Rate of young kids hospitalized for RSV spiked after first year of COVID pandemic – University of Minnesota Twin Cities

A cross-sectional study identified several racial differences in the clinical presentation and treatment of Lyme disease, researchers reported today in JAMA Network Open.

The study by researchers with Johns Hopkins University School of Medicine found that, among 1,395 Lyme disease patients (50.4% men, median age 48 years) treated at a specialty clinic in suburban Maryland, Black patients had 4.93 times (95% confidence interval [CI], 2.02 to 12.02) the odds of being diagnosed as having disseminated disease compared with patients who only had signs of the erythema migrans (EM) rashthe most common early sign of infection. The EM rash typically occurs within days or weeks of a deer tick bite.

Among 1,325 patients, Black patients (odds ratio [OR], 2.07; 95% CI, 1.12 to 3.84), women (OR, 1.39; 95% CI, 1.09 to 1.77), and younger patients (per 10 years: OR, 1.12; 95% CI, 1.04 to 1.20) all independently had higher odds of being in the symptoms-only group.

Analysis of 1,295 patients also found that Black patients had a significantly longer median time to appropriate antibiotic treatment (35 days) compared with White patients (7 days). This was significant among patients with EM (Black, 26 days; White, 4 days) but not those with disseminated disease or symptoms only. Initial inappropriate antibiotics were found in 6 of 37 Black patients (16.2%) and 90 of 1,165 White patients (7.7%)

When administered early, antibiotics cure Lyme disease in more than 99% of cases. Untreated infection can lead to complications involving the joints, heart, and nervous system.

Although this is one of the few large, clinic-based studies to examine racial differences in Lyme disease treatment, the study authors note that the findings are consistent with prior surveillance and insurance-claims studies. They suggest EM under-recognition could be attributed to EM images on Black patients being underrepresented in medical literature, gaps in healthcare access, racial discrimination, and implicit bias.

"Efforts are needed to increase patient and clinician awareness to ensure equitable reductions in disease burden," the authors wrote.

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Rate of young kids hospitalized for RSV spiked after first year of COVID pandemic - University of Minnesota Twin Cities