Outcomes of COVID-19 and Influenza in Cerebral Palsy Patients Hospitalized in the United States: Comparative Study of a Nationwide Database
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Jonsson, U.; Eek, M.N.; Sunnerhagen, K.S.; Himmelmann, K. Health Conditions in Adults With Cerebral Palsy: The Association with CP Subtype and Severity of Impairments. Front. Neurol. 2021, 12, 732939. [Google Scholar] [CrossRef] [PubMed]
- Brooks, J.C.; Strauss, D.J.; Shavelle, R.M.; Tran, L.M.; Rosenbloom, L.; Wu, Y.W. Recent trends in cerebral palsy survival. Part I: Period and cohort effects. Dev. Med. Child Neurol. 2014, 56, 1059–1064. [Google Scholar] [CrossRef]
- Blair, E.; Langdon, K.; McIntyre, S.; Lawrence, D.; Watson, L. Survival and mortality in cerebral palsy: Observations to the sixth decade from a data linkage study of a total population register and National Death Index. BMC Neurol 2019, 19, 111. [Google Scholar] [CrossRef] [PubMed]
- Ryan, J.M.; Peterson, M.D.; Ryan, N.; Smith, K.J.; O’Connell, N.E.; Liverani, S.; Anokye, N.; Victor, C.; Allen, E. Mortality due to cardiovascular disease, respiratory disease, and cancer in adults with cerebral palsy. Dev. Med. Child Neurol. 2019, 61, 924–928. [Google Scholar] [CrossRef] [PubMed]
- Hurvitz, E.A.; Whitney, D.G.; Waldron-Perrine, B.; Ryan, D.; Haapala, H.J.; Schmidt, M.; Gray, C.; Peterson, M.D. Navigating the Pathway to Care in Adults with Cerebral Palsy. Front. Neurol. 2021, 12, 734139. [Google Scholar] [CrossRef] [PubMed]
- Healthcare Cost and Utilization Project. NIS Database Documentation. Available online: https://hcup-us.ahrq.gov/db/nation/nis/nisdbdocumentation.jsp (accessed on 12 March 2024).
- U.S. Department of Health and Human Services. Federal Policy for the Protection of Human Subjects (‘Common Rule’). Available online: https://www.hhs.gov/ohrp/regulations-and-policy/regulations/common-rule/index.html (accessed on 12 March 2024).
- Cohen, E.; Kuo, D.Z.; Agrawal, R.; Berry, J.G.; Bhagat, S.K.; Simon, T.D.; Srivastava, R. Children with medical complexity: An emerging population for clinical and research initiatives. Pediatrics 2019, 127, 529–538. [Google Scholar] [CrossRef] [PubMed]
- Brehm, T.T.; van der Meirschen, M.; Hennigs, A.; Roedl, K.; Jarczak, D.; Wichmann, D.; Frings, D.; Nierhaus, A.; Oqueka, T.; Fiedler, W.; et al. Comparison of clinical characteristics and disease outcome of COVID-19 and seasonal influenza. Sci. Rep. 2021, 11, 5803. [Google Scholar] [CrossRef] [PubMed]
- Vahidy, F.S.; Pan, A.P.; Ahnstedt, H.; Munshi, Y.; Choi, H.A.; Tiruneh, Y.; Nasir, K.; Kash, B.A.; Andrieni, J.D.; McCullough, L.D. Sex differences in susceptibility, severity, and outcomes of coronavirus disease 2019: Cross-sectional analysis from a diverse US metropolitan area. PLoS ONE 2021, 16, e0245556. [Google Scholar] [CrossRef]
- Pijls, B.G.; Jolani, S.; Atherley, A.; Dijkstra, J.I.R.; Franssen, G.H.L.; Hendriks, S.; Yi-Wen Yu, E.; Zalpuri, S.; Richters, A.; Zeegers, M.P. Temporal trends of sex differences for COVID-19 infection, hospitalisation, severe disease, intensive care unit (ICU) admission and death: A meta-analysis of 229 studies covering over 10M patients. F1000Res 2022, 11, 5. [Google Scholar] [CrossRef]
