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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 13 of 13 Research Studies DisplayedAklilu AM, Kumar S, Nugent J
COVID-19-associated acute kidney injury and longitudinal kidney outcomes.
This retrospective longitudinal multicenter cohort study’s objective was to assess long-term kidney outcomes of patient who had COVID-19-associated acute kidney injury (AKI). This study was conducted in a large hospital system using electronic health records data on adult hospitalized patients with AKI and COVID-19 or other illnesses. Included patients were those 1) who were hospitalized during the COVID-19 pandemic (March 2020-June 2022), were screened for SARS-CoV-2, had AKI, and survived to discharge, or 2) had been hospitalized during the 5 years before the pandemic (October 2016-January 2020), had a positive influenza A or B test result, had AKI, and survived to discharge. The study cohort included 9624 hospitalized patients (mean age, 69.0 years; 4955 females) with AKI, including 987 patients with COVID-AKI, 276 with influenza-associated AKI, and 8361 with AKI associated with other illnesses (other-AKI). When compared with the other 2 groups, patients with COVID-19-associated AKI were slightly younger in age, had a higher baseline eGFR, worse baseline comorbidity scores, higher markers of illness severity, and longer hospital stay. Compared with the other-AKI group, the COVID-AKI group had lower major adverse kidney events (MAKE) (adjusted hazard ratio [aHR], 0.67) due to lower all-cause mortality (aHR, 0.31) and lower rates of worsened kidney function.
AHRQ-funded; HS027626.
Citation: Aklilu AM, Kumar S, Nugent J .
COVID-19-associated acute kidney injury and longitudinal kidney outcomes.
JAMA Intern Med 2024 Apr; 18(4):414-23. doi: 10.1001/jamainternmed.2023.8225..
Keywords: COVID-19, Kidney Disease and Health, Outcomes
Fingar KR, Weiss AJ, Roemer M
AHRQ Author: Roemer M, Reid LD
Effects of the COVID-19 early pandemic on delivery outcomes among women with and without COVID-19 at birth.
This AHRQ-authored paper examined the early pandemic-related changes in birth outcomes for pregnant women with and without a COVID-19 diagnosis at delivery. They compared four delivery outcomes-preterm delivery (PTD), severe maternal morbidity (SMM), stillbirth, and cesarean birth-between 2017 and 2019 (prepandemic) and between April and December 2020 (early pandemic) using interrupted time series models on 11.8 million deliveries, stratified by COVID-19 infection status at birth with entropy weighting for historical controls, from the HCUP across 43 states and the District of Columbia. Relative to 2017-2019, women without COVID-19 at delivery in 2020 had lower odds of PTD (OR = 0.93) and SMM (OR = 0.88) but increased odds of stillbirth (OR = 1.04). COVID-19 deliveries had an excess of each outcome, by factors of 1.07-1.46 for outcomes except SMM at 4.21. The effect for SMM was more pronounced for Asian/Pacific Islander non-Hispanic (API; OR = 10.51) and Hispanic (OR = 5.09) pregnant women than for White non-Hispanic (OR = 3.28) women.
AHRQ-authored; AHRQ-funded; 290201800001C.
Citation: Fingar KR, Weiss AJ, Roemer M .
Effects of the COVID-19 early pandemic on delivery outcomes among women with and without COVID-19 at birth.
Birth 2023 Dec; 50(4):996-1008. doi: 10.1111/birt.12753..
Keywords: Healthcare Cost and Utilization Project (HCUP), COVID-19, Maternal Care, Women, Outcomes
Wu W, Bhatraju PK, Cobb N
Radiographic findings and association with clinical severity and outcomes in critically ill patients with COVID-19.
Investigators sought to describe evolution and severity of radiographic findings and to assess association with disease severity and outcomes in critically ill COVID-19 patients. They found that evolution of radiographic features indicates rapid disease progression and correlates with requirement for invasive MV or vasopressors but not mortality, which suggests potential non-pulmonary pathways to death in COVID-19.
AHRQ-funded; HS026369.
Citation: Wu W, Bhatraju PK, Cobb N .
Radiographic findings and association with clinical severity and outcomes in critically ill patients with COVID-19.
Curr Probl Diagn Radiol 2022 Nov-Dec;51(6):884-91. doi: 10.1067/j.cpradiol.2022.04.002..
Keywords: COVID-19, Critical Care, Outcomes
Drewry AM, Mohr NM, Ablordeppey EA
Therapeutic hyperthermia is associated with improved survival in afebrile critically ill patients with sepsis: a pilot randomized trial.
This study’s objective was to test the hypothesis that forced-air warming of critically ill afebrile sepsis patients improves immune function compared to standard temperature management. Patients were considered eligible patients if they were mechanically ventilated septic adults with: 1) a diagnosis of sepsis within 48 hours of enrollment; 2) anticipated need for mechanical ventilation of greater than 48 hours; and 3) a maximum temperature less than 38.3°C within the 24 hours prior to enrollment. Intervention treatment was external warming using a forced-air warming blanket for 48 hours, with a goal temperature 1.5°C above the lowest temperature documented in the previous 24 hours. The authors enrolled 56 patients in this randomized, controlled trial. Participants allocated to external warming had lower 28-day mortality (18% vs 43%) and more 28-day hospital-free days. No differences were observed between the groups in HLA-DR expression or IFN-γ production.
