scholarly journals Older age groups and country-specific case fatality rates of COVID-19 in Europe, USA and Canada

Infection ◽  
2020 ◽  
Author(s):  
Christian Hoffmann ◽  
Eva Wolf

Abstract Purpose To evaluate the association between the percentages of older age groups among confirmed SARS-CoV-2 infections and the country-specific case fatality rate (CFR). Methods This ecological study analyzed data from the 20 most severely affected European countries, USA and Canada, in which national health authorities provided data on age distribution and gender among confirmed SARS-CoV-2 cases and deaths. Results The proportion of individuals older than 70 years among confirmed SARS-CoV-2 cases differed markedly between the countries, ranging from 4.9 to 40.4%. There was a strong linear association between the proportion of individuals older than 75 years and the country-specific CFRs (R2 = 0.803 for all countries, R2 = 0.961 after exclusion of three countries with incongruent data). Each 5% point increase of this older age group among confirmed SARS-CoV-2 cases was associated with an increase in CFR of 2.5% points (95% CI 1.9–3.1). Conclusion Data from 20 European countries and the USA and Canada showed that the variance of crude CFR of COVID-19 is predominantly (80–96%) determined by the proportion of older individuals who are diagnosed with SARS-CoV-2. The age distribution of SARS-CoV-2 infections is still far from being homogeneous. Detailed demographic data have to be taken into account in all the analyses on COVID-19-associated mortality. We urgently call for standardized data collection by national health authorities.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christian Staerk ◽  
Tobias Wistuba ◽  
Andreas Mayr

Abstract Background The infection fatality rate (IFR) of the Coronavirus Disease 2019 (COVID-19) is one of the most discussed figures in the context of this pandemic. In contrast to the case fatality rate (CFR), the IFR depends on the total number of infected individuals – not just on the number of confirmed cases. In order to estimate the IFR, several seroprevalence studies have been or are currently conducted. Methods Using German COVID-19 surveillance data and age-group specific IFR estimates from multiple international studies, this work investigates time-dependent variations in effective IFR over the course of the pandemic. Three different methods for estimating (effective) IFRs are presented: (a) population-averaged IFRs based on the assumption that the infection risk is independent of age and time, (b) effective IFRs based on the assumption that the age distribution of confirmed cases approximately reflects the age distribution of infected individuals, and (c) effective IFRs accounting for age- and time-dependent dark figures of infections. Results Effective IFRs in Germany are estimated to vary over time, as the age distributions of confirmed cases and estimated infections are changing during the course of the pandemic. In particular during the first and second waves of infections in spring and autumn/winter 2020, there has been a pronounced shift in the age distribution of confirmed cases towards older age groups, resulting in larger effective IFR estimates. The temporary increase in effective IFR during the first wave is estimated to be smaller but still remains when adjusting for age- and time-dependent dark figures. A comparison of effective IFRs with observed CFRs indicates that a substantial fraction of the time-dependent variability in observed mortality can be explained by changes in the age distribution of infections. Furthermore, a vanishing gap between effective IFRs and observed CFRs is apparent after the first infection wave, while an increasing gap can be observed during the second wave. Conclusions The development of estimated effective IFR and observed CFR reflects the changing age distribution of infections over the course of the COVID-19 pandemic in Germany. Further research is warranted to obtain timely age-stratified IFR estimates, particularly in light of new variants of the virus.


PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261061
Author(s):  
Diego Casas-Deza ◽  
Vanesa Bernal-Monterde ◽  
Angel Nicolás Aranda-Alonso ◽  
Enrique Montil-Miguel ◽  
Ana Belen Julián-Gomara ◽  
...  

