Publications by authors named "Baughman A"

Background: (pneumococcus) causes invasive pneumococcal disease (IPD) and non-invasive acute respiratory infections (ARIs). Three pneumococcal conjugate vaccines (PCVs) are recommended in the United States with additional products in clinical trials. We aimed to estimate 1) proportions of IPD cases and pneumococcal ARIs caused by serotypes targeted by existing and pipeline PCVs and 2) annual U.

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Background: clinical guidelines recommend initiation of antiviral therapy as soon as possible for patients hospitalized with confirmed or suspected influenza.

Methods: A multicenter US observational sentinel surveillance network prospectively enrolled adults (aged ≥18 years) hospitalized with laboratory-confirmed influenza at 24 hospitals during October 1, 2022-July 21, 2023. A multivariable proportional odds model was used to compare peak pulmonary disease severity (no oxygen support, standard supplemental oxygen, high-flow oxygen/non-invasive ventilation, invasive mechanical ventilation, or death) after the day of hospital admission among patients starting oseltamivir treatment on the day of admission (early) versus those who did not (late or not treated), adjusting for baseline (admission day) severity, age, sex, site, and vaccination status.

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Background: Assessments of COVID-19 vaccine effectiveness are needed to monitor the protection provided by updated vaccines against severe COVID-19. We evaluated the effectiveness of original monovalent and bivalent (ancestral strain and Omicron BA.4/5) COVID-19 vaccination against COVID-19-associated hospitalization and severe in-hospital outcomes.

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Article Synopsis
  • The study assessed the effectiveness of the updated 2023-2024 COVID-19 vaccine against hospitalization for two variant lineages, XBB and JN, in hospitalized patients across 26 hospitals in the U.S. between October 2023 and March 2024.
  • The results indicated a vaccine effectiveness (VE) of 54.2% against XBB and 32.7% against JN, suggesting that the JN lineage may have some level of immune escape.
  • However, the severity of cases with the JN lineage was not significantly worse compared to those with the XBB lineage, indicating similar risks of severe outcomes like ICU admission and death.
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  • * A study conducted between September 2018 and October 2022 in Tennessee and Georgia found that 12.1% of hospitalized adults with CAP had Streptococcus pneumoniae detected, with the most common serotypes being 3, 22F, 19A, and others.
  • * Findings suggest that a significant portion of detected serotypes, approximately one-third, are not covered by current vaccines like PCV15 and PCV20, indicating the need for new vaccines with broader serotype coverage to reduce disease occurrence.
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Importance: On June 21, 2023, the Centers for Disease Control and Prevention recommended the first respiratory syncytial virus (RSV) vaccines for adults aged 60 years and older using shared clinical decision-making. Understanding the severity of RSV disease in adults can help guide this clinical decision-making.

Objective: To describe disease severity among adults hospitalized with RSV and compare it with the severity of COVID-19 and influenza disease by vaccination status.

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  • Prolonged SARS-CoV-2 infections may pose a risk for the development of mutated variants, particularly in immunocompromised individuals, but the specific types of immunosuppressive conditions that increase this risk have not been extensively studied.
  • A study conducted across five US medical centers involved 150 immunocompromised patients to identify factors contributing to extended SARS-CoV-2 infections through regular testing and genetic sequencing.
  • Results showed that patients with B-cell dysfunction and those who had solid organ transplants or HIV had longer durations of infection compared to those with autoimmune conditions, indicating varying risks based on the type of immunosuppression.
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Background: Influenza circulation during the 2022-2023 season in the United States largely returned to pre-coronavirus disease 2019 (COVID-19)-pandemic patterns and levels. Influenza A(H3N2) viruses were detected most frequently this season, predominately clade 3C.2a1b.

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  • On June 21, 2023, the CDC recommended RSV vaccination for adults aged 60 and older based on shared clinical decision-making, highlighting the need for understanding RSV disease severity among this group.
  • A study involving 5,784 hospitalized adults aged 60+ with respiratory illnesses from February 2022 to May 2023 showed that although RSV was less common, it was associated with more severe health outcomes compared to COVID-19 and influenza.
  • The findings indicated that older adults hospitalized with RSV were more likely to require intensive oxygen support, ICU admission, and had higher rates of invasive mechanical ventilation or death compared to those hospitalized for influenza.
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. Upcoming missions of the National Aeronautics and Space Administration (NASA) to the Moon will include extensive human exploration of the lunar surface. Walking will be essential for many exploration tasks, and metabolic cost during ambulation on simulated complex lunar surfaces requires further characterization.

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  • The study focused on prolonged SARS-CoV-2 infections in immunocompromised patients, aiming to identify which types of immunosuppression might lead to longer infections and increased viral mutations.
  • Conducted at five hospitals, the research enrolled 150 adults with various immunocompromising conditions and monitored their nasal specimens for changes in viral presence and mutations over several months.
  • Results indicated that while prolonged infections were rare, individuals with infections lasting over 56 days developed unique spike mutations not commonly found in the broader population, highlighting the risk of viral evolution in these patients.
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Background: Time spent awaiting discharge after the acute need for hospitalization has resolved is an important potential contributor to hospital length of stay (LOS).