- Abate, B.B.; Kassie, A.M.; Kassaw, M.W.; Aragie, T.G.; Masresha, S.A. Sex difference in coronavirus disease (COVID-19): A systematic review and meta-analysis. BMJ Open 2020, 10, e040129. [Google Scholar] [CrossRef]
- Danielsen, A.C.; Lee, K.M.; Boulicault, M.; Rushovich, T.; Gompers, A.; Tarrant, A.; Reiches, M.; Shattuck-Heidorn, H.; Miratrix, L.W.; Richardson, S.S. Sex disparities in COVID-19 outcomes in the United States: Quantifying and contextualizing variation. Soc. Sci. Med. 2022, 294, 114716. [Google Scholar] [CrossRef]
- Kharroubi, S.A.; Diab-El-Harake, M. Sex-differences in COVID-19 diagnosis, risk factors and disease comorbidities: A large US-based cohort study. Front. Public Health 2022, 10, 1029190. [Google Scholar] [CrossRef]
- Talbot, H.K.; Martin, E.T.; Gaglani, M.; Middleton, D.B.; Ghamande, S.; Silveira, F.P.; Murthy, K.; Zimmerman, R.K.; Trabue, C.H.; Olson, S.M.; et al. Coronavirus disease 2019 (COVID-19) Versus Influenza in Hospitalized Adult Patients in the United States: Differences in Demographic and Severity Indicators. Clin. Infect. Dis. 2021, 73, 2240–2247. [Google Scholar] [CrossRef]
- People with Disabilities and COVID-19. Centers for Disease Control and Prevention. Available online: https://www.cdc.gov/ncbddd/humandevelopment/covid-19/people-with-disabilities.html (accessed on 5 April 2024).
- 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]
- Rubin-Miller, L.; Alban, C.; Artiga, S.; Sullivan, S. COVID-19 Racial Disparities in Testing, Infection, Hospitalization, and Death: Analysis of Epic Patient Data; Kaiser Family Foundation: San Francisco, CA, USA, 2020. [Google Scholar]
- Tai, D.B.G.; Shah, A.; Doubeni, C.A.; Sia, I.G.; Wieland, M.L. The Disproportionate Impact of COVID-19 on Racial and Ethnic Minorities in the United States. Clin. Infect. Dis. 2021, 72, 703–706. [Google Scholar] [CrossRef]
- Piroth, L.; Cottenet, J.; Mariet, A.-S.; Bonniaud, P.; Blot, M.; Tubert-Bitter, P.; Quantin, C. Comparison of the characteristics, morbidity, and mortality of COVID-19 and seasonal influenza: A nationwide, population-based retrospective cohort study. Lancet Respir. Med. 2021, 9, 251–259. [Google Scholar] [CrossRef]
- Nersesjan, V.; Amiri, M.; Christensen, H.K.; Benros, M.E.; Kondziella, D. Thirty-Day Mortality and Morbidity in COVID-19 Positive vs. COVID-19 Negative Individuals and vs. Individuals Tested for Influenza A/B: A Population-Based Study. Front. Med. 2020, 7, 598272. [Google Scholar] [CrossRef]
- Alimohamadi, Y.; Tola, H.H.; Abbasi-Ghahramanloo, A.; Janani, M.; Sepandi, M. Case fatality rate of COVID-19: A systematic review and meta-analysis. J. Prev. Med. Hyg. 2021, 62, E311–E320. [Google Scholar] [CrossRef]
- Past Seasons Estimated Influenza Disease Burden. Available online: https://www.cdc.gov/flu/about/burden/past-seasons.html (accessed on 4 April 2024).
