Publications by authors named "Laurie M Billing"

Background: We sought to determine whether race/ethnicity disparities in severe coronavirus disease 2019 (COVID-19) outcomes persist in the era of vaccination.

Methods: Population-based age-adjusted monthly rate ratios (RRs) of laboratory-confirmed COVID-19-associated hospitalizations were calculated among adult patients from the COVID-19-Associated Hospitalization Surveillance Network, March 2020 - August 2022 by race/ethnicity. Among randomly sampled patients July 2021 - August 2022, RRs for hospitalization, intensive care unit (ICU) admission, and in-hospital mortality were calculated for Hispanic, Black, American Indian/Alaskan Native (AI/AN), and Asian/Pacific Islander (API) persons vs White persons.

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  • The study aimed to evaluate the effects of respiratory virus codetections in children hospitalized with SARS-CoV-2 from March 2020 to February 2022.
  • Out of 4,372 hospitalized children, 21% had additional respiratory virus codetections, which were more common in younger children (under 5 years old) and associated with a higher likelihood of severe illness and ICU admission.
  • Findings suggest that codetections with viruses like RSV and rhinovirus/enterovirus could worsen the severity of illness in children under 5 years old who are infected with SARS-CoV-2.
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  • The study aimed to understand the risk factors for hospitalization due to COVID-19, focusing on both vaccinated and unvaccinated individuals to aid public health measures.
  • Data was collected from over 250 hospitals between January 2021 and April 2022, comparing hospitalization rates and patient characteristics of vaccinated and unvaccinated persons with confirmed COVID-19 infections.
  • Results indicated that unvaccinated individuals had significantly higher hospitalization rates—up to 17.7 times higher compared to vaccinated individuals—particularly during the Omicron variant surge.
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Background: Pregnant women less frequently receive COVID-19 vaccination and are at increased risk for adverse pregnancy outcomes from COVID-19.

Objective: This study aimed to first, describe the vaccination status, treatment, and outcomes of hospitalized, symptomatic pregnant women with COVID-19, and second, estimate whether treatment differs by pregnancy status among treatment-eligible (ie, requiring supplemental oxygen per National Institutes of Health guidelines at the time of the study) women.

Study Design: From January to November 2021, the COVID-19-Associated Hospitalization Surveillance Network completed medical chart abstraction for a probability sample of 2715 hospitalized women aged 15 to 49 years with laboratory-confirmed SARS-CoV-2 infection.

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  • Influenza and SARS-CoV-2 cause significant respiratory illness in children, prompting an analysis of hospitalization rates and outcomes among those under 18 years old.
  • The study found that the COVID-19 hospitalization rate (48.2 per 100,000) was higher than influenza rates from previous seasons, especially among adolescents aged 12-17.
  • While more children with COVID-19 required ICU admission compared to those with influenza, pediatric deaths were rare for both illnesses, indicating COVID-19 adds to the existing burden of severe respiratory illness in children.
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On October 29, 2021, the Food and Drug Administration expanded the Emergency Use Authorization for Pfizer-BioNTech COVID-19 vaccine to children aged 5-11 years; CDC's Advisory Committee on Immunization Practices' recommendation followed on November 2, 2021.* In late December 2021, the B.1.

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Article Synopsis
  • * Hospitalization rates during the Omicron period surged, peaking at 38.4 per 100,000 adults, significantly higher than the rates during Delta predominance, affecting all demographics regardless of vaccination status.
  • * Unvaccinated adults faced 12 times higher hospitalization rates compared to those who received boosters, with non-Hispanic Black adults experiencing nearly four times the hospitalization rates of non-Hispanic White adults, indicating stark racial disparities.
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The first U.S. case of COVID-19 attributed to the Omicron variant of SARS-CoV-2 (the virus that causes COVID-19) was reported on December 1, 2021 (1), and by the week ending December 25, 2021, Omicron was the predominant circulating variant in the United States.

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Background: Pregnant women may be at increased risk for severe influenza-associated outcomes.

Objective: To describe characteristics and outcomes of hospitalized pregnant women with influenza.

Design: Repeated cross-sectional study.

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Objectives: Describe population-based rates and risk factors for severe coronavirus disease 2019 (COVID-19) (ie, ICU admission, invasive mechanical ventilation, or death) among hospitalized children.

Methods: During March 2020 to May 2021, the COVID-19-Associated Hospitalization Surveillance Network identified 3106 children hospitalized with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection in 14 states. Among 2293 children primarily admitted for COVID-19, multivariable generalized estimating equations generated adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) of the associations between demographic and medical characteristics abstracted from medical records and severe COVID-19.

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Objective: To estimate population-based rates and to describe clinical characteristics of hospital-acquired (HA) influenza.

Design: Cross-sectional study.

Setting: US Influenza Hospitalization Surveillance Network (FluSurv-NET) during 2011-2012 through 2018-2019 seasons.