Background Risk for severe COVID-19 increases with age. Different vaccination strategies are currently being considered, including those aimed at slowing down transmission and those aimed at providing direct protection to those most at risk. Methods The objectives of the current study were i) to assess age-related incidence and survival between PCR-diagnosed COVID-19 cases (n = 61,993) in the Autonomous Community of Aragon from March to November 2020, and ii) to characterize age differences regarding the course of the disease in hospitalized patients in a tertiary university hospital. Results We found a similar incidence of COVID-19 in individuals between 10 and 79 years. Incidence increased in those over 80 years possibly because of the elevated transmission within the nursing homes. We observed a profound disparity among age groups; case fatality rates (CFRs) were near 0 in cases younger than 39 years throughout different waves. In contrast, there was an age-dependent and progressive increase in the CFRs, especially during the first pandemic wave. SARS-CoV-2 infection caused a more severe and rapid progression in older patients. The elderly required faster hospitalization, presented more serious symptoms on admission, and had a worse clinical course. Hospitalized older individuals, even without comorbidities, had an increased mortality risk directly associated with their age. Lastly, the existence of comorbidities dramatically increased the CFRs in the elderly, especially in males. Conclusion The elevated incidence of COVID-19 and the vulnerability of the elderly call for their prioritization in vaccination and targeted prevention measures specifically focused on this aged population.


2020 ◽  
pp. 1-23
Author(s):  
Kirsti Melesk

Abstract Institutional contexts shape learning participation throughout the course of life. Combining micro-data on adult education from 26 European countries with country-level indicators on retirement systems in multi-level logistic regression models, the focus is on analysis of participation in non-formal learning among people aged 50–64 and its interactions with retirement policies. The analysis makes use of the largest sample of European countries used so far for exploring the issue. For the first time, gender differences in retirement policies are considered. The results imply that for all women and highly educated men, participation in non-formal training is higher when retirement age in the country is set at 65 years or higher. However, men with less education do not profit from a higher retirement age because their training participation remains unaffected by retirement policies. In the current analysis, training participation in older age groups remains unaffected by the generosity of pensions. The results outline gender differences in learning participation in older age groups. Also, after the age of 50, men with a low education are at particular risk of labour market exclusion and unemployment because the retirement age in European countries keeps rising and technological advancements make additional demands on workers’ skills.


2007 ◽  
Vol 56 (4) ◽  
pp. 533-537 ◽  
Author(s):  
Yu-Chi Lin ◽  
Shu-Man Yao ◽  
Jer-Jea Yan ◽  
Ying-Yan Chen ◽  
Chuen-Sheue Chiang ◽  
...  

In Taiwan, routine pertussis immunization has been implemented for more than 40 years and a low incidence of pertussis was maintained until an 80-fold increase in cases occurred in 1992. The unexpected increase emphasized the significance of pertussis. This study evaluated a total of 2452 reported cases of pertussis during 1993–2004 and surveillance data on incidence, age distribution and seasonality. The highest morbidity was in infants aged <1 year, and upward trends in the incidence of pertussis were significant for infants aged <1 year and adolescents aged 10–14 years. The highest mean number of cases was observed in August and upward trends were in colder months. This study indicates that the epidemiology of pertussis may have been changed by waning immunity in Taiwan. Increased surveillance activities, especially in older age groups, and additional booster doses of acellular pertussis vaccine for children aged 6–8 years and adolescents/young adults aged 15–20 years are necessary to control and prevent pertussis.


1954 ◽  
Vol 44 (6) ◽  
pp. 658-664 ◽  
Author(s):  
Morris Siegel ◽  
Morris Greenberg

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11236
Author(s):  
Jia-Cih Kang ◽  
Chien-Hsiang Lin ◽  
Chun-Hsiang Chang