- Nasrullah, A.; Gangu, K.; Garg, I.; Javed, A.; Shuja, H.; Chourasia, P.; Shekhar, R.; Sheikh, A.B. Trends in Hospitalization and Mortality for Influenza and Other Respiratory Viruses during the COVID-19 Pandemic in the United States. Vaccines 2023, 11, 412. [Google Scholar] [CrossRef] [PubMed]
- Xie, Y.; Bowe, B.; Maddukuri, G.; Al-Aly, Z. Comparative evaluation of clinical manifestations and risk of death in patients admitted to hospital with COVID-19 and seasonal influenza: Cohort study. BMJ 2020, 371, m4677. [Google Scholar] [CrossRef] [PubMed]
- Uyeki, T.M.; Wentworth, D.E.; Jernigan, D.B. Influenza Activity in the US During the 2020–2021 Season. JAMA 2021, 325, 2247–2248. [Google Scholar] [CrossRef]
- Pelton, S.I.; Mould-Quevedo, J.F.; Nguyen, V.H. The Impact of Adjuvanted Influenza Vaccine on Disease Severity in the US: A Stochastic Model. Vaccines 2023, 11, 1525. [Google Scholar] [CrossRef]
- McGovern, I.; Bogdanov, A.; Cappell, K.; Whipple, S.; Haag, M. Influenza Vaccine Uptake in the United States before and during the COVID-19 Pandemic. Vaccines 2022, 10, 1610. [Google Scholar] [CrossRef]
- Peacock, G.; Ryerson, A.B.; Koppaka, R.; Tschida, J. The importance of seasonal influenza vaccination for people with disabilities during the COVID-19 pandemic. Disabil. Health J. 2021, 14, 101058. [Google Scholar] [CrossRef] [PubMed]
- Virk, S.; Quazi, M.A.; Nasrullah, A.; Shah, A.; Kudron, E.; Chourasia, P.; Javed, A.; Jain, P.; Gangu, K.; Cheema, T.; et al. Comparing Clinical Outcomes of COVID-19 and Influenza-Induced Acute Respiratory Distress Syndrome: A Propensity-Matched Analysis. Viruses 2023, 15, 922. [Google Scholar] [CrossRef] [PubMed]
- Kronibus, N.; Seiler, F.; Danziger, G.; Muellenbach, R.M.; Reyher, C.; Becker, A.P.; Kamphorst, M.; Rixecker, T.M.; Metz, C.; Bals, R.; et al. Respiratory Physiology of COVID-19 and Influenza Associated Acute Respiratory Distress Syndrome. J. Clin. Med. 2022, 11, 6237. [Google Scholar] [CrossRef] [PubMed]
- Marois, C.; Nedelec, T.; Pelle, J.; Rozes, A.; Durrleman, S.; Dufouil, C.; Demoule, A. Comparison of Clinical Profiles and Mortality Outcomes Between Influenza and COVID-19 Patients Invasively Ventilated in the ICU: A Retrospective Study From All Paris Public Hospitals From 2016 to 2021. Crit. Care Explor. 2022, 4, e0737. [Google Scholar] [CrossRef] [PubMed]
- Jeganathan, N.; Grewal, S.; Sathananthan, M. Comparison of Deaths from COVID-19 and Seasonal Influenza in the USA. Lung 2021, 199, 559–561. [Google Scholar] [CrossRef]
Disclaimer/Publisher’s Note: The statements, opinions, and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions, or products referred to in the content. |
Characteristics | CP and COVID-19+ | CP and Influenza+ | p-Value | ||
---|---|---|---|---|---|
N | % | N | % | ||
N = 12,025 | 10,560 | 87.82 | 1465 | 12.18 | |
Gender (%) | N | % | N | % | 0.111 |
Female | 4375 | 41.43 | 575 | 39.25 | |
Male | 6185 | 58.57 | 890 | 60.75 | |
Mean Age Years (SD) | Mean | SD | Mean | SD | |
Female | 51.61 | 17.62 | 46.77 | 18.75 | |
Male | 51.16 | 16.75 | 42.88 | 16.97 | |
AGE Groups (%) | N | % | N | % | <0.001 |
18–29 | 1505 | 14.25 | 395 | 26.96 | |
30–49 | 2985 | 28.27 | 455 | 31.06 | |
50–69 | 4495 | 42.57 | 470 | 32.08 | |
