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Background:
Early reports indicate that AKI is common among patients with coronavirus disease 2019 (COVID-19) and associatedwith worse outcomes. However, AKI among hospitalized patients with COVID19 in the United States is not well described.
Methods:
This retrospective, observational study involved a review of data from electronic health records of patients aged >= 18 years with laboratory-confirmed COVID-19 admitted to the Mount Sinai Health System from February 27 to May 30, 2020. We describe the frequency of AKI and dialysis requirement, AKI recovery, and adjusted odds ratios (aORs) with mortality.
Results:
Of 3993 hospitalized patients with COVID-19, AKI occurred in 1835 (46%) patients; 347 (19%) of the patientswith AKI required dialysis. The proportionswith stages 1, 2, or 3 AKIwere 39%, 19%, and 42%, respectively. A total of 976 (24%) patients were admitted to intensive care, and 745 (76%) experienced AKI. Of the 435 patients with AKI and urine studies, 84% had proteinuria, 81% had hematuria, and 60% had leukocyturia. Independent predictors of severe AKI were CKD, men, and higher serum potassium at admission. In-hospital mortality was 50% among patients with AKI versus 8% among those without AKI (aOR, 9.2; 95% confidence interval, 7.5 to 11.3). Of survivors with AKI who were discharged, 35% had not recovered to baseline kidney function by the time of discharge. An additional 28 of 77 (36%) patients who had not recovered kidney function at discharge did so on posthospital follow-up.
Conclusions:
AKI is common among patients hospitalized with COVID-19 and is associated with high mortality. Of all patients with AKI, only 30% survived with recovery of kidney function by the time of discharge.
COVID-19
(2021)
We investigate how the economic consequences of the pandemic and the government-mandated measures to contain its spread affect the self-employed — particularly women — in Germany. For our analysis, we use representative, real-time survey data in which respondents were asked about their situation during the COVID-19 pandemic. Our findings indicate that among the self-employed, who generally face a higher likelihood of income losses due to COVID-19 than employees, women are about one-third more likely to experience income losses than their male counterparts. We do not find a comparable gender gap among employees. Our results further suggest that the gender gap among the self-employed is largely explained by the fact that women disproportionately work in industries that are more severely affected by the COVID-19 pandemic. Our analysis of potential mechanisms reveals that women are significantly more likely to be impacted by government-imposed restrictions, e.g., the regulation of opening hours. We conclude that future policy measures intending to mitigate the consequences of such shocks should account for this considerable variation in economic hardship.
We investigate how the economic consequences of the pandemic, and of the government-mandated measures to contain its spread, affect the self-employed – particularly women – in Germany. For our analysis, we use representative, real-time survey data in which respondents were asked about their situation during the COVID-19 pandemic. Our findings indicate that among the self-employed, who generally face a higher likelihood of income losses due to COVID-19 than employees, women are 35% more likely to experience income losses than their male counterparts. Conversely, we do not find a comparable gender gap among employees. Our results further suggest that the gender gap among the self-employed is largely explained by the fact that women disproportionately work in industries that are more severely affected by the COVID-19 pandemic. Our analysis of potential mechanisms reveals that women are significantly more likely to be impacted by government-imposed restrictions, i.e. the regulation of opening hours. We conclude that future policy measures intending to mitigate the consequences of such shocks should account for this considerable variation in economic hardship.
Die vorliegende Studie zeigt, dass Daten in der Krise eine herausragende Bedeutung für die wissenschaftliche Politikberatung, administrative Entscheidungsvorbereitung und politische Entscheidungsfindung haben. In der Krise gab es jedoch gravierende Kommunikationsprobleme und Unsicherheiten in der wechselseitigen Erwartungshaltung von wissenschaftlichen Datengebern und politisch-administrativen Datennutzern. Die Wissensakkumulation und Entscheidungsabwägung wurde außerdem durch eine unsichere und volatile Datenlage zum Pandemiegeschehen, verbunden mit einer dynamischen Lageentwicklung, erschwert. Nach wie vor sind das Bewusstsein und wechselseitige Verständnis für die spezifischen Rollenprofile der am wissenschaftlichen Politikberatungsprozess beteiligten Akteure sowie insbesondere deren Abgrenzung als unzureichend einzuschätzen.
