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The CDC has raised concerns about increased isolation, fear, and anxiety during the pandemic. This brief examines how COVID-19 changed care delivery patterns for patients with anxiety or depression, in both established and newly diagnosed patients. Additionally, our analysis shows the initial steep drop-off in total visits has returned to pre-pandemic levels, with telehealth compensating for the reduction in office visits…

Earlier this year, we published data demonstrating a 300-fold increase in telehealth, broken down by encounter reason and specialty. Many speculated that telehealth volumes would remain high throughout (and perhaps beyond) the pandemic; however, recent EHR data show that volumes peaked in mid-April. Since then, levels have dropped to make up only 21% of total visits, though this is still much higher than the rates seen before the pandemic…

Public policy decisions in the United States have relied on epidemiologic models that predict the course of the COVID-19 pandemic. We compared the assumptions in the IHME model to a sample of admissions across 21 states, and found the median estimates differ from the assumptions…

Our analysis found a dramatic–but temporary–decrease in procedures for cardiac arrhythmia and coronary artery disease, as well as procedures for all of the major organ cancers we examined. At their lowest point, these procedure volumes were 49-88% below their historical weekly averages…

Patients with severely elevated liver enzymes during admission for COVID-19 showed 2.5 times higher mortality rates when compared to patients with normal or moderately elevated levels…

Early in the COVID-19 pandemic, experts expressed concerns that hypertensive patients taking RAAS inhibitors to control blood pressure might be at a higher risk of increased COVID-19 disease severity and mortality. However, analysis of EHR data suggests…

The number of cancer screenings has recently begun to rise, but has not yet reached previously expected levels: June 16 weekly volumes remained 29%, 36%, and 35% lower than their pre-COVID-19 levels for breast, colon, and cervical cancer screenings. The gap between the expected screenings and the actual screenings created a sizable deficit of “missed” screenings…

Using data from nearly 50,000 hospitalized COVID-19 positive patients across the United States, statistically significant geographic variations in supportive oxygen treatment were demonstrated and not explained by differences in age, sex, or severity…

Life was so normal a few weeks ago. For me, and I imagine for many other health care workers, before the novel coronavirus etched its deadly path across the U.S., day broke to a remarkably similar routine. The alarm would go off at six-thirty; I would walk my dear-but-crazy mutt, Scrappy; swim a mile; grab a coffee; and then head into a clinic of waiting teenagers. I would greet my coworkers with hugs. And I would spend the day seeing the patients I love.

COVID-19 is primarily a respiratory infection; however, there are multiple examples of multi-organ and systemic dysfunction associated with this infection. In addition to lung damage, it appears that the virus affects the lining of blood vessels, potentially leading to clotting, embolization, and organ damage…

The number of patients receiving first-time prescriptions for Medications for Opioid Use Disorder (MOUD) decreased by over 30% in the spring of 2020 when compared to trends observed in EHR data from January 2017 to May 2020. This finding suggests that patients at risk for opioid use disorder (OUD) and overdose are increasingly vulnerable during the COVID-19 pandemic. This risk is further demonstrated by reports from the American Medical Association of increases in opioid-related mortality reported in more than 30 states1 over this time period. Since January 2017, the number of patients receiving buprenorphine, methadone, or naltrexone for the first time […]

This brief was updated on June 26, 2020, with data as of June 18, 2020. Overall findings remain consistent, but the percentage of patients with an unknown outcome has decreased from 34% to 6%. Here we examine the mortality of patients who received invasive mechanical ventilation as treatment for acute respiratory failure due to COVID-19…

Evidence from one large health system—NYU Langone Health—at an epicenter of the coronavirus disease 2019 outbreak in the United States shows possibility of sharp and rapid transition to telemedicine in a matter of days.

For numerous reasons, some patients are tested for SARS-CoV-2 virus multiple times, and a small percentage of patients test positive more than once. We were interested in better understanding how often patients undergo multiple tests, and what the time frame is between the first and last positive results. We speculate that fewer days between repeat positive results likely represents a true positive for live virus. A longer day separation seems to better support the concept of PCR tests detecting non-active viral RNA, as suggested in a recent article from the Korea Centers for Disease Control and Prevention (KCDC).1 Our sample included […]

Recent data show that, while overall visit volumes have decreased dramatically since the beginning of the COVID-19 pandemic in the United States, telehealth visits overall have increased 300-fold.1 This brief describes the diagnoses and specialties that saw the largest visit volumes of telehealth, with the goal of informing future strategy around telehealth…

Story contributed by OCHIN. Recent EHR data show that while the rate of COVID-19 infection appears to be slowing in some parts of the country, the number of patients testing positive for the virus continues to grow. Across the OCHIN network of providers, which treats a total of 5 million complex and underserved patients nationally, 87 OCHIN Epic organizations are actively testing patients for COVID-19.

Using data from 190,194 COVID-19 patients, the following conditions were found to be most strongly associated with a higher risk of hospitalization and death: Heart failure, diabetes, a weakened immune system, COPD, and a BMI of 40 or higher…

Recent EHR data show that immunization administrations for pediatric patients have decreased by 42% in the spring of 2020 compared to prior years. It is estimated that 260,000 immunizations expected for March 8-May 9 were missed or delayed across all age groups at sampled organizations. Patients under 6 months of age showed the smallest reduction in immunization volume, but these patients still missed or delayed an estimated 29,000 immunizations this spring.  This trend has also been observed for immunizations that provide protection against very contagious and sometimes deadly diseases, such as measles. Only 44% of the nearly 2,600 MMR immunizations that […]

Severe obesity, defined as having a body mass index (BMI) of 40 kg/m2 or higher, has been identified by the CDC as a risk factor for more severe COVID-19 illness. This brief examines the relationship between obesity and severity of illness for adult COVID-19 positive patients. In this sample of 119,582 COVID-19 positive patients, 79% have a BMI documented in their electronic medical record…

There has been recent conversation about the role that smoking status may play in severity of COVID-19 disease. To investigate this role, we examined the relationship between smoking status, as documented in the electronic health record, and general outcome severity of COVID-19 in a large national cohort of adult COVID-19 positive patients…