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result(s) for
"Simeone, Regina M."
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Functional Limitations and Illness-Related Absenteeism among School-Aged Children with and without Long COVID, United States, 2022–2023
2025
We examined functional limitations and illness-related chronic absenteeism (i.e., missing >18 days of school for health reasons) in a cross-sectional nationally representative sample of 11,057 US children 5-17 years of age who ever or never had long COVID (i.e., symptoms lasting >3 months after COVID-19 illness). Among 4,587 children with prior COVID-19, we estimated whether long COVID was associated with increased illness-related chronic absenteeism by using logistic regression. Our analysis showed that ≈1.4% of school-aged children had long COVID at some point. Among children with prior COVID-19, those who had long COVID at some point more frequently reported functional limitations, such as difficulty with memory, than those who did not have long COVID (18.3% vs. 8.6%). Having long COVID was associated with higher odds of illness-related chronic absenteeism. Children who had long COVID could experience functional limitations and absenteeism. School accommodations might be an option to improve functional limitations.
Journal Article
Evaluating Differences in Whole Blood, Serum, and Urine Screening Tests for Zika Virus, Puerto Rico, USA, 2016
2021
We evaluated nucleic acid amplification testing (NAAT) for Zika virus on whole-blood specimens compared with NAAT on serum and urine specimens among asymptomatic pregnant women during the 2015-2016 Puerto Rico Zika outbreak. Using NAAT, more infections were detected in serum and urine than in whole blood specimens.
Journal Article
Risk for Stillbirth Among Women With and Without COVID-19 at Delivery Hospitalization — United States, March 2020–September 2021
2021
What is already known about this topic? Pregnant women are at increased risk for severe disease from COVID-19, and COVID-19 is associated with an increased risk for adverse perinatal outcomes. What is added by this report? Among 1,249,634 delivery hospitalizations during March 2020–September 2021, U.S. women with COVID-19 were at increased risk for stillbirth compared with women without COVID-19 (adjusted relative risk [aRR] = 1.90; 95% CI = 1.69–2.15). The magnitude of association was higher during the period of SARS-CoV-2 B.1.617.2 (Delta) variant predominance than during the pre-Delta period. What are the implications for public health practice? Implementing evidence-based COVID-19 prevention strategies, including vaccination before or during pregnancy, is critical to reduce the impact of COVID-19 on stillbirths.
Journal Article
Concordance between parent-reported and documented COVID-19 vaccination status among hospitalized children and adolescents: Implications for vaccine effectiveness estimates, May 2021–October 2023
by
Orzel-Lockwood, Amber O.
,
Wu, Michael J.
,
Fleming-Dutra, Katherine E.
in
Adolescent
,
Allergy and Immunology
,
Bias
2025
During the U.S. COVID-19 Public Health Emergency (PHE), healthcare providers were required to report all administered COVID-19 vaccines in Immunization Information Systems (IIS), a key data source for vaccine effectiveness (VE) evaluations. Expiration of the PHE and commercialization of COVID-19 vaccines raised concerns about IIS data completeness. Parental report is an alternative source of vaccination data but might be inaccurate.
Using VE surveillance network data during May 2021–October 2023, we compared parent-reported and documented COVID-19 vaccine doses for patients aged 5–18 years admitted to 35 hospitals in 25 states, overall and by case/control status. We calculated percent agreement, kappa, sensitivity, specificity, and positive and negative predictive value (NPV) of parental report. We compared proportions of patients with discordant vaccination history by demographics and incident SARS-CoV-2 infection status. We estimated VE separately using parental report and independently documented sources.
Among 3262 patients, agreement between parent-reported and documented COVID-19 vaccination doses was 88 % (kappa = 0.77). Most discordant pairs (346/390) were because of parental over-reporting of doses. Among patients documented as unvaccinated, most (specificity = 90 %) were reported as such by parents; nearly all reported as unvaccinated by parents had no documented vaccination (NPV = 99 %). Discordance decreased with shorter admission-to-interview intervals and varied regionally from 8 % in the Midwest to 16 % in the West. Proportions of discordant reports were similar between patients with and without SARS-CoV-2 infection (11 % vs 13 %). Median days from last vaccine dose to hospital admission was 167 (IQR: 86–288). VE of two doses (99 % original formula) against COVID-19–related hospitalization was 58 % using documented sources and 60 % using parental report.
Parental report of COVID-19 vaccination agreed strongly with documented sources, especially among unvaccinated patients. Despite discrepancies from parental overreporting, VE estimates from both sources were similar. As reliance on parental report increases, reducing admission-to-interview time is important for accurate vaccination history.
Journal Article
Changes in rates of adverse pregnancy outcomes during the COVID-19 pandemic: a cross-sectional study in the United States, 2019–2020
by
Bailey, Wallace
,
Ellington, Sascha R
,
Simeone, Regina M
in
Coronaviruses
,
COVID-19
,
Cross-sectional studies
2022
ObjectiveOur objective was to assess differences in pregnancy outcomes during the COVID-19 pandemic compared to the previous year.Study designIn a cross-sectional study of delivery hospitalizations in the Premier Healthcare Database Special COVID-19 Release, we assessed differences in selected maternal and pregnancy outcomes occurring April–December in 2019 and 2020 in the United States.ResultAmong 663,620 deliveries occurring in 2019 and 614,093 deliveries occurring in 2020, we observed an increase in in-hospital maternal death from 2019 to 2020, which was no longer statistically significant after excluding deliveries with a COVID-19 diagnosis. Intensive care unit admission and preterm birth decreased from 2019 to 2020. There was no difference in the prevalence of most other outcomes examined.ConclusionThe full impact of the COVID-19 pandemic on maternal and pregnancy outcomes remains to be understood. Most outcomes investigated experienced minimal change from 2019 to 2020.
