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This retrospective cohort study used propensity-matched cohorts with a 3-year follow-up (March 2020–July 2023) to determine incidence rates, relative risks, and risk factors for incident pulmonary conditions after COVID-19 exposure. Data were drawn from a multi-center health system in New York City. Participants had at least 30 days of follow-up and included patients with or without COVID-19 confirmed by PCR, diagnosed with lower respiratory tract infection (LRTI), or without COVID-19/LRTI testing. COVID-19 status was defined by positive PCR, LRTI requiring hospitalization, or neither. The final cohort ( n  = 69,632) comprised 1:1 propensity-matched comparisons based on age, sex, race/ethnicity, obesity, type II diabetes, hypertension, and smoking, stratified by hospitalization. Primary outcomes were incidence rates, hazard ratios (HRs), and incidence rate ratios (IRRs) for new-onset pulmonary conditions. The study included 34,816 matched COVID-19 survivors and 34,816 non-COVID survivors. Non-hospitalized COVID-19 patients had a threefold higher risk of incident pulmonary conditions compared to non-COVID controls (aHR = 3.36, 95% CI: 3.02–3.73). Hospitalized COVID-19 patients showed similar risk to hospitalized LRTI controls (aHR = 1.24, 95% CI: 0.84–1.84). Multiple sensitivity analyses were conducted. COVID-19 increases pulmonary risk in non-hospitalized patients but not in hospitalized cohorts compared with LRTI. These findings underscore the need for monitoring and intervention in at-risk individuals.

The long-term effects of the COVID-19 pandemic on asthma exacerbations across sociodemographic groups is unknown. We conducted a retrospective cohort study of 162,113 asthma patients within the Montefiore Health System from March 2018 to February 2024 to evaluate pandemic-related changes in exacerbation risk across demographic, socioeconomic, and social determinant subgroups. Difference-in-differences logistic regression compared pre-pandemic (2018-2020) and late-pandemic (2022-2024) periods by age, sex, race and ethnicity, income, insurance, and unmet social needs. Interrupted time series regression assessed level and trend changes in March 2020, with sensitivity analyses confirming robustness. Before the pandemic, exacerbation odds were higher among Black, Hispanic, and Other race patients, females, Medicaid-insured individuals, and children. After pandemic onset, risk increased disproportionately for patients with unmet social needs, children, males, Medicaid, and low-income groups, while racial and ethnic disparities persisted. Interrupted time series showed immediate decreases among children and adults, with subsequent rebound to baseline in children but sustained suppression among adults. The pandemic was associated with widened socioeconomic disparities, a transient reduction in pediatric exacerbations, and a lasting decline among adults, underscoring the need for interventions addressing socioeconomic and social drivers of asthma outcomes.

We investigated the long-term kidney and cardiovascular outcomes of patients with chronic kidney disease (CKD) after COVID-19. Our retrospective cohort consisted of 834 CKD patients with COVID-19 and 6,167 CKD patients without COVID-19 between 3/11/2020 to 7/1/2023. Multivariate competing risk regression models were used to estimate risk (as adjusted hazard ratios (aHR) with 95% confidence intervals (CI)) of CKD progression to a more advanced stage (Stage 4 or 5) and major adverse kidney events (MAKE), and risk of major adverse cardiovascular events (MACE) at 6-, 12-, and 24-month follow up. Hospitalized COVID-19 patients at 12 and 24 months (aHR 1.62 95% CI[1.24,2.13] and 1.76 [1.30, 2.40], respectively), but not non-hospitalized COVID-19 patients, were at higher risk of CKD progression compared to those without COVID-19. Both hospitalized and non-hospitalized COVID-19 patients were at higher risk of MAKE at 6-, 12- and 24-months compared to those without COVID-19. Hospitalized COVID-19 patients at 6-, 12- and 24-months (aHR 1.73 [1.21, 2.50], 1.77 [1.34, 2.33], and 1.31 [1.05, 1.64], respectively), but not non-hospitalized COVID-19 patients, were at higher risk of MACE compared to those without COVID-19. COVID-19 increases the risk of long-term CKD progression and cardiovascular events in patients with CKD. These findings highlight the need for close follow up care and therapies that slow CKD progression in this high-risk subgroup.

