Manuela DiFusco

Ms. Manuela DiFusco

orcid

Research Focus & Metrics

Academic Career Length

7Years (2020-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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1 January 2021 in Journal of Medical Economics
Verified
Journal Article
Open access
MDManuela DiFusco
Manuela DiFusco
KSKimberly M. Shea
Kimberly M. Shea
JLJay Lin
Jay Lin
JNJennifer L. Nguyen
Jennifer L. Nguyen
FAFrederick J. Angulo
Frederick J. Angulo
ACApostolos Charos
Apostolos Charos
The aims of this study were to evaluate health outcomes and the economic burden of hospitalized COVID-19 patients in the United States.Hospitalized patients with a primary or secondary discharge di...

3 February 2022 in Expert Review of Vaccines
Verified
Journal Article
Open access
MDManuela DiFusco
Manuela DiFusco
JLJay Lin
Jay Lin
SVShailja Vaghela
Shailja Vaghela
MLMelissa Lingohr-Smith
Melissa Lingohr-Smith
JNJennifer L. Nguyen
Jennifer L. Nguyen
MMMary M. Moran
Mary M. Moran
From July through October of 2021, several countries issued recommendations for increased COVID-19 vaccine protection for individuals with one or more immunocompromised (IC) conditions. It is criti...

1 January 2021 in Journal of Medical Economics
Verified
Journal Article
Open access
MDManuela DiFusco
Manuela DiFusco
MMMary M. Moran
Mary M. Moran
ACAlejandro Cane
Alejandro Cane
DCDaniel Curcio
Daniel Curcio
FKFarid Khan
Farid Khan
JNJennifer L. Nguyen
Jennifer L. Nguyen
To evaluate COVID-19 vaccine breakthrough infections among immunocompromised (IC) individuals.Individuals vaccinated with BNT162b2 were selected from the US HealthVerity database (10 December 2020 ...

15 May 2022 in Journal of Medical Economics
Verified
Journal Article
Open access
MDManuela DiFusco
Manuela DiFusco
KMKinga Marczell
Kinga Marczell
KDKristen A. Deger
Kristen A. Deger
MMMary M. Moran
Mary M. Moran
TWTimothy L. Wiemken
Timothy L. Wiemken
JRJulie Roiz
Julie Roiz
As the body of evidence on COVID-19 and post-vaccination outcomes continues to expand, this analysis sought to evaluate the public health impact of the Pfizer-BioNTech COVID-19 Vaccine, BNT162b2, d...

5 December 2022 in Journal of Patient-Reported Outcomes
Verified
Journal Article
Open access
PDF file
MDManuela DiFusco
Manuela DiFusco
XSXiaowu Sun
Xiaowu Sun
MMMary M. Moran
Mary M. Moran
HCHenriette Coetzer
Henriette Coetzer
JZJoann M. Zamparo
Joann M. Zamparo
JCJoseph C. Cappelleri
Joseph C. Cappelleri
Background: Although there is extensive literature on the clinical benefits of COVID-19 vaccination, data on humanistic effects are limited. This study evaluated the impact of SARS-CoV-2 infection on symptoms, Health-Related Quality of Life (HRQoL) and Work Productivity and Impairment (WPAI) prior to and one month following infection between individuals vaccinated with BNT162b2 and those unvaccinated. Methods: Subjects with ≥ 1 self-reported symptom and positive RT-PCR for SARS-CoV-2 at CVS Health US test sites were recruited between 01/31/2022 and 04/30/2022. Socio-demographics, clinical characteristics and vaccination status were evaluated. Self-reported symptoms, HRQoL, and WPAI outcomes were assessed using questionnaires and validated instruments (EQ-5D-5L, WPAI-GH) across acute COVID time points from pre-COVID to Week 4, and between vaccination groups. Mixed models for repeated measures were conducted for multivariable analyses, adjusting for several covariates. Effect size (ES) of Cohen’s d was calculated to quantify the magnitude of outcome changes within and between vaccination groups. Results: The study population included 430 subjects: 197 unvaccinated and 233 vaccinated with BNT162b2. Mean (SD) age was 42.4 years (14.3), 76.0% were female, 38.8% reported prior infection and 24.2% at least one comorbidity. Statistically significant differences in outcomes were observed compared with baseline and between groups. The EQ-Visual analogue scale scores and Utility Index dropped in both cohorts at Day 3 and increased by Week 4 but did not return to pre-COVID levels. The mean changes were statistically lower in the BNT162b2 cohort at Day 3 and Week 4. The BNT162b2 cohort reported lower prevalence and fewer symptoms at index date and Week 4. At Week 1, COVID-19 had a large impact on all WPAI-GH domains: the work productivity time loss among unvaccinated and vaccinated was 65.0% and 53.8%, and the mean activity impairment was 50.2% and 43.9%, respectively. Except for absenteeism at Week 4, the BNT162b2 cohort was associated with statistically significant less worsening in all WPAI-GH scores at both Week 1 and 4. Conclusions: COVID-19 negatively impacted HRQoL and work productivity among mildly symptomatic outpatients. Compared with unvaccinated, those vaccinated with BNT162b2 were less impacted by COVID-19 infection and recovered faster.