AHRQ-funded; HS025753.
Citation: Drewry AM, Mohr NM, Ablordeppey EA .
Therapeutic hyperthermia is associated with improved survival in afebrile critically ill patients with sepsis: a pilot randomized trial.
Crit Care Med 2022 Jun;50(6):924-34. doi: 10.1097/ccm.0000000000005470..
Keywords: COVID-19, Sepsis, Treatments, Comparative Effectiveness, Evidence-Based Practice, Outcomes
Bergman ZR, Usher M, Olson A
Comparison of outcomes and process of care for patients treated at hospitals dedicated for COVID-19 care vs other hospitals.
The purpose of this study was to analyze the mortality rate and complications associated with treatment at the COVID-19-dedicated hospitals. Findings showed that, in this cohort study, COVID-19-dedicated hospitals in Minnesota had multiple benefits, including providing high-volume repetitive treatment and isolating patients with the infection. This experience suggests improved in-hospital mortality for patients treated at dedicated hospitals.
AHRQ-funded; HS026732; HS026379.
Citation: Bergman ZR, Usher M, Olson A .
Comparison of outcomes and process of care for patients treated at hospitals dedicated for COVID-19 care vs other hospitals.
JAMA Netw Open 2022 Mar;5(3):e220873. doi: 10.1001/jamanetworkopen.2022.0873..
Keywords: COVID-19, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes, Healthcare Delivery, Hospitals
Shao CC, McLeod MC, Gleason L
Effect of COVID-19 pandemic restructuring on surgical volume and outcomes of non-COVID patients undergoing surgery.
The authors sought to assess changes in surgical case mix and outcomes due to restructuring during the pandemic. Institutional ACS-NSQIP data was used to identify patients undergoing surgery at a single tertiary care institution in the Deep South. They found that surgeries during the COVID-19 pandemic were more often outpatient without differences in post-operative outcomes. They recommended additional analysis to determine the impact of duration of operative delay on surgical outcomes with restructuring focusing more on outpatient surgeries.
AHRQ-funded; HS013852.
Citation: Shao CC, McLeod MC, Gleason L .
Effect of COVID-19 pandemic restructuring on surgical volume and outcomes of non-COVID patients undergoing surgery.
Am Surg 2022 Mar;88(3):489-97. doi: 10.1177/00031348211054528..
Keywords: COVID-19, Surgery, Public Health, Outcomes
Song Zhang, Zhang X, Patterson LJ
Racial and ethnic disparities in hospitalization outcomes among Medicare beneficiaries during the COVID-19 pandemic.
This study assessed assess racial and ethnic differences in hospitalization outcomes during the COVID-19 pandemic among Medicare beneficiaries. Medicare claims from the Social Security Administration was used to determine in-hospital mortality and mortality inclusive of discharges to hospice and discharges to postacute care. Over 31 million Medicare recipients in the database were analyzed with over 14 million hospitalizations from January 2019 to February 2021. There was a decline in non-COVID-19 and an emergence of COVID-19 hospitalizations among beneficiaries of different racial and ethnic minority groups through February 2021. In-hospital mortality was not significantly different among Black patients relative to White patients but was 3.5 percentage points higher among Hispanic patients and other racial and ethnic minority groups. There were disparities in discharges to hospice and postacute care as well.
AHRQ-funded; HS024072.
Citation: Song Zhang, Zhang X, Patterson LJ .
Racial and ethnic disparities in hospitalization outcomes among Medicare beneficiaries during the COVID-19 pandemic.
JAMA Health Forum 2021 Dec 23;2(12):e214223. doi: 10.1001/jamahealthforum.2021.4223..
Keywords: COVID-19, Racial and Ethnic Minorities, Disparities, Medicare, Hospitalization, Outcomes, Mortality
Anesi GL, Kerlin MP
The impact of resource limitations on care delivery and outcomes: routine variation, the coronavirus disease 2019 pandemic, and persistent shortage.
Researchers discuss the impact of resource limitations on care delivery and outcomes. They conclude that the interaction between resource limitation and care delivery and outcomes is complex and incompletely understood. Further, the COVID-19 pandemic provides a learning opportunity for strain response during both pandemic and non-pandemic times.
AHRQ-funded; HS026372.
Citation: Anesi GL, Kerlin MP .
The impact of resource limitations on care delivery and outcomes: routine variation, the coronavirus disease 2019 pandemic, and persistent shortage.
Curr Opin Crit Care 2021 Oct 1;27(5):513-19. doi: 10.1097/mcc.0000000000000859..
Keywords: COVID-19, Public Health, Healthcare Delivery, Intensive Care Unit (ICU), Outcomes
Klein IA, Rosenberg SM, Reynolds KL
Impact of cancer history on outcomes among hospitalized patients with COVID-19.
