News Scan for May 13, 2021

Most long-haul COVID-19 patients younger, healthier, Mayo Clinic says

The inaugural cohort of Mayo Clinic’s COVID-19 Activity Rehabilitation Program (CARP) for post–COVID-19 syndrome (PCS) were mostly women, younger, had few pre-existing comorbidities, and experienced milder forms of COVID-19, but only a third were able to return to full-time work.

The descriptive study, published in Mayo Clinic Proceedings, involved 100 CARP participants from June to December 2020 and found the most common ailments to be fatigue (80%), neurologic complaints like headaches (59%), and respiratory complaints like breathlessness (59%). Other symptoms included cognitive impairment, sleep disturbance, and mental health symptoms. A little over a third of patients (34%) said they had difficulties performing basic daily activities, and only one in three who had been employed had fully returned to unrestricted work by the time they were evaluated.

Contrary to other studies, Mayo Clinic researchers found that the cohort consisted of younger (mean age, 45.4 years) and previously healthier patients, whose main pre-existing comorbidities were respiratory issues like asthma (23%), a history of depression or anxiety (34%), or high blood pressure (19%). More than two-thirds (68%) were women. Three in four did not have to be hospitalized during their initial COVID-19 symptoms. The average time between COVID-19 diagnosis or symptom onset and CARP enrollment was 93.4 days.

Also in contrast with previous findings, most diagnostic test results (eg, heart and lung function) returned to normal, and no life-threatening conditions were found. “These findings underscore that diagnostic testing should be performed judiciously, and that clinically significant symptoms may not be explained solely by diagnostic results,” the researchers write.

They add, “Patients reported that their cognitive and mood symptoms were often minimized or dismissed by healthcare providers, which is concerning since many PCS symptoms are similar to prolonged sequela following traumatic brain injury for which prolonged or permanent inability to return to work has been recorded.” The study notes that 26% of patients experienced increased anxiety and depression.

“As the pandemic continues, we expect to see more patients who experience symptoms long after infection, and health care providers need to prepare for this, know what to look for, and know how to best provide for their patients’ needs,” says first author Greg Vanichkachorn, MD, MPH, in a Mayo Clinic news release.
May 11 Mayo Clinic Proc study
May 12 Mayo Clinic news release

 

Manufacturing, retail among LA County sectors hit hardest by COVID-19

Nearly 60% of non-healthcare COVID-19 worksite outbreaks in Los Angeles County occurred in manufacturing (26.4%), retail (19.6%), and transportation and warehousing (10.5%), according to an Emerging Infectious Disease study yesterday. Data also showed that Hispanic people were disproportionately affected.

The 698 non-healthcare worksite outbreaks identified through September 2020 involved 7,625 COVID-19 patients. Median cases per outbreak was 6 (range, 3 to 277), and median duration was 13 days (range, 0 to 189). At the time of analysis, 14% of outbreaks (96) were still under investigation.

Overall, the three sectors with the most outbreaks (manufacturing, retail, and transportation and warehousing) also had the highest case counts, accounting for 43.5%, 11.4%, and 12.9% of patients, respectively.

The incidence rate in the manufacturing sector was more than five times greater than the overall incidence rate (980.8 vs 171.8 infections per 100,000 people) and more than twice as high as the second-ranked sector (transportation and warehousing, 425.1). The researchers say that manufacturing may present specific COVID-related challenges, such as many people in close contact, long shifts, shared equipment, common spaces, carpooling tendencies, and poor worksite ventilation and sanitation.

The investigation showed that 70.4% of COVID-19 patients were of Hispanic ethnicity, compared with the 40% of Hispanic people employed across the assessed sectors. Patients were also more likely to be male (60.2%), and 29.3% were 50 years or older.

“Regardless of whether workplace exposure has driven community transmission or vice versa, a controlled worksite environment provides an opportunity to mitigate transmission within highly affected communities,” the researchers write. “Public health departments must continue to target essential workers in the affected industries in vaccination efforts to address gaps in vaccine access and barriers to uptake.”
May 12 Emerg Infect Dis study

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