Die Studie hat darüber hinaus vielfältige Defizite hinsichtlich der Verfügbarkeit, Qualität, Zugänglichkeit, Teilbarkeit und Nutzbarkeit von Daten identifiziert, die Datenproduzenten und -verwender vor erhebliche Herausforderungen stellen und einen umfangreichen Reformbedarf aufzeigen, da zum einen wichtige Datenbestände für eine krisenbezogene Politikberatung fehlen. Zum anderen sind die Tiefenschärfe und Differenziertheit des verfügbaren Datenbestandes teilweise unzureichend. Dies gilt z.B. für sozialstrukturelle Daten zur Schwere der Pandemiebetroffenheit verschiedener Gruppen oder für kleinräumige Daten über Belastungs- und Kapazitätsparameter, etwa zur Personalabdeckung auf Intensivstationen, in Gesundheitsämtern und Pflegeeinrichtungen. Datendefizite sind ferner im Hinblick auf eine ganzheitliche Pandemiebeurteilung festzustellen, zum Beispiel bezüglich der Gesundheitseffekte im weiteren Sinne, die aufgrund der ergriffenen Maßnahmen entstanden sind (Verschiebung oder Wegfall von Operationen, Behandlungen und Prävention, aber auch häusliche Gewalt und psychische Belastungen). Mangels systematischer Begleitstudien und evaluativer Untersuchungen, u.a. auch zu lokalen Pilotprojekten und Experimenten, bestehen außerdem Datendefizite im Hinblick auf die Wirkungen von Eindämmungsmaßnahmen oder deren Aufhebung auf der gebietskörperschaftlichen Ebene.
Insgesamt belegt die Studie, dass es zur Optimierung der datenbasierten Politikberatung und politischen Entscheidungsfindung in und außerhalb von Krisen nicht nur darum gehen kann, ein „Mehr“ an Daten zu produzieren sowie deren Qualität, Verknüpfung und Teilung zu verbessern. Vielmehr müssen auch die Anreizstrukturen und Interessenlagen in Politik, Verwaltung und Wissenschaft sowie die Kompetenzen, Handlungsorientierungen und kognitiv-kulturellen Prägungen der verschiedenen Akteure in den Blick genommen werden. Es müssten also Anreize gesetzt und Strukturen geschaffen werden, um das Interesse, den Willen und das Können (will and skill) zur Datennutzung auf Seiten politisch-administrativer Entscheider und zur Dateneinspeisung auf Seiten von Wissenschaftlern zu stärken. Neben adressatengerechter Informationsaufbereitung geht es dabei auch um die Gestaltung eines normativen und institutionellen Rahmens, innerhalb dessen die Nutzung von Daten für Entscheidungen effektiver, qualifizierter, aber auch transparenter, nachvollziehbarer und damit demokratisch legitimer erfolgen kann.
Vor dem Hintergrund dieser empirischen Befunde werden acht Cluster von Optimierungsmaßnahmen vorgeschlagen:
(1) Etablierung von Datenstrecken und Datenteams,
(2) Schaffung regionaler Datenkompetenzzentren,
(3) Stärkung von Data Literacy und Beschleunigung des Kulturwandels in der öffentlichen Verwaltung,
(4) Datenstandardisierung, Interoperabilität und Registermodernisierung,
(5) Ausbau von Public Data Pools und Open Data Nutzung,
(6) Effektivere Verbindung von Datenschutz und Datennutzung,
(7) Entwicklung eines hochfrequenten, repräsentativen Datensatzes,
(8) Förderung der europäischen Daten-Zusammenarbeit.
Digital inclusion
(2021)
In this thesis, we tackle two social disruptions: recent refugee waves in Germany and the COVID-19 pandemic. We focus on the use of information and communication technology (ICT) as a key means of alleviating these disruptions and promoting social inclusion. As social disruptions typically lead to frustration and fragmentation, it is essential to ensure the social inclusion of individuals and societies during such times.
In the context of the social inclusion of refugees, we focus on the Syrian refugees who arrived in Germany as of 2015, as they form a large and coherent refugee community. In particular, we address the role of ICTs in refugees’ social inclusion and investigate how different ICTs (especially smartphones and social networks) can foster refugees’ integration and social inclusion. In the context of the COVID-19 pandemic, we focus on the widespread unconventional working model of work from home (WFH). Our research here centers on the main constructs of WFH and the key differences in WFH experiences based on personal characteristics such as gender and parental status.
We reveal novel insights through four well-established research methods: literature review, mixed methods, qualitative method, and quantitative method. The results of our research have been published in the form of eight articles in major information systems venues and journals. Key results from the refugee research stream include the following: Smartphones represent a central component of refugee ICT use; refugees view ICT as a source of information and power; the social connectedness of refugees is strongly correlated with their Internet use; refugees are not relying solely on traditional methods to learn the German language or pursue further education; the ability to use smartphones anytime and anywhere gives refugees an empowering feeling of global connectedness; and ICTs empower refugees on three levels (community participation, sense of control, and self-efficacy).