Background Fatigue is a common sequela of SARS-CoV-2 infection, with many COVID-19 patients subsequently developing chronic fatigue syndrome and myalgic encephalomyelitis (CFS/ME). Long-term associations between COVID-19, new-onset CFS/ME, and other independent predictors such as vaccination for SARS-CoV-2, re-infection, and blood biomarkers at time of infection remain unclear. This study investigated the incidence and independent predictors of developing new-onset CFS/ME up to 4 years post SARS-CoV-2 infection in comparison to COVID− controls. Methods This retrospective analysis conducted within the Montefiore Health System from February 1, 2020, to January 12, 2024 included adults without a prior diagnosis of fatigue or CFS/ME who were hospitalized for COVID-19 (n = 10,667), not hospitalized for COVID-19 (n = 25,409), and non-COVID-19 controls (n = 111,301). The observation time was between 30 days and 4 years post index date. The outcome was new-onset CFS/ME. Multivariate adjusted hazard ratios (HR) with 95% confidence intervals were calculated, assessing risk posed by SARS-CoV-2 infection, re-infection, and vaccination. Whether abnormal levels of aspartate aminotransferase, creatinine, D-dimer, lactate dehydrogenase, ferritin, hemoglobin, platelets, neutrophil/lymphocyte ratio, and temperature during hospitalization were associated with future CFS/ME risk was examined. Results Compared to COVID− controls, the risk of developing new-onset CFS/ME was higher among both COVID-19 hospitalized (adjusted HR = 1.46 [1.07, 1.99]) and non-hospitalized patients (1.56 [1.25, 1.93]). Females (1.54 [1.27, 1.89]), patients with liver disease (1.61 [1.29, 2.00]), autoimmune disorders (1.57 [1.18, 2.08]), and anxiety disorders (1.35 [1.04, 1.74]) were more likely to develop CFS/ME ( p  < 0.05). Re-infection with SARS-CoV-2 was not associated with increased risk of incident CFS/ME. COVID-19 vaccination status during the initial phase of the rollout (prior to 2022) was associated with an increased risk of new-onset CFS/ME ( p  < 0.05). None of the blood biomarkers during acute COVID-19 were associated with new-onset CFS/ME risk ( p  > 0.05). Conclusion SARS-CoV-2 infection is associated with an increased risk of new-onset CFS/ME, independent of hospitalization status. Females, and individuals with autoimmune and anxiety disorders were more susceptible. These findings highlight the need for ongoing surveillance and management of fatigue-related symptoms in COVID-19 survivors.

Chimeric antigen receptor T-cell (CAR-T) therapy has transformed diffuse large B-cell lymphoma (DLBCL) treatment, but data in diverse urban populations remain limited. We report outcomes from a comprehensive cancer center in the Bronx. Montefiore Health System treated 79 DLBCL patients with CAR-T from March 2018 to July 2024. Demographics, comorbidities, socioeconomic factors, and acute complications, including immune effector cell neurotoxicity syndrome (ICANS), cytokine release syndrome (CRS), cardiotoxicity, and pulmonary events, were tabulated. Kaplan-Meier survival analysis was performed up to five years. Multivariate adjusted hazard ratios (aHR) were calculated for remission and 3-year mortality. CAR-T achieved complete remissions in 50.6%, partial remission in 16.5%, and progression in 22.8%. Cumulative mortality was 10.1% during treatment and 34.2% by five years. Complete remission reduced 3-year mortality (aHR 0.13; 95% CI 0.04–0.43). Complications included CRS (76.0%), ICANS (49.4%), neutropenic fever (58.2%), and sepsis (19.0%). ICANS correlated with CRS, ICU stay, and sepsis. Socioeconomic status was not linked to mortality, but comorbidities increased risk. CAR-T complete remission is an independent predictor of reduced mortality. High rates of complications, particularly CRS and ICAN, reinforce the need for vigilant monitoring and management strategies to enhance long-term outcomes.

This study examined the incidence, characteristics, and risk factors of new gastrointestinal disorders (GID) associated with SARS-CoV-2 infection up to 3.5 years post-infection. This retrospective study included 35,102 COVID-19 patients and 682,594 contemporary non-COVID-19 patients without past medical history of GID (controls) from the Montefiore Health System in the Bronx (3/1/2020 to 7/31/2023). Comparisons were made with unmatched and propensity-matched (1:2) controls. The primary outcome was new GID which included peptic ulcer, inflammatory bowel disease, irritable bowel syndrome, diverticulosis, diverticulitis, and biliary disease. Multivariate Cox proportional hazards model analysis was performed with adjustment for covariates. There were 2,228 (6.34%) COVID-19 positive patients who developed new GID compared to 38,928 (5.70%) controls. COVID-19 patients had an elevated risk of developing new GID (adjusted HR = 1.18 (95% CI 1.12–1.25) compared to propensity-matched controls, after adjusting for confounders that included smoking, obesity, diabetes, hypertension. These findings underscore the need for additional research and follow-up of at-risk individuals for developing GID post infection.