Researchers investigated whether a current cancer diagnosis or cancer history is an independent risk factor for death in hospitalized patients with COVID-19. They found that patients with a history of cancer hospitalized for COVID-19 had similar mortality to matched hospitalized patients with COVID-19 without cancer, and a lower risk of complications, while patients with active cancer or recent cancer treatment had a similar risk for adverse outcomes compared with survivors of cancer. They concluded that active cancer, systemic cancer therapy, and a cancer history are not independent risk factors for death from COVID-19 among hospitalized patients, and hospitalized patients without cancer are more likely to have severe COVID-19.
AHRQ-funded; HS023680.
Citation: Klein IA, Rosenberg SM, Reynolds KL .
Impact of cancer history on outcomes among hospitalized patients with COVID-19.
Oncologist 2021 Aug;26(8):685-93. doi: 10.1002/onco.13794..
Keywords: COVID-19, Cancer, Risk, Mortality, Hospitalization, Outcomes
Bramante CT, Buse J, Tamaritz L
Outpatient metformin use is associated with reduced severity of COVID-19 disease in adults with overweight or obesity.
This study investigated whether outpatient metformin use is associated with reduced severity of COVID-19 in adults with overweight or obesity. Metformin can decrease interleukin-6 and tumor-necrosis factor- α, which appears to contribute to COVID-19 mortality. The authors conducted a retrospective cohort analysis of electronic health record (EHR) data that was pooled across multiple EHR systems from 12 hospitals and 60 primary care clinics in the Midwest between March and December 2020. Inclusion criteria included data for BMI > 25 kg/m(2); age range 30-85 years; and a positive SARS-CoV-2 polymerase chain reaction test. Metformin was associated with a decrease in mortality from COVID-19 and a nonsignificant decrease in hospital admission in the overall cohort.
AHRQ-funded; HS026379.
Citation: Bramante CT, Buse J, Tamaritz L .
Outpatient metformin use is associated with reduced severity of COVID-19 disease in adults with overweight or obesity.
J Med Virol 2021 Jul;93(7):4273-79. doi: 10.1002/jmv.26873..
Keywords: COVID-19, Infectious Diseases, Obesity, Medication, Treatments, Outcomes
Anesi GL, Jablonski J, Harhay MO
Characteristics, outcomes, and trends of patients with COVID-19-related critical illness at a learning health system in the United States.
This study’s objective is to describe the epidemiology of COVID-19-related critical illness, including trends in outcomes and care delivery, using five hospitals within the University of Pennsylvania Health System as a setting. Findings showed that, among patients with COVID-19-related critical illness admitted to ICUs of a learning health system in the United States, mortality seemed to decrease over time despite stable patient characteristics. Recommendations included further studies to confirm this result and to investigate causal mechanisms.
AHRQ-funded; HS026372.
Citation: Anesi GL, Jablonski J, Harhay MO .
Characteristics, outcomes, and trends of patients with COVID-19-related critical illness at a learning health system in the United States.
Ann Intern Med 2021 May;174(5):613-21. doi: 10.7326/m20-5327..
Keywords: COVID-19, Critical Care, Intensive Care Unit (ICU), Mortality, Hospitals, Outcomes, Infectious Diseases
Donnelly JP, Wang XQ, Iwashyna TJ
Readmission and death after initial hospital discharge among patients with COVID-19 in a large multihospital system.
This study describes reasons for readmission, use of intensive care unit (ICU) interventions during readmission, and proportions of death after initial hospital discharge of COVID-19 patients from US Veterans Affairs (VA) hospitals March-June 2020.
AHRQ-funded; HS026725.
Citation: Donnelly JP, Wang XQ, Iwashyna TJ .
Readmission and death after initial hospital discharge among patients with COVID-19 in a large multihospital system.
JAMA 2021 Jan 19;325(3):304-06. doi: 10.1001/jama.2020.21465.
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Keywords: Respiratory Conditions, COVID-19, Hospital Readmissions, Hospital Discharge, Mortality, Outcomes
Lara OD, O'Cearbhaill RE, Smith MJ
COVID-19 outcomes of patients with gynecologic cancer in New York City.
Researchers studied clinical characteristics and outcomes of vulnerable populations with gynecologic cancer who developed COVID-19 infections. Among patients from six New York City area hospital systems with known gynecologic cancer and a COVID-19 diagnosis, the researchers found a case fatality rate of 14 percent, with no association between cytotoxic chemotherapy and cancer-directed surgery and COVID-19 severity or death. They recommended that patients be counseled regarding the safety of continued anticancer treatments during the pandemic, as the ability to continue cancer therapies for cancer control and cure is critical.
AHRQ-funded; HS026120.
Citation: Lara OD, O'Cearbhaill RE, Smith MJ .
COVID-19 outcomes of patients with gynecologic cancer in New York City.
Cancer 2020 Oct 1;126(19):4294-303. doi: 10.1002/cncr.33084..
Keywords: COVID-19, Respiratory Conditions, Cancer, Women, Vulnerable Populations, Outcomes, Urban Health