EHRN is a journal for the 21st century, designed for rapid sharing of knowledge to help solve medical problems. We make this information available with internal peer review, but without third-party peer review, to expedite sharing. It’s important that good data be available sooner, rather than perfect data be available too late. Submissions are welcome.
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.
As the COVID-19 pandemic continues, there are growing concerns that patients with urgent conditions are not seeking the care they need for fear of exposure to COVID-19. Recent EHR data show that the weekly incidence of acute myocardial infarctions (AMI), commonly known as heart attacks, has decreased by 45% since the United States declared a national emergency for COVID-19 on March 13, 2020. Similarly, the weekly incidence of strokes decreased by 38% relative to the average number of strokes prior to March 13, 2020.
As coronavirus cases mount, racial minorities appear to be disproportionately affected by the pandemic. Across a sample population of 23 million patients across 16 states, 12% were black and 65% were white, but among the 108,000 of those patients who are documented COVID-19 positive, 22% were black and 46% were white.
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.1 This brief examines the relationship between obesity and severity of illness for adult COVID-19 positive patients.
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.
Physicians at Mount Sinai are exploring new avenues of clinical investigation, based on the beneficial response of patients to tPA in a small, preliminary case series. Use of tPA, short for tissue plasminogen activator, is common in emergencies such as ischemic stroke, pulmonary embolism, and other dangerous situations where its clot-busting clinical benefits outweigh the risks.
COVID-19 hospitalization and mortality information were assessed in a sample of 36 million active patients.1 Nearly 10 million of those patients have documented hypertension, diabetes, chronic obstructive pulmonary disease (COPD), or moderate/severe asthma as of April 30, 2020. The summarized data were contributed by 31 health systems (300 hospitals) across 18 states. Table 1 shows the prevalence of these conditions in the sample data set as compared to national baselines for adults.