Background/Objectives: Individuals with arrhythmia who survived COVID-19 could be susceptible to long-term cardiovascular complications and clinical outcomes. Methods: We performed a retrospective cohort study of adults with a history of arrhythmia in the Montefiore Health System (1 January 2016–17 August 2024). COVID-19 status was determined by a positive or negative polymerase-chain-reaction test. Outcomes included all-cause mortality, first-time myocardial infarction (MI), heart failure (HF), ischemic or hemorrhagic stroke, and major adverse cardiovascular events (MACE: defined as MI, HF, stroke, or death) > 30 days post-index date. Cox proportional hazards and Fine–Gray competing risk models, adjusted for demographic, clinical, socioeconomic, and COVID-19 vaccination variables, were employed. The association of outcomes with blood biomarkers taken at time of infection were also assessed in hospitalized COVID-19 patients. Results: Among the 6830 arrhythmia patients, 985 were hospitalized for COVID-19, 1591 were not hospitalized for COVID-19, and 4254 did not have COVID-19. Patients hospitalized for COVID-19 had a higher risk of all-cause mortality (adjusted hazard ratio = 2.90, 95% confidence-interval [2.08, 4.04]), first-time MI, HF, and MACE compared to controls without COVID-19. No increased risk was observed among non-hospitalized COVID-19-positive patients compared to controls, except for all-cause mortality. Older age, male sex, Medicaid, and significant comorbidities were associated with the risk of MACE. Elevated levels of creatinine, lactate dehydrogenase, D-dimer, neutrophil-to-lymphocyte ratio, low hemoglobin, and low left ventricular ejection fraction during infection were associated with higher future MACE risk. Conclusions. In individuals with arrhythmia, severe COVID-19 is associated with increased long-term risks of mortality and new-onset cardiovascular complications, while mild infection with mortality risk. These findings highlight the need for long-term cardiovascular monitoring in this population.

BackgroundA few studies have reported conjunctivitis is a complication associated with acute COVID-19. It is unknown whether SARS-CoV-2 infection increases the risk of conjunctivitis post-COVID-19 long term.ObjectivesThis study investigated the incidence of new-onset conjunctivitis 3.5 years post SARS-CoV-2 infection and compared it with patients without SARS-CoV-2 infection.MethodsThis retrospective study consisted of 67 702 patients who tested positive for COVID-19 (defined by a positive PCR test), and 1 391 135 COVID-19-negative patients with no prior records of conjunctivitis in the Montefiore Health System from 11 March 2020 to 31 December 2022. The study included adult patients re-presenting to our centre with conjunctivitis. Outcome was new conjunctivitis between 14 days and 3.5 years post index date. Analysis was performed with unmatched and matched cohorts. Matching was done for age, sex, race and ethnicity. Cumulative incidence and hazard ratio (HR) with and without adjustment for competitive risks were analysed.ResultsThere were 1154 (2.27%) individuals with COVID-19 and contemporary 13 899 (1.57%) controls who developed new conjunctivitis. COVID-19-positive patients had a significantly higher risk of developing new incident conjunctivitis (unmatched cohort adjusted HR 1.11 (95% CI 1.04 to 1.17), matched cohort adjusted HR 1.10 (95% CI 1.02 to 1.16)) compared with COVID-19-negative patients.ConclusionsCOVID-19-positive patients had significantly higher risk of developing new conjunctivitis compared with contemporary COVID-19-negative controls. Identifying risk factors for developing new-onset conjunctivitis may draw clinical attention for careful follow-up in at-risk individuals for ocular infections.

Background: SARS-CoV-2 infection could trigger hypercoagulation and hyperinflammation that may predispose patients to cerebrovascular events. The long-term risk of stroke among COVID-19 patients remains unclear. This study investigated the long-term risks of ischemic stroke and transient cerebral ischemia (TCI) among patients with and without COVID-19. Methods: We conducted an observational cohort study in the Montefiore Health System (February 2020–January 2024), with 52,117 COVID+ and 837,395 COVID− patients without prior cerebrovascular events. Demographics, comorbidities, insurance, unmet social needs, and median income were adjusted for using inverse probability weighting. Cox-proportional regression hazard ratios (HR) and their 95% confidence intervals were computed for ischemic stroke and TCI. Results: Compared to COVID− controls, ischemic stroke risk was higher among hospitalized COVID+ patients (HR = 1.32 [1.12–1.55]) and non-hospitalized COVID+ patients (1.21 [1.05–1.39]). Compared to COVID− controls, TCI risk was similar among hospitalized COVID+ patients (1.00 [0.75–1.33]), but higher among non-hospitalized COVID+ patients (2.15 [1.81–2.56]). Conclusions: Hospitalized and non-hospitalized COVID-19 patients had a higher long-term risk of ischemic stroke while only non-hospitalized COVID-19 patients had a higher long-term risk of TCI. These findings underscore the needs for long-term monitoring of cerebrovascular risk factors in COVID-19 survivors.