Publications
Department of Medicine faculty members published more than 3,600 peer-reviewed articles in 2024.
2022
2022
2022
2022
BACKGROUND
The implications of coronavirus disease 2019 (COVID-19) infection on outcomes after invasive therapeutic strategies among patients presenting with acute myocardial infarction (AMI) are not well studied.
HYPOTHESIS
To assess the outcomes of COVID-19 patients presenting with AMI undergoing an early invasive treatment strategy.
METHODS
This study was a cross-sectional, retrospective analysis of the National COVID Cohort Collaborative database including all patients presenting with a recorded diagnosis of AMI (ST-elevation myocardial infarction (MI) and non-ST elevation MI). COVID-19 positive patients with AMI were stratified into one of four groups: (1a) patients who had a coronary angiogram with percutaneous coronary intervention (PCI) within 3 days of their AMI; (1b) PCI within 3 days of AMI with coronary artery bypass graft (CABG) within 30 days; (2a) coronary angiogram without PCI and without CABG within 30 days; and (2b) coronary angiogram with CABG within 30 days. The main outcomes were respiratory failure, cardiogenic shock, prolonged length of stay, rehospitalization, and death.
RESULTS
There were 10 506 COVID-19 positive patients with a diagnosis of AMI. COVID-19 positive patients with PCI had 8.2 times higher odds of respiratory failure than COVID-19 negative patients (p = .001). The odds of prolonged length of stay were 1.7 times higher in COVID-19 patients who underwent PCI (p = .024) and 1.9 times higher in patients who underwent coronary angiogram followed by CABG (p = .001).
CONCLUSION
These data demonstrate that COVID-19 positive patients with AMI undergoing early invasive coronary angiography had worse outcomes than COVID-19 negative patients.
View on PubMed2022
2022
2022
BACKGROUND
The COVID-19 pandemic has negatively impacted parental and child mental health; however, it is critical to examine this impact in the context of parental histories of adversity. We hypothesized that maternal adverse childhood experiences (ACEs) and pandemic-related negative life events would predict child traumatic stress symptoms (TSS) and tested potential mediating pathways through maternal pandemic-related TSS and/or poorer maternal sensitivity during the pandemic.
METHODS
Data were collected from a longitudinal sample of low-income, racially/ethnically diverse mothers and their children. Between May and November 2020, mothers (n = 111) of young children (M age = 7.42 years, SD = 0.45) completed questionnaires to assess their own and their child's pandemic-related TSS, exposure to pandemic-related negative events, and parent-child relationship quality. Maternal ACEs, maternal depression, parent-child relationship quality, and child internalizing symptoms had been assessed approximately 1-3 years prior.
RESULTS
Structural equation analyses revealed that pandemic negative life events were indirectly associated with child TSS via greater maternal TSS. For mothers, recent pandemic-related negative events were associated with their own TSS, whereas maternal ACEs were not. Maternal ACEs directly predicted greater child TSS, with no evidence of mediation by either maternal TSS or maternal sensitivity.
LIMITATIONS
All measures were parent report, and pandemic-related measures were collected at the same time point.
CONCLUSIONS
Findings underscore the long reach of mothers' own adverse childhood experiences, highlighting the negative consequences of these prior traumatic exposures alongside current pandemic-related maternal trauma symptoms for children's adjustment during the pandemic.
View on PubMed