Dental material attributed to Palaeoloxodon huaihoensis from the Middle to Late Pleistocene were recovered over decades from the Penghu Channel during commercial fisheries activities. The National Museum of Nature Science (NMNS) has a collection of such dental material, which differs in size and morphology and likely represents ontogenetic variation and growth trajectory of various age groups of P. huaihoensis. However, little is known regarding age determination. By using length of dental material, enamel thickness (ET), and plate counts, we established the method to distinguish the age of the species, which is directly derived from the extant African forest elephant Loxodonta africana. When measuring signs of allometric growth, we found that in both the upper and lower jaws, tooth width was correlated negatively with lamellar frequency but positively with ET. In the same age group, the number of lamellae was higher in P. huaihoensis than in L. africana. The reconstructed age distribution indicated no difference in the upper or lower jaw. Notably, within our sample, P. huaihoensis is skewed towards adult and older individuals with median age between 33–34.5 years and differed significantly from that of Mammuthus primigenius in the European Kraków Spadzista site. This age distribution pattern is speculated to be related to the harsh environmental conditions and intense intraspecific competition among P. huaihoensis during the last ice age.


2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Roger Morbey ◽  
Alex J. Elliot ◽  
Gillian E. Smith

ObjectiveTo investigate whether aberration detection methods for syndromicsurveillance would be more useful if data were stratified by age band.IntroductionWhen monitoring public health incidents using syndromicsurveillance systems, Public Health England (PHE) uses the ageof the presenting patient as a key indicator to further assess theseverity, impact of the incident, and to provide intelligence on thelikely cause. However the age distribution of cases is usually notconsidered until after unusual activity has been identified in the all-ages population data. We assessed whether monitoring specific agegroups contemporaneously could improve the timeliness, specificityand sensitivity of public health surveillance.MethodsFirst, we examined a wide range of health indicators from the PHEsyndromic surveillance systems to identify for further study thosewith the greatest seasonal variation in the age distribution of cases.Secondly, we examined the identified indicators to ascertain whetherany age bands consistently lagged behind other age bands. Finally,we applied outbreak detection methods retrospectively to age specificdata, identifying periods of increased activity that were only detectedor detected earlier when age-specific surveillance was used.ResultsSeasonal increases in respiratory indicators occurred first inyounger age groups, with increases in children under 5 providingearly warning of subsequent increases occurring in older age groups.Also, we found age specific indicators improved the specificity ofsurveillance using indicators relating to respiratory and eye problems;identifying unusual activity that was less apparent in the all-agespopulation.ConclusionsRoutine surveillance of respiratory indicators in young childrenwould have provided early warning of increases in older age groups,where the burden on health care usage, e.g. hospital admissions, isgreatest. Furthermore this cross-correlation between ages occurredconsistently even though the age distribution of the burden ofrespiratory cases varied between seasons. Age specific surveillancecan improve sensitivity of outbreak detection although all-agesurveillance remains more powerful when case numbers are low.


2020 ◽  
Vol 14 (11) ◽  
pp. e0008771
Author(s):  