Journal Article
Differences in delivery hospitalization experiences during the COVID-19 pandemic by maternal race and ethnicity, Pregnancy Risk Assessment Monitoring System, 2020
by
Salvesen Von Essen, Beatriz
,
Meeker, Jessica R.
,
Galang, Romeo R.
in
692/308/174
,
692/699/255
,
692/700/478/174
2024
Objective
We investigated maternal COVID-19 related experiences during delivery hospitalizations, and whether experiences differed by maternal race and ethnicity.
Study design
Data from the Pregnancy Risk Assessment Monitoring System among women with live births between April–December 2020 were used. Adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) estimated associations between maternal race and ethnicity and COVID-19 related delivery experiences.
Results
Among 12,879 women, 3.6% reported infant separation and 1.8% reported not being allowed support persons. Compared with non-Hispanic White women, American Indian/Alaska Native (AI/AN) (aPR = 2.7; CI: 1.2–6.2), Hispanic (aPR = 2.2; CI: 1.5–3.1), non-Hispanic Black (aPR = 2.4; CI: 1.7–3.6), and non-Hispanic Asian (aPR = 2.8; CI: 1.6–4.9) women reported more infant separation due to COVID-19. Not being allowed support persons was more common among AI/AN (aPR = 5.2; CI: 1.8–14.8) and non-Hispanic Black (aPR = 2.3; CI: 1.3–4.1) women.
Conclusions
COVID-19 related delivery hospitalization experiences were unequally distributed among racial and ethnic minorities.
Journal Article
Inpatient Hospitalization Costs Associated with Birth Defects Among Persons of All Ages — United States, 2013
2017
In the United States, major structural or genetic birth defects affect approximately 3% of live births (1) and are responsible for 20% of infant deaths (2). Birth defects can affect persons across their lifespan and are the cause of significant lifelong disabilities. CDC used the Healthcare Cost and Utilization Project (HCUP) 2013 National Inpatient Sample (NIS), a 20% stratified sample of discharges from nonfederal community hospitals, to estimate the annual cost of birth defect-associated hospitalizations in the United States, both for persons of all ages and by age group. Birth defect-associated hospitalizations had disproportionately high costs, accounting for 3.0% of all hospitalizations and 5.2% of total hospital costs. The estimated annual cost of birth defect-associated hospitalizations in the United States in 2013 was $22.9 billion. Estimates of the cost of birth defect-associated hospitalizations offer important information about the impact of birth defects among persons of all ages on the overall health care system and can be used to prioritize prevention, early detection, and care.
Journal Article
CDC Grand Rounds
by
Reefhuis, Jennita
,
Iskander, John
,
Simeone, Regina M.
in
Abdominal wall
,
Biomedical Research
,
Birth defects
2015
Major birth defects (birth defects) are defined as structural abnormalities, present at birth, with surgical, medical, or cosmetic importance. Each year in the United States, 3% of live births (approximately 120,000 infants) have an identifiable structural birth defect. Examples of birth defects include neural tube defects, such as spina bifida; orofacial clefts; abdominal wall defects, such as gastroschisis; and congenital heart defects, such as hypoplastic left heart syndrome. Collectively, congenital heart defects are the most common birth defects (27%), followed by musculoskeletal defects (18%), genitourinary defects (15%), orofacial defects (5%), and neural tube defects (2%).
Journal Article
Update: Interim Guidance for Preconception Counseling and Prevention of Sexual Transmission of Zika Virus for Men with Possible Zika Virus Exposure — United States, August 2018
by
Meaney-Delman, Dana
,
Hills, Susan
,
Oduyebo, Titilope
in
Antiretroviral drugs
,
Birth defects
,
Body fluids
2018
Zika virus infection can occur as a result of mosquitoborne or sexual transmission of the virus. Infection during pregnancy is a cause of fetal brain abnormalities and other serious birth defects (1,2). CDC has updated the interim guidance for men with possible Zika virus exposure who 1) are planning to conceive with their partner, or 2) want to prevent sexual transmission of Zika virus at any time (3). CDC now recommends that men with possible Zika virus exposure who are planning to conceive with their partner wait for at least 3 months after symptom onset (if symptomatic) or their last possible Zika virus exposure (if asymptomatic) before engaging in unprotected sex. CDC now also recommends that for couples who are not trying to conceive, men can consider using condoms or abstaining from sex for at least 3 months after symptom onset (if symptomatic) or their last possible Zika virus exposure (if asymptomatic) to minimize their risk for sexual transmission of Zika virus. All other guidance for Zika virus remains unchanged. The definition of possible Zika virus exposure remains unchanged and includes travel to or residence in an area with risk for Zika virus transmission (https://wwwnc.cdc.gov/travel/page/world-map-areas-with-zika) or sex without a condom with a partner who traveled to or lives in an area with risk for Zika virus transmission. CDC will continue to update recommendations as new information becomes available.
Journal Article