≥70 | 1575 | 14.91 | 145 | 9.9 | |
RACE (%) | N | % | N | % | <0.001 |
Asian or Pacific Islander | 160 | 1.52 | 30 | 2.05 | |
Black | 1815 | 17.19 | 215 | 14.68 | |
Hispanic | 1025 | 9.71 | 205 | 13.99 | |
Native American | 85 | 0.8 | * | * | |
Other | 350 | 3.31 | 55 | 3.75 | |
White | 7125 | 67.47 | 960 | 65.53 | |
MEDIAN HOUSEHOLD INCOME (%) | N | % | N | % | 0.494 |
≤51,999 | 3245 | 30.73 | 435 | 29.69 | |
52,000–65,999 | 2890 | 27.37 | 420 | 28.67 | |
66,000–87,999 | 2495 | 23.63 | 330 | 22.53 | |
≥88,000 | 1930 | 18.28 | 280 | 19.11 | |
INSURANCE STATUS (%) | N | % | N | % | <0.001 |
Medicaid | 2600 | 24.62 | 490 | 33.45 | |
Medicare | 6920 | 65.53 | 830 | 56.66 | |
Other | 135 | 1.28 | * | * | |
Private Insurance | 825 | 7.81 | 125 | 8.53 | |
Self-pay | 80 | 0.76 | * | * | |
HOSPITAL DIVISION (%) | N | % | N | % | <0.001 |
East North Central | 2030 | 19.22 | 265 | 18.09 | |
East South Central | 590 | 5.59 | 35 | 2.39 | |
Middle Atlantic | 1880 | 17.8 | 235 | 16.04 | |
Mountain | 520 | 4.92 | 115 | 7.85 | |
New England | 550 | 5.21 | 95 | 6.48 | |
Pacific | 1185 | 11.22 | 195 | 13.31 | |
South Atlantic | 1990 | 18.84 | 215 | 14.68 | |
West North Central | 775 | 7.34 | 135 | 9.22 | |
West South Central | 1040 | 9.85 | 175 | 11.95 | |
HOSPITAL BED SIZE (%) | N | % | N | % | 0.007 |
Large | 4810 | 45.55 | 690 | 47.1 | |
Medium | 3125 | 29.59 | 465 | 31.74 | |
Small | 2625 | 24.86 | 310 | 21.16 | |
HOSPITAL TEACHING STATUS (%) | N | % | N | % | 0.306 |
Rural | 1110 | 10.51 | 145 | 9.9 | |
Urban nonteaching | 1785 | 16.9 | 270 | 18.43 | |
COMORBIDITIES (%) | N | % | N | % | p-value |
HTN | 4430 | 41.95 | 460 | 31.4 | 0.046 |
Diabetes | 2050 | 19.41 | 160 | 10.92 | <0.001 |
Cancer | 185 | 1.75 | 30 | 2.05 | 0.423 |
Obesity | 1645 | 15.58 | 120 | 8.19 | <0.001 |
Drug Misuse | 80 | 0.76 | * | * | 0.755 |
Smoking | 800 | 7.58 | 100 | 6.83 | 0.306 |
Alcohol | 70 | 0.66 | N/A | N/A | 0.93 |
Chronic Pulmonary Disease | 1930 | 18.28 | 380 | 25.94 | <0.001 |
Hypothyroidism | 1675 | 15.86 | 245 | 16.72 | 0.398 |
Autoimmune | 160 | 1.52 | * | * | 0.141 |
Depression | 1355 | 12.83 | 100 | 6.83 | <0.001 |
AIDS | 30 | 0.28 | * | * | 0.703 |
Dementia | 505 | 4.78 | * | * | <0.001 |
Complications | COVID-19 N (%) | Influenza N (%) | Odds Ratio for COVID-19+ | 95% CI Lower Limit | 95% CI Upper Limit | p-Value |
---|---|---|---|---|---|---|
Sudden Cardiac Arrest | 215 (2.04) | ** | 2.00 | 0.61 | 6.57 | 0.256 |
Vasopressor Use | 310 (2.94) | 35 (2.39) | 1.16 | 0.52 | 2.59 | 0.712 |
Acute Kidney Injury (AKI) | 1995 (18.89) | 190 (12.97) | 1.32 | 0.91 | 1.91 | 0.139 |
Invasive Mechanical Ventilation | 1410 (13.35) | 170 (11.6) | 1.25 | 0.84 | 1.85 | 0.267 |
Non-Invasive Mechanical Ventilation | 610 (5.78) | 105 (7.17) | 0.78 | 0.48 | 1.28 | 0.322 |
Hemodialysis | 145 (1.37) | 20 (1.37) | 0.66 | 0.22 | 1.98 | 0.455 |
Venous Thromboembolism (VTE) | 425 (4.02) | 35 (2.39) | 1.71 | 0.78 | 3.74 | 0.179 |
Tracheostomy | 110 (1.04) | 30 (2.05) | 0.60 | 0.24 | 1.51 | 0.276 |
Seizures | 4620 (43.75) | 815 (55.63) | 0.80 | 0.62 | 1.04 | 0.095 |
Cardiac Dysrhythmia | 850 (8.05) | 95 (6.48) | 0.92 | 0.55 | 1.54 | 0.749 |
Acute Respiratory Distress Syndrome (ARDS) | 535 (5.07) | 35 (2.39) | 1.96 | 0.89 | 4.29 | 0.094 |
