COVID-19 in the New York City Jail System: Epidemiology and Health Care Response, March-April 2020
COVID-19 in the New York City Jail System: Epidemiology and Health Care Response, March-April 2020
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DOI：
10.1177/0033354921999385
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发表时间：
2021-03-05
影响因子：
3.3
通讯作者：
MacDonald, Ross
中科院分区：
文献类型：
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作者：
Chan, Justin;Burke, Kelsey;MacDonald, Ross
目的被拘留在惩教机构的人感染严重急性呼吸系统综合征冠状病毒2的风险很高，这种病毒导致2019冠状病毒病（COVID-19）。我们描述了一个大型城市监狱系统中COVID-19爆发的流行病学，包括检测时的体征和症状以及住院治疗的风险因素。MethodsThis回顾性观察性队列研究包括2020年3月11日至4月28日期间在纽约市监狱系统中被拘留期间接受COVID-19检测的所有年龄≥ 18岁的患者（N = 978）。我们描述了检测时的人口统计学特征和体征和症状，并进行了考克斯回归分析，以确定与检测结果阳性者住院相关的因素。结果在978名接受COVID-19检测的人中，有568人获得了阳性检测结果。在有症状的患者中，接受阳性检测结果的患者中最常见的症状是咳嗽（n = 293/510，57%）和客观发热（n = 288/510，56%）。在接受检测的257名无症状患者中，58名（23%）获得阳性检测结果。45名（8%）检测结果呈阳性的人因COVID-19住院。年龄较大（年龄>= 55岁vs 18-34岁）（校正风险比[aHR] = 13.41; 95% CI，3.80-47.33）和糖尿病（aHR = 1.99; 95%CI，1.00-3.95）与住院治疗显著相关。结论在纽约市监狱接受COVID-19检测的人中，包括很大一部分在无症状时接受检测的人。在持续传播期间，无症状筛查应补充惩教设施中由艾滋病驱动的COVID-19检测。老年患者和糖尿病患者在确诊COVID-19后应密切监测，因为他们住院的风险增加。
ObjectivesPeople detained in correctional facilities are at high risk for infection with severe acute respiratory syndrome coronavirus 2, the virus that causes coronavirus disease 2019 (COVID-19). We described the epidemiology of the COVID-19 outbreak in a large urban jail system, including signs and symptoms at time of testing and risk factors for hospitalization.MethodsThis retrospective observational cohort study included all patients aged >= 18 years who were tested for COVID-19 during March 11-April 28, 2020, while in custody in the New York City jail system (N = 978). We described demographic characteristics and signs and symptoms at the time of testing and performed Cox regression analysis to identify factors associated with hospitalization among those with a positive test result.ResultsOf 978 people tested for COVID-19, 568 received a positive test result. Among symptomatic patients, the most common symptoms among those who received a positive test result were cough (n = 293 of 510, 57%) and objective fever (n = 288 of 510, 56%). Of 257 asymptomatic patients who were tested, 58 (23%) received a positive test result. Forty-five (8%) people who received a positive test result were hospitalized for COVID-19. Older age (aged >= 55 vs 18-34) (adjusted hazard ratio [aHR] = 13.41; 95% CI, 3.80-47.33) and diabetes mellitus (aHR = 1.99; 95% CI, 1.00-3.95) were significantly associated with hospitalization.ConclusionsA substantial proportion of people tested in New York City jails received a positive test result for COVID-19, including a large proportion of people tested while asymptomatic. During periods of ongoing transmission, asymptomatic screening should complement symptom-driven COVID-19 testing in correctional facilities. Older patients and people with diabetes mellitus should be closely monitored after COVID-19 diagnosis because of their increased risk for hospitalization.