Medical College of Wisconsin, Milwaukee, Wisconsin,
Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.
WMJ. 2023 Dec;122(5):456-463.
Wisconsin experienced overlapping and accelerating epidemics of opioid use and COVID-19 after March 2020. We hypothesized that Wisconsin neonatal abstinence syndrome rates increased after March 2020 alongside other markers of opioid burden.
Retrospective cohort analysis examined deidentified Wisconsin census, birth certificate, death certificate, hospital discharge, Prescription Drug Monitoring Program, emergency medical service run, and COVID-19 diagnosis records spanning January 1, 2019, through December 31, 2021. January 2019 through March 2020 was considered before the onset of COVID-19 (pre); April 2020 through December 2021 was considered post-onset of COVID-19 (post). Wisconsin Department of Health Services guidelines defined 5 Wisconsin regions. Rates pre- to post-onset were compared with values < 0.05 considered statistically significant.
Of 1362 patients, 83.3% completed a COVID-19 vaccination series. Younger patients had increased odds of not completing a COVID-19 vaccination series (mean [SD] 46.7 [14.7] vs 54.3 [15.8]; OR 1.03; 95% CI, 1.02-1.04; < 0.001). Those who identified as non-White (1.88; 95% CI, 1.16-3.04; P = 0.010) or current smoker (1.85, 95% CI, 1.85-2.79; P = 0.004) had increased odds of not completing a COVID-19 vaccination series. Those who resided in rural ZIP codes (1.81; 95% CI, 1.35-2.43; < 0.001), had not received a 2019-2020 influenza vaccine (5.13; 95% CI, 3.79-6.96; < 0.001), or had lower comorbidity scores (2.95; 95% CI, 1.98-4.41; < 0.001) had higher odds of not completing a COVID-19 vaccination series.
Opioid-associated morbidity and mortality increased in Wisconsin during the study period, including among females age 15 to 44 years. Despite increased opioid burden, neonatal abstinence syndrome incidence decreased in the Southeastern Region. Ongoing neonatal abstinence syndrome and opioid analysis may benefit from region-based contextualization.
2020 年 3 月后，威斯康星州经历了阿片类药物使用和 COVID-19 的重叠和加速流行。我们假设，威斯康星州的新生儿戒断综合征发生率在 2020 年 3 月后与其他阿片类药物负担指标一起增加。
回顾性队列分析研究了 2019 年 1 月 1 日至 2021 年 12 月 31 日跨越的威斯康星州人口普查、出生证明、死亡证明、医院出院、处方药物监测计划、紧急医疗服务运行和 COVID-19 诊断记录的匿名威斯康星州记录。2020 年 4 月至 2021 年 12 月被认为是 COVID-19 发病后（后）。威斯康星州卫生服务部的指南定义了 5 个威斯康星州地区。发病前到发病后的比率与值<0.05 相比有统计学意义。
在 1362 名患者中，83.3%完成了 COVID-19 疫苗系列接种。年龄较小的患者完成 COVID-19 疫苗系列接种的可能性较低（平均[SD]46.7[14.7]vs 54.3[15.8]；OR 1.03；95%CI，1.02-1.04；<0.001）。那些被认定为非白人（1.88；95%CI，1.16-3.04；P=0.010）或当前吸烟者（1.85，95%CI，1.85-2.79；P=0.004）的人完成 COVID-19 疫苗系列接种的可能性增加。那些居住在农村邮政编码（1.81；95%CI，1.35-2.43；<0.001）、未接种 2019-2020 年流感疫苗（5.13；95%CI，3.79-6.96；<0.001）或合并症评分较低（2.95；95%CI，1.98-4.41；<0.001）的患者完成 COVID-19 疫苗系列接种的可能性更高。
在研究期间，威斯康星州的阿片类药物相关发病率和死亡率增加，包括 15 至 44 岁的女性。尽管阿片类药物负担增加，但东南地区的新生儿戒断综合征发病率下降。正在进行的新生儿戒断综合征和阿片类药物分析可能受益于基于区域的背景化。