24 July 2023 in Journal of Patient-Reported Outcomes
Verified
Journal Article
Open access
PDF file
MDManuela DiFusco
Manuela DiFusco
XSXiaowu Sun
Xiaowu Sun
MMMary M. Moran
Mary M. Moran
HCHenriette Coetzer
Henriette Coetzer
JZJoann M. Zamparo
Joann M. Zamparo
JCJoseph C. Cappelleri
Joseph C. Cappelleri
Background: Longitudinal estimates of long COVID burden during Omicron remain limited. This study characterized long-term impacts of COVID-19 and booster vaccination on symptoms, Health-Related Quality of Life (HRQoL), and Work Productivity Activity Impairment (WPAI). Methods: Outpatients with ≥ 1 self-reported symptom and positive SARS-CoV-2 test at CVS Health United States test sites were recruited between 01/31 and 04/30/2022. Symptoms, EQ-5D and WPAI were collected via online surveys until 6 months following infection. Both observed and model-based estimates were analyzed. Effect sizes based on Cohen’s d quantified the magnitude of outcome changes over time, within and between vaccination groups. Mixed models for repeated measures were conducted for multivariable analyses, adjusting for covariates. Logistic regression assessed odds ratio (OR) of long COVID between vaccination groups. Results: At long COVID start (Week 4), 328 participants included 87 (27%) Boosted with BNT162b2, 86 (26%) with a BNT162b2 primary series (Primed), and 155 (47%) Unvaccinated. Mean age was 42.0 years, 73.8% were female, 26.5% had ≥ 1 comorbidity, 36.9% prior infection, and 39.6% reported ≥ 3 symptoms (mean: 3.1 symptoms). At Month 6, among 260 participants, Boosted reported a mean of 1.1 symptoms versus 3.4 and 2.8 in Unvaccinated and Primed, respectively (p < 0.001). Boosted had reduced risks of ≥ 3 symptoms versus Unvaccinated (observed: OR 0.22, 95% CI 0.10–0.47, p < 0.001; model-based: OR 0.36, 95% CI 0.15–0.87, p = 0.019) and Primed (observed: OR 0.29, 95% CI 0.13–0.67, p = 0.003; model-based: OR 0.59, 95% CI 0.21–1.65, p = 0.459). Results were consistent using ≥ 2 symptoms. Regarding HRQoL, among those with long COVID, Boosted had higher EQ-5D Utility Index (UI) than Unvaccinated (observed: 0.922 vs. 0.731, p = 0.014; model-based: 0.910 vs. 0.758, p-value = 0.038) and Primed (0.922 vs. 0.648, p = 0.014; model-based: 0.910 vs. 0.708, p-value = 0.008). Observed and model-based estimates for EQ-VAS and UI among Boosted were comparable with pre-COVID since Month 3. Subjects vaccinated generally reported better WPAI scores. Conclusions: Long COVID negatively impacted HRQoL and WPAI. The BNT162b2 booster could have a beneficial effect in reducing the risk and burden of long COVID. Boosted participants reported fewer and less durable symptoms, which contributed to improve HRQoL and maintain WPAI levels. Limitations included self-reported data and small sample size for WPAI.