Chu, H.Y.; Luetkemeyer, A.; Kline, S.; et al. Remdesivir for the Treatment of COVID-19—Final Report. N. Engl. J. Med. 2020, 383, 1813–1826. [Google Scholar] [CrossRef]
- Ader, F.; Bouscambert-Duchamp, M.; Hites, M.; Peiffer-Smadja, N.; Poissy, J.; Belhadi, D.; Diallo, A.; Lê, M.-P.; Peytavin, G.; Staub, T.; et al. Remdesivir plus Standard of Care versus Standard of Care Alone for the Treatment of Patients Admitted to Hospital with COVID-19 (DisCoVeRy): A Phase 3, Randomised, Controlled, Open-Label Trial. Lancet Infect. Dis. 2022, 22, 209–221. [Google Scholar] [CrossRef]
- Remdesivir (Veklury) FDA Approved Package Insert 2020 Gilead. Available online: https://www.gilead.com/-/media/files/pdfs/medicines/covid-19/veklury/veklury_pi.pdf (accessed on 12 January 2022).
- NIH Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. Available online: https://www.covid19treatmentguidelines.nih.gov/ (accessed on 14 June 2022).
- Li, H.; Yan, B.; Gao, R.; Ren, J.; Yang, J. Effectiveness of Corticosteroids to Treat Severe COVID-19: A Systematic Review and Meta-Analysis of Prospective Studies. Int. Immunopharmacol. 2021, 100, 108121. [Google Scholar] [CrossRef]
- WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group; Sterne, J.A.C.; Murthy, S.; Diaz, J.V.; Slutsky, A.S.; Villar, J.; Angus, D.C.; Annane, D.; Azevedo, L.C.P.; Berwanger, O.; et al. Association between Administration of Systemic Corticosteroids and Mortality among Critically Ill Patients with COVID-19: A Meta-Analysis. JAMA 2020, 324, 1330–1341. [Google Scholar] [CrossRef] [PubMed]
- RECOVERY Collaborative Group. Tocilizumab in Patients Admitted to Hospital with COVID-19 (RECOVERY): A Randomised, Controlled, Open-Label, Platform Trial. Lancet 2021, 397, 1637–1645. [Google Scholar] [CrossRef]
- REMAP-CAP Investigators; Gordon, A.C.; Mouncey, P.R.; Al-Beidh, F.; Rowan, K.M.; Nichol, A.D.; Arabi, Y.M.; Annane, D.; Beane, A.; van Bentum-Puijk, W.; et al. Interleukin-6 Receptor Antagonists in Critically Ill Patients with COVID-19. N. Engl. J. Med. 2021, 384, 1491–1502. [Google Scholar] [CrossRef] [PubMed]
- Biran, N.; Ip, A.; Ahn, J.; Go, R.C.; Wang, S.; Mathura, S.; Sinclaire, B.A.; Bednarz, U.; Marafelias, M.; Hansen, E.; et al. Tocilizumab among Patients with COVID-19 in the Intensive Care Unit: A Multicentre Observational Study. Lancet Rheumatol. 2020, 2, e603–e612. [Google Scholar] [CrossRef]
- Antinori, S.; Bonazzetti, C.; Gubertini, G.; Capetti, A.; Pagani, C.; Morena, V.; Rimoldi, S.; Galimberti, L.; Sarzi-Puttini, P.; Ridolfo, A.L. Tocilizumab for Cytokine Storm Syndrome in COVID-19 Pneumonia: An Increased Risk for Candidemia? Autoimmun. Rev. 2020, 19, 102564. [Google Scholar] [CrossRef] [PubMed]
- Beigel, J.H.; Tomashek, K.M.; Dodd, L.E. Remdesivir for the Treatment of COVID-19—Preliminary Report. Reply. N. Engl. J. Med. 2020, 383, 994. [Google Scholar] [CrossRef]
- Goldman, J.D.; Lye, D.C.B.; Hui, D.S.; Marks, K.M.; Bruno, R.; Montejano, R.; Spinner, C.D.; Galli, M.; Ahn, M.-Y.; Nahass, R.G.; et al. Remdesivir for 5 or 10 Days in Patients with Severe COVID-19. N. Engl. J. Med. 2020, 383, 1827–1837. [Google Scholar] [CrossRef]
- Bloch, E.M.; Shoham, S.; Casadevall, A.; Sachais, B.S.; Shaz, B.; Winters, J.L.; van Buskirk, C.; Grossman, B.J.; Joyner, M.; Henderson, J.P.; et al. Deployment of Convalescent Plasma for the Prevention and Treatment of COVID-19. J. Clin. Investig. 2020, 130, 2757–2765. [Google Scholar] [CrossRef] [Green Version]
- Farhat, R.M.; Mousa, M.A.; Daas, E.J.; Glassberg, M.K. Treatment of COVID-19: Perspective on Convalescent Plasma Transfusion. Front. Med. 2020, 7, 435. [Google Scholar] [CrossRef]
- Price-Haywood, E.G.; Burton, J.; Fort, D.; Seoane, L. Hospitalization and Mortality among Black Patients and White Patients with COVID-19. N. Engl. J. Med. 2020, 382, 2534–2543. [Google Scholar] [CrossRef]
