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Type 1 diabetes is an autoimmune disease that can be triggered by viral infections. Recent studies have hypothesized that the COVID-19 pandemic might cause a global surge in diabetes diagnoses beyond what we typically see for patients with respiratory infections.

While a survey and a study have reported an increase in patient weight during the COVID-19 pandemic, it is not widely known whether this trend was seen across the population. We evaluated weight change for adults during the pandemic compared to weight change for adults in the year prior to the pandemic. A weight loss or gain of 2.5 pounds, which we define as a normal fluctuation or “no change,” was most common, both pre-pandemic and during the pandemic. Nearly as many patients lost weight (35%) as gained weight (39%) during the pandemic.

Several studies have found that a small percentage of fully vaccinated patients develop SARS-CoV-2 infections. In our study, we found that of patients who received the COVID-19 vaccine, fewer than 0.049% had a breakthrough positive PCR-based SARS-CoV-2 test and fewer than 0.018% had a breakthrough admission with a COVID-19 diagnosis more than 14 days after completing the vaccine series.

To investigate potential impacts of the COVID-19 pandemic on nine common communicable infections, we compared the number of confirmed cases from March 2020 to February 2021 to the same period of the past three years, starting with March 2017. We found that all nine diseases declined during the pandemic, and the general pattern of reduced communicable infections during the COVID-19 pandemic appears to be shared across multiple communicable infections.

In our recent study, we found that 3,945 patients had new heart failure documented within 3 months after their COVID-19 admission. To determine whether this heart failure was new or pre-existing, we examined new documentation of heart failure for patients admitted with hip fracture or stroke to compare with our finding for COVID-19. We selected hip fracture as a comparison because there is no expected clinical, causal relationship between hip fracture and heart failure, and we selected stroke because it shares a similar risk profile as severe COVID-19.

The U.S. Preventive Services Task Force (USPSTF) recommends that patients eligible for lung cancer screening receive a low-dose CT scan to screen for lung cancer each year. Our study includes 381,849 patients eligible for lung cancer screening per USPSTF guidelines who have insurance coverage for a CT lung cancer screening through Medicaid or Medicare. We found 87.1% of eligible patients were not screened, despite having insurance coverage. We did not see large variability between Medicaid and Medicare screening rates as shown in Figure 1.

In May 2020, we reported a significant drop in the weekly rate of routine cancer screenings. At that time, there was a 94% decrease in breast cancer screenings, an 86% decrease in colon cancer screenings, and a 94% decrease in cervical cancer screenings. In July 2020, our follow-up study showed weekly screening rates for these three cancers were on the rise but had not yet reached pre-pandemic levels, remaining 29%-36% lower than their pre-COVID-19 levels.

Recent studies indicate that the incidence of pediatric type 1 diabetes is increasing. However, there is little data on whether the severity of illness at initial diagnosis is increasing. One way to define severity at diagnosis is to review incidence of DKA (Diabetic Ketoacidosis). Patients diagnosed with DKA often present with very high blood sugars and require hospitalization.

Respiratory Syncytial Virus (RSV) is a common cause of acute cough in kids and is the most common cause of pneumonia in infants. Similar to influenza, RSV can cause mild respiratory symptoms or can become severe and require hospitalization. We saw that influenza infections drastically dropped during October through March of the 2020-2021 respiratory season3 and wondered whether RSV infections did as well.

During the COVID-19 pandemic, mental health diagnoses made up a greater proportion of pediatric visits than before the pandemic. As shown in Figure 1, outpatient mental health visits for adolescent females increased by 11.3% over predicted volumes during the COVID-19 pandemic. Mental health visits for adolescent males decreased by 0.4% from predicted volumes during the same time period.

The COVID-19 pandemic has dramatically impacted utilization of healthcare services in the U.S. Previous studies of the early months of the pandemic reported substantial reductions in hospital inpatient admissions and outpatient visits, including ED visits, compared to pre-COVID levels. More recent studies, using updated data, have reported that trends began to normalize, with hospital utilization seen approaching pre-COVID levels.

Previous studies have shown that pregnant women with COVID-19 are at greater risk of having a premature birth than those without COVID-19. We previously studied neonatal outcomes related to COVID-19. Now that more time has passed and more COVID-19 positive women have given birth, we re-examined neonatal outcomes of babies who were born during the pandemic.

Studies have noted how social isolation during the COVID-19 pandemic has negatively impacted the mental health of children. We reviewed data from January 1, 2017, to February 28, 2021, to see if the number of pediatric mental health visits has increased during the pandemic.

We reviewed 13,321,570 vaccine administrations across 8,081,360 patients to see whether different vaccination types were associated with four criteria typically associated with Thrombosis with Thrombocytopenia Syndrome (TTS).

The number of opioids patients receive after surgical procedures has a significant impact on their risk of developing chronic opioid use. Several expert panels have issued recommendations for safe opioid prescribing for the maximum number of opioid tablets that should be prescribed following common outpatient procedures.

To investigate potential impacts of the COVID-19 pandemic on influenza, we compared the number of confirmed influenza cases from October 2020 to January 2021 to the same period of the past four years, starting with the 2016-2017 season.

Hospitals have expressed concern that they are seeing an increase in hospitalization of adolescents with eating disorders during the pandemic. To evaluate these concerns, we analyzed the rates of hospital admissions that included an eating disorder diagnosis and found that those increased by 25% overall for patients ages 12-18 as compared to predictions based on pre-pandemic trends. When looking at males versus females, females had a 30% increase in hospital admissions (1,326 admissions were predicted and 1,718 occurred). Admissions for males did not increase (199 admissions were predicted and 192 occurred).

While several cases of reinfection with SARS-CoV-2 have been reported, it remains unclear how frequently these events occur. The CDC suggests that a positive test within 90 days of initial onset of illness is more likely to represent continued viral shedding than a reinfection. Based on this, we used the time between positive COVID tests as an indication for which patients were possibly reinfected. We determined that 0.4% of patients who previously had COVID were possibly reinfected.

Recent studies have suggested COVID-19 may result in new cardiovascular disease. To better understand this, we examined patterns of heart failure diagnoses for patients admitted with COVID-19.

The CDC reports rates of anxiety, depression, and suicidal ideation seem to be rising during the pandemic. We wondered whether mental health visits were also on the rise. We studied whether outpatient visits for depression or anxiety and ED visits for suicidal ideation, suicide attempt, or self-harm were increasing.