Objective: To measure the prevalence, impact, and context of patients who remain hospitalized for prolonged periods after completion of acute care needs.

Design, Setting, And Participants: We conducted a cross-sectional "point-in-time" survey at each of 15 academic US hospitals using a structured data collection tool with on-service acute care medicine attending physicians in fall 2022.

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Background: Accurate determination of COVID-19 vaccination status is necessary to produce reliable COVID-19 vaccine effectiveness (VE) estimates. Data comparing differences in COVID-19 VE by vaccination sources (i.e.

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Introduction: Understanding the changing epidemiology of adults hospitalized with coronavirus disease 2019 (COVID-19) informs research priorities and public health policies.

Methods: Among adults (≥18 years) hospitalized with laboratory-confirmed, acute COVID-19 between 11 March 2021, and 31 August 2022 at 21 hospitals in 18 states, those hospitalized during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron-predominant period (BA.1, BA.

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Article Synopsis
  • - As of April 2023, the COVID-19 pandemic resulted in 1.1 million deaths in the U.S., with 75% of those being adults aged 65 and older.
  • - A study evaluated the effectiveness of 2-4 doses of monovalent mRNA COVID-19 vaccines on preventing severe outcomes, finding a 62% effectiveness against invasive mechanical ventilation and in-hospital death for adults aged 18+, and 69% for those 65+.
  • - The vaccine effectiveness varied over time: 76% within the first 180 days after the last dose, dropping to 54% after 180-364 days and 56% after a year, emphasizing the importance of staying updated
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For two decades, the U.S. government has publicly reported performance measures for most nursing homes, spurring some improvements in quality.

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  • SARS-CoV-2 RNA levels, specifically total nucleocapsid (N) and subgenomic N (sgN), are commonly used indicators of how infectious someone with COVID-19 might be, but the influence of various host factors and virus variants on these levels was uncertain.
  • Researchers analyzed RNA levels in samples from over 3,200 hospitalized COVID-19 patients using RT-qPCR, examining how factors like time of sampling, virus variant, age, and vaccination impacted the RNA viral load.
  • Results indicated that RNA levels varied primarily by the type of SARS-CoV-2 variant and timing of symptom onset, but not based on patient age or vaccination, suggesting that subgenomic RNA measurements may not provide significant additional
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Background: Coronavirus disease 2019 (COVID-19) vaccine effectiveness (VE) studies are increasingly reporting relative VE (rVE) comparing a primary series plus booster doses with a primary series only. Interpretation of rVE differs from traditional studies measuring absolute VE (aVE) of a vaccine regimen against an unvaccinated referent group. We estimated aVE and rVE against COVID-19 hospitalization in primary-series plus first-booster recipients of COVID-19 vaccines.

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Monovalent COVID-19 mRNA vaccines, designed against the ancestral strain of SARS-CoV-2, successfully reduced COVID-19-related morbidity and mortality in the United States and globally (1,2). However, vaccine effectiveness (VE) against COVID-19-associated hospitalization has declined over time, likely related to a combination of factors, including waning immunity and, with the emergence of the Omicron variant and its sublineages, immune evasion (3). To address these factors, on September 1, 2022, the Advisory Committee on Immunization Practices recommended a bivalent COVID-19 mRNA booster (bivalent booster) dose, developed against the spike protein from ancestral SARS-CoV-2 and Omicron BA.

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Background: During the initial surge of coronavirus disease 2019 (COVID-19), health-care utilization fluctuated dramatically, straining acute hospital capacity across the USA and potentially contributing to excess mortality.

Methods: This was an observational retrospective study of patients with COVID-19 admitted to a large US urban academic medical center during a 12-week COVID-19 surge in the Spring of 2020. We describe patterns in length of stay (LOS) over time.

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Background: Test-negative design (TND) studies have produced validated estimates of vaccine effectiveness (VE) for influenza vaccine studies. However, syndrome-negative controls have been proposed for differentiating bias and true estimates in VE evaluations for COVID-19. To understand the use of alternative control groups, we compared characteristics and VE estimates of syndrome-negative and test-negative VE controls.

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  • The COVID-19 pandemic led to a decrease in influenza cases in 2020-2021, but there was a resurgence in 2021-2022 with a strain that was different from the vaccine used that season.
  • A study analyzed the effectiveness of the 2021-2022 influenza vaccine by comparing vaccinated and unvaccinated hospitalized patients across different age groups and health conditions using a multistate surveillance network.
  • Results showed that the vaccine reduced hospitalization risk for younger adults without health issues, but was ineffective for seniors aged 65 and older, highlighting the need for better vaccines and prevention methods.
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