Global efforts to control morbidity associated with soil-transmitted helminth infections (STH) have focused largely on the targeted treatment of high-risk groups, including children and pregnant women. However, it is not clear when such programs can be discontinued and there are concerns about the sustainability of current STH control programs. The DeWorm3 project is a large multi-country community cluster randomized trial in Benin, India and Malawi designed to determine the feasibility of interrupting the transmission of STH using community-wide delivery of mass drug administration (MDA) with anthelmintics over multiple rounds. Here, we present baseline data and estimate key epidemiological parameters important in determining the likelihood of transmission interruption in the DeWorm3 trial. A baseline census was conducted in October-December 2017 in India, November-December 2017 in Malawi and in January-February 2018 in Benin. The baseline census enumerated all members of each household and collected demographic data and information on occupation, assets, and access to water, sanitation and hygiene (WASH). Each study site was divided into 40 clusters of at least 1,650 individuals per cluster. Clusters were randomized to receive twice yearly community-wide MDA with albendazole (GSK) targeting eligible individuals of all ages (20 clusters), or to receive the standard-of-care deworming program targeting children provided in each country. In each site, a randomly selected group of 150 individuals per cluster (6,000 total per site) was selected from the baseline census using stratified random sampling, and each individual provided a single stool sample for analysis of STH infection using the Kato-Katz technique. Study site, household and individual characteristics were summarized as appropriate. We estimated key epidemiological parameters including the force of infection and the degree of parasite aggregation within the population. The DeWorm3 sites range in population from 94,969 to 140,932. The population age distribution varied significantly by site, with the highest proportion of infants and young children in Malawi and the highest proportion of adults in India. The baseline age- and cluster-weighted prevalence, as measured by Kato-Katz, varied across sites and by species, Baseline hookworm prevalence in India was 21.4% (95% CI: 20.4–22.4%), while prevalence of Ascaris and Trichuris by Kato-Katz was low (0.1% and 0.3% overall). In Malawi, the overall age- and cluster-weighted STH prevalence was 7.7% (95% CI: 7.1–8.4%) predominantly driven by hookworm infections (7.4%) while Ascaris (0.1%) and Trichuris (0.3%) infections were rare. In Benin, the overall age- and cluster-weighted prevalence was significantly lower (5.6%, 95% CI: 5.1–6.2%) and Ascaris (2.0%, 95% CI: 1.6–2.3%) was more common than in other sites. Ascaris infections were more likely to be moderate- or heavy-intensity (43.7%, unweighted) compared to hookworm (5.0%). The force of infection for hookworm was highest in adults in India and Malawi but appeared relatively stable across age groups in Benin. These data demonstrate the significant variability between the sites in terms of demography, socio-economic status and environmental characteristics. In addition, the baseline prevalence and intensity data from DeWorm3 suggest that each site has unique epidemiologic characteristics that will be critical in determining correlates of achieving STH transmission interruption in the DeWorm3 trial. Trial registration: The trial was registered at ClinicalTrials.gov (NCT03014167).


Author(s):  
Anthony Medford ◽  
Sergi Trias-Llimós

AbstractTo date any attention paid to the age shape of COVID-19 deaths has been mostly in relation to attempts to understand the differences in case fatality rates between countries. The aim of this paper is to explore differences in age distribution of deaths from COVID-19 among European countries which have old age structures. We do this by way of a cross-country comparison and put forward some reasons for potential differences.


2021 ◽  
pp. 1-15
Author(s):  
Mohammad Tahseen Al Bataineh ◽  
Ayman Alzaatreh ◽  
Rima Hajjo ◽  
Bayan Hassan Banimfreg ◽  
Nihar Ranjan Dash

BACKGROUND: Age-related alterations in the composition and function of gut microbiota may influence human health and disease mechanisms. However, connections between compositional changes in gut bacterial and fungal communities, and their role in the aging process, remain poorly understood. OBJECTIVE: Compare the gut microbiota and mycobiota composition in different age groups and evaluate the functionality. METHODS: In this study, we performed 16S rRNA and ITS2 gene-based microbial profiling analysis and shotgun metagenomics using the NextSeq platform. RESULTS: We observed a shift in compositional changes of human gut microbiota with age. Older individuals revealed a significantly different gut microbiota profile compared to younger individuals. For example, gut microbiota composition of the older individuals showed increase in genera Bacteroides, Blautia, Ruminococcaceae, and Escherichia coli. Additionally, older individuals had significant reduction in fungi belonging to saccharomyces cerevisiae and candida albicans in comparison to their younger counterparts. Moreover, metagenomics functional profiling analysis using shotgun metagenomics sequencing data showed substantial differences in the enrichment of 48 pathways between the young and older age groups. Metabolic pathways such as amino acid biosynthesis, carbohydrate metabolism, cell structure biosynthesis and vitamin biosynthesis were declined in the older age group, in comparison with the younger individuals. CONCLUSIONS: The identified differences provide a new insight to enrich our understanding of age-related changes in gut microbiota, their metabolic capabilities, and potential impact on health and disease conditions.


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