Key insights from the COVID-19 WFH stream include: Gender and the presence of children under the age of 18 affect workers’ control over their time, technology usefulness, and WFH conflicts, while not affecting their WFH attitudes; and both personal and technology-related factors affect an individual’s attitude toward WFH and their productivity. Further insights are being gathered at the time of submitting this thesis.
This thesis contributes to the discussion within the information systems community regarding how to use different ICT solutions to promote the social inclusion of refugees in their new communities and foster an inclusive society. It also adds to the growing body of research on COVID-19, in particular on the sudden workplace transformation to WFH. The insights gathered in this thesis reveal theoretical implications and future opportunities for research in the field of information systems, practical implications for relevant stakeholders, and social implications related to the refugee crisis and the COVID-19 pandemic that must be addressed.
During COVID-19, various public institutions tried to shape citizens’ behaviour to slow the spread of the pandemic. How did their authority affect citizens’ support of public measures taken to combat the spread of COVID-19? The article makes two contributions. First, it presents a novel conceptualisation of authority as a source heuristic. Second, it analyses the authority of four types of public institutions (health ministries, universities, public health agencies, the WHO) in two countries (Germany and the UK), drawing on novel data from a survey experiment conducted in May 2020. On average, institutional endorsements seem to have mattered little. However, there is an observable polarisation effect where citizens who ascribe much expertise to public institutions support COVID-19 measures more than the control group. Furthermore, those who ascribe little expertise support them less than the control group. Finally, neither perception of biases nor exposure to institutions in public debates seems consistently to affect their authority.
The coronavirus disease of 2019 (COVID-19) pandemic has forced most academics to work from home. This sudden venue change can affect academics' productivity and exacerbate the challenges that confront universities as they face an uncertain future. In this paper, we identify factors that influence academics' productivity while working from home during the mandate to self-isolate. From analyzing results from a global survey we conducted, we found that both personal and technology-related factors affect an individual's attitude toward working from home and productivity. Our results should prove valuable to university administrators to better address the work-life challenges that academics face.
Urban air pollution is a substantial threat to human health. Traffic emissions remain a large contributor to air pollution in urban areas. The mobility restrictions put in place in response to the COVID-19 pandemic provided a large-scale real-world experiment that allows for the evaluation of changes in traffic emissions and the corresponding changes in air quality. Here we use observational data, as well as modelling, to analyse changes in nitrogen dioxide, ozone, and particulate matter resulting from the COVID-19 restrictions at the height of the lockdown period in Spring of 2020. Accounting for the influence of meteorology on air quality, we found that reduction of ca. 30-50 % in traffic counts, dominated by changes in passenger cars, corresponded to reductions in median observed nitrogen dioxide concentrations of ca. 40 % (traffic and urban background locations) and a ca. 22 % increase in ozone (urban background locations) during weekdays. Lesser reductions in nitrogen dioxide concentrations were observed at urban background stations at weekends, and no change in ozone was observed. The modelled reductions in median nitrogen dioxide at urban background locations were smaller than the observed reductions and the change was not significant. The model results showed no significant change in ozone on weekdays or weekends. The lack of a simulated weekday/weekend effect is consistent with previous work suggesting that NOx emissions from traffic could be significantly underestimated in European cities by models. These results indicate the potential for improvements in air quality due to policies for reducing traffic, along with the scale of reductions that would be needed to result in meaningful changes in air quality if a transition to sustainable mobility is to be seriously considered. They also confirm once more the highly relevant role of traffic for air quality in urban areas.
This article provides a conceptual framework for the analysis of COVID-19 crisis governance in the first half of 2020 from a cross-country comparative perspective. It focuses on the issue of opportunity management, that is, how the crisis was used by relevant actors of distinctly different administrative cultures as a window of opportunity. We started from an overall interest in the factors that have influenced the national politics of crisis management to answer the question of whether and how political and administrative actors in various countries have used the crisis as an opportunity to facilitate, accelerate or prevent changes in institutional settings. The objective is to study the institutional settings and governance structures, (alleged) solutions and remedies, and constellations of actors and preferences that have influenced the mode of crisis and opportunity management. Finally, the article summarizes some major comparative findings drawn from the country studies of this Special Issue, focusing on similarities and differences in crisis responses and patterns of opportunity management.