Mean Inflation-Adjusted Cost ($) * | $23,447.62 * | $19,337.74 * | - | - | - | 0.004 |
Mean Length of Stay (Days) ^ | 9.46 ^ | 7.19 ^ | - | - | - | <0.001 |
In Hospital Mortality (N = 1185) | 1140 (10.8) | 45 (3.07) | 3.21 | 1.62 | 6.36 | 0.001 |
Disposition | <0.001 | |||||
Against Medical Advice | 45 (0.43) | ** | - | - | - | |
Home Health Care | 1580 (14.96) | 240 (16.38) | - | - | - | |
Routine | 4185 (39.63) | 830 (56.66) | - | - | - | |
Transfer Other | 3395 (32.15) | 310 (21.16) | - | - | - | - |
Transfer to a Short-Term Hospital | 210 (1.99) | 30 (2.05) | - | - | - | - |
Complications | COVID-19 N (%) | Influenza N (%) | Odds Ratio for COVID-19+ | 95% CI Lower Limit | 95% CI Upper Limit | p-Value |
---|---|---|---|---|---|---|
Sudden Cardiac Arrest | 20 (1.37) | ** | 1.23 | 0.26 | 5.82 | 0.798 |
Vasopressor use | 35 (2.39) | 35 (2.39) | 1.01 | 0.35 | 2.94 | 0.985 |
Acute Kidney Injury (AKI) | 190 (12.97) | 190 (12.97) | 1.01 | 0.62 | 1.65 | 0.968 |
Invasive Mechanical Ventilation | 225 (15.36) | 170 (11.6) | 1.36 | 0.84 | 2.22 | 0.210 |
Non-Invasive Mechanical Ventilation | 55 (3.75) | 105 (7.17) | 0.46 | 0.21 | 0.99 | 0.048 |
Hemodialysis | ** | 20 (1.37) | 0.57 | 0.10 | 3.15 | 0.517 |
Venous Thromboembolism (VTE) | 45 (3.07) | 35 (2.39) | 1.46 | 0.52 | 4.14 | 0.471 |
Tracheostomy | ** | 30 (2.05) | 0.54 | 0.13 | 2.20 | 0.389 |
Seizures | 730 (49.8) | 815 (55.63) | 0.71 | 0.50 | 1.01 | 0.057 |
Cardiac Dysrhythmia | 40 (2.73) | 95 (6.48) | 0.35 | 0.15 | 0.85 | 0.020 |
Acute Respiratory Distress Syndrome (ARDS) | 70 (4.78) | 35 (2.39) | 2.05 | 0.81 | 5.18 | 0.130 |
Mean Inflation-Adjusted Cost ($) * | $24,058.25 * | $19,337.74 * | - | - | - | 0.004 |
Mean Length of Stay (Days) * | 9.95 * | 7.19 * | - | - | - | <0.001 |
In Hospital Mortality (N = 1185) | 125 (8.5) | 45 (3.07) | 2.97 | 1.35 | 6.56 | 0.007 |
Disposition | <0.001 | |||||
Against Medical Advice | ** | ** | - | - | - | |
Home Health Care | 230 (15.7) | 240 (16.38) | - | - | - | |
Routine | 700 (47.78) | 830 (56.66) | - | - | - | |
Transfer Other | 355 (24.23) | 310 (21.16) | - | - | - | - |
Transfer to a Short-Term Hospital | 50 (3.41) | 30 (2.05) | - | - | - | - |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Quazi, M.A.; Shakir, M.H.; Faiz, Z.; Quraishi, I.; Nasrullah, A.; Ikram, H.A.; Sohail, A.H.; Sultan, S.; Sheikh, A.B. Outcomes of COVID-19 and Influenza in Cerebral Palsy Patients Hospitalized in the United States: Comparative Study of a Nationwide Database. Viruses 2024, 16, 1284. https://doi.org/10.3390/v16081284
Quazi MA, Shakir MH, Faiz Z, Quraishi I, Nasrullah A, Ikram HA, Sohail AH, Sultan S, Sheikh AB. Outcomes of COVID-19 and Influenza in Cerebral Palsy Patients Hospitalized in the United States: Comparative Study of a Nationwide Database. Viruses. 2024; 16(8):1284. https://doi.org/10.3390/v16081284
Chicago/Turabian StyleQuazi, Mohammed A., Muhammad Hassan Shakir, Zohaa Faiz, Ibrahim Quraishi, Adeel Nasrullah, Hafiz Abdullah Ikram, Amir H Sohail, Sulaiman Sultan, and Abu Baker Sheikh. 2024. "Outcomes of COVID-19 and Influenza in Cerebral Palsy Patients Hospitalized in the United States: Comparative Study of a Nationwide Database" Viruses 16, no. 8: 1284. https://doi.org/10.3390/v16081284