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  • This study investigates the relationship between race/ethnicity, socioeconomic status, and COVID-19 hospitalization rates using data from the COVID-NET surveillance network during early 2020.
  • Findings show that a significant portion of COVID-19 hospitalizations occurred among racial and ethnic minorities, with the highest rates found in high-poverty areas, particularly among Black and Hispanic populations.
  • The conclusion emphasizes the need for targeted public health strategies and vaccination efforts to support racial and ethnic minorities and those in high-poverty communities effectively.
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  • COVID-19 can cause serious health issues in children and adolescents, despite adults being more frequently hospitalized or dying from the virus.
  • * As schools reopen for in-person learning during an uptick in cases from the Delta variant, monitoring COVID-19 impacts on younger populations becomes crucial.
  • * Data from March 2020 to August 2021 reveals a significant increase in COVID-19 hospitalizations among children, especially in unvaccinated individuals, highlighting the importance of vaccination and preventative measures in schools to protect this age group.
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Background: Antiviral treatment is recommended for hospitalized patients with suspected and confirmed influenza, but evidence is limited among children. We evaluated the effect of antiviral treatment on hospital length of stay (LOS) among children hospitalized with influenza.

Methods: We included children <18 years hospitalized with laboratory-confirmed influenza in the US Influenza Hospitalization Surveillance Network.

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Importance: Racial and ethnic minority groups, such as Black, Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons, often experience higher rates of severe influenza disease.

Objective: To describe rates of influenza-associated hospitalization, intensive care unit (ICU) admission, and in-hospital death by race and ethnicity over 10 influenza seasons.

Design, Setting, And Participants: This cross-sectional study used data from the Influenza-Associated Hospitalization Surveillance Network (FluSurv-NET), which conducts population-based surveillance for laboratory-confirmed influenza-associated hospitalizations in selected counties, representing approximately 9% of the US population.

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Most COVID-19-associated hospitalizations occur in older adults, but severe disease that requires hospitalization occurs in all age groups, including adolescents aged 12-17 years (1). On May 10, 2021, the Food and Drug Administration expanded the Emergency Use Authorization for Pfizer-BioNTech COVID-19 vaccine to include persons aged 12-15 years, and CDC's Advisory Committee on Immunization Practices recommended it for this age group on May 12, 2021.* Before that time, COVID-19 vaccines had been available only to persons aged ≥16 years.

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  • A study analyzed hospitalized COVID-19 cases from March to June 2020 and found that 42.5% of patients received at least one investigational treatment for the virus.
  • The antibiotics hydroxychloroquine and azithromycin were commonly administered, but their usage decreased over time.
  • In contrast, the antiviral drug remdesivir saw an increase in use during the same period.
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Among 513 adults aged 18-49 years without underlying medical conditions hospitalized with coronavirus disease 2019 (COVID-19) during March 2020-August 2020, 22% were admitted to an intensive care unit, 10% required mechanical ventilation, and 3 patients died (0.6%). These data demonstrate that healthy younger adults can develop severe COVID-19.

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Health care personnel (HCP) can be exposed to SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), both within and outside the workplace, increasing their risk for infection. Among 6,760 adults hospitalized during March 1-May 31, 2020, for whom HCP status was determined by the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET), 5.9% were HCP.

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Pregnant women might be at increased risk for severe coronavirus disease 2019 (COVID-19) (1,2). The COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) (3) collects data on hospitalized pregnant women with laboratory-confirmed SARS-CoV-2, the virus that causes COVID-19; to date, such data have been limited. During March 1-August 22, 2020, approximately one in four hospitalized women aged 15-49 years with COVID-19 was pregnant.

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Most reported cases of coronavirus disease 2019 (COVID-19) in children aged <18 years appear to be asymptomatic or mild (1). Less is known about severe COVID-19 illness requiring hospitalization in children. During March 1-July 25, 2020, 576 pediatric COVID-19 cases were reported to the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET), a population-based surveillance system that collects data on laboratory-confirmed COVID-19-associated hospitalizations in 14 states (2,3).

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Background: Rates of influenza hospitalizations differ by age, but few data are available regarding differences in laboratory-confirmed rates among adults aged ≥65 years.

Methods: We evaluated age-related differences in influenza-associated hospitalization rates, clinical presentation, and outcomes among 19 760 older adults with laboratory-confirmed influenza at 14 FluSurv-NET sites during the 2011-2012 through 2014-2015 influenza seasons using 10-year age groups.

Results: There were large stepwise increases in the population rates of influenza hospitalization with each 10-year increase in age.

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Harmful algal blooms (HABs) are excessive accumulations of microscopic photosynthesizing aquatic organisms (phytoplankton) that produce biotoxins or otherwise adversely affect humans, animals, and ecosystems. HABs occur sporadically and often produce a visible algal scum on the water. This report summarizes human health data and water sampling results voluntarily reported to CDC's Waterborne Disease and Outbreak Surveillance System (WBDOSS) via the National Outbreak Reporting System (NORS) and the Harmful Algal Bloom-Related Illness Surveillance System (HABISS)* for the years 2009-2010.

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