- Mackey, K.; Ayers, C.K.; Kondo, K.K.; Saha, S.; Advani, S.M.; Young, S.; Spencer, H.; Rusek, M.; Anderson, J.; Veazie, S.; et al. Racial and Ethnic Disparities in COVID-19-Related Infections, Hospitalizations, and Deaths: A Systematic Review. Ann. Intern. Med. 2021, 174, 362–373. [Google Scholar] [CrossRef] [PubMed]
- Ogedegbe, G.; Ravenell, J.; Adhikari, S.; Butler, M.; Cook, T.; Francois, F.; Iturrate, E.; Jean-Louis, G.; Jones, S.A.; Onakomaiya, D.; et al. Assessment of Racial/Ethnic Disparities in Hospitalization and Mortality in Patients with COVID-19 in New York City. JAMA Netw. Open 2020, 3, e2026881. [Google Scholar] [CrossRef] [PubMed]
- Magesh, S.; John, D.; Li, W.T.; Li, Y.; Mattingly-App, A.; Jain, S.; Chang, E.Y.; Ongkeko, W.M. Disparities in COVID-19 Outcomes by Race, Ethnicity, and Socioeconomic Status: A Systematic-Review and Meta-Analysis. JAMA Netw. Open 2021, 4, e2134147. [Google Scholar] [CrossRef] [PubMed]
- Sze, S.; Pan, D.; Nevill, C.R.; Gray, L.J.; Martin, C.A.; Nazareth, J.; Minhas, J.S.; Divall, P.; Khunti, K.; Abrams, K.R.; et al. Ethnicity and Clinical Outcomes in COVID-19: A Systematic Review and Meta-Analysis. EClinicalMedicine 2020, 29, 100630. [Google Scholar] [CrossRef]
Variable | Result (n = 471) |
---|---|
Nursing home | 148 (32%) |
Food-processing facility | 74 (16%) |
Patient age (yrs) | 62.5 ± 17.7 |
Body weight (kgs) | 86.3 ± 27.1 |
APACHE II score | 9.9 ± 6.5 |
Patient required intubation | 134 (29%) |
Patient required proning | 88 (19%) |
Patient required vasopressor use | 97 (29%) |
Admission CrCl (ml/min) | 75.2 ± 49.2 |
Inflammatory Marker | COVID-19 Survivor | COVID-19 Fatality |
---|---|---|
Initial CRP * | 72.3 ± 76.4 | 106.6 ± 86.1 |
Max CRP * | 128.7 ± 91.7 | 200.3 ± 83.5 |
Initial D-dimer | 199.9 ± 1128.5 | 297.7 ± 888.2 |
Max D-dimer | 390.6 ± 1495.2 | 625.9 ± 2095.5 |
Initial ferritin | 1032.2 ± 2095.5 | 875.9 ± 1936.4 |
Max ferritin | 1207.8 ± 1954.7 | 2042.6 ± 3526.5 |
Initial LDH | 374.0 ± 160.2 | 369.8 ± 160.0 |
Max LDH * | 467.9 ± 292.2 | 598.8 ± 330.9 |
Lowest absolute lymphocytes count | 1.2 ± 2.1 | 0.7 ± 0.7 |
Variable | Exp (B) | 95% C.I. |
---|---|---|
HCQ therapy | 0.986 | 0.221; 4.23 |
Azithromycin therapy | 1.17 | 0.46; 3.02 |
Remdesivir | 0.97 | 0.12; 1.07 |
Convalescent plasma | 1.51 | 0.52; 4.37 |
Steroid use * | 4.70 | 1.65; 13.46 |
Requiring intubation * | 11.94 | 4.23; 33.66 |
Concomitant cardiovascular disease | 2.02 | 0.77; 5.36 |
Concomitant diabetes | 1.80 | 0.72; 4.48 |
Obesity | 1.69 | 0.62; 4.62 |
Food-processing facility | 0.54 | 0.03; 0.90 |
African-American race * | 2.96 | 0.80; 11.01 |
Asian race * | 14.25 | 2.17; 93.50 |
Hispanic race | 2.96 | 0.75; 11.02 |
Skilled nursing facility prior to admission * | 12.07 | 3.47 41.97 |
Tocilizumab | 3.77 | 0.96; 14.85 |
Constant | 8.282 |
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Destache, C.J.; Ahmad, F.; Rajendrapasad, S.; Loranger, A.; Pruett, W.; Jagan, N.; Krajicek, B.; Schmidt, D.; Quimby, D.; Velagapudi, M.; et al. COVID-19 Mortality and Therapeutics in Nebraska and Southwest Iowa during Early Pandemic. Pharmacy 2022, 10, 69. https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy10040069
Destache CJ, Ahmad F, Rajendrapasad S, Loranger A, Pruett W, Jagan N, Krajicek B, Schmidt D, Quimby D, Velagapudi M, et al. COVID-19 Mortality and Therapeutics in Nebraska and Southwest Iowa during Early Pandemic. Pharmacy. 2022; 10(4):69. https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy10040069
Chicago/Turabian StyleDestache, Christopher J., Faran Ahmad, Sanu Rajendrapasad, Austin Loranger, William Pruett, Nikhal Jagan, Bryan Krajicek, David Schmidt, David Quimby, Manasa Velagapudi, and et al. 2022. "COVID-19 Mortality and Therapeutics in Nebraska and Southwest Iowa during Early Pandemic" Pharmacy 10, no. 4: 69. https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy10040069