scholarly journals Explaining among-country variation in COVID-19 case fatality rate

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Gabriele Sorci ◽  
Bruno Faivre ◽  
Serge Morand
Keyword(s):  
Case Fatality Rate ◽  
Respiratory Infections ◽  
Case Fatality ◽  
Population Level ◽  
Fatality Rate ◽  
Negatively Associated ◽  
Chronic Respiratory Diseases ◽  
Factors Associated ◽  
Increased Risk ◽  
Political Variables

Abstract While the epidemic of SARS-CoV-2 has spread worldwide, there is much concern over the mortality rate that the infection induces. Available data suggest that COVID-19 case fatality rate had varied temporally (as the epidemic has progressed) and spatially (among countries). Here, we attempted to identify key factors possibly explaining the variability in case fatality rate across countries. We used data on the temporal trajectory of case fatality rate provided by the European Center for Disease Prevention and Control, and country-specific data on different metrics describing the incidence of known comorbidity factors associated with an increased risk of COVID-19 mortality at the individual level. We also compiled data on demography, economy and political regimes for each country. We found that temporal trajectories of case fatality rate greatly vary among countries. We found several factors associated with temporal changes in case fatality rate both among variables describing comorbidity risk and demographic, economic and political variables. In particular, countries with the highest values of DALYs lost to cardiovascular, cancer and chronic respiratory diseases had the highest values of COVID-19 CFR. CFR was also positively associated with the death rate due to smoking in people over 70 years. Interestingly, CFR was negatively associated with share of death due to lower respiratory infections. Among the demographic, economic and political variables, CFR was positively associated with share of the population over 70, GDP per capita, and level of democracy, while it was negatively associated with number of hospital beds ×1000. Overall, these results emphasize the role of comorbidity and socio-economic factors as possible drivers of COVID-19 case fatality rate at the population level.

scholarly journals Meta-analysis and metaregression of risk factors associated with mortality in hip fracture patients during the COVID-19 pandemic

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Firas J. Raheman ◽  
Djamila M. Rojoa ◽  
Jvalant Nayan Parekh ◽  
Reshid Berber ◽  
Robert Ashford
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Case Fatality Rate ◽  
Excess Mortality ◽  
Meta Analysis ◽  
Case Fatality ◽  
Pooled Analysis ◽  
Fatality Rate ◽  
Increased Risk ◽  
The Impact

AbstractIncidence of hip fractures has remained unchanged during the pandemic with overlapping vulnerabilities observed in patients with hip fractures and those infected with COVID-19. We aimed to investigate the independent impact of COVID-19 infection on the mortality of these patients. Healthcare databases were systematically searched over 2-weeks from 1st–14th November 2020 to identify eligible studies assessing the impact of COVID-19 on hip fracture patients. Meta-analysis of proportion was performed to obtain pooled values of prevalence, incidence and case fatality rate of hip fracture patients with COVID-19 infection. 30-day mortality, excess mortality and all-cause mortality were analysed using a mixed-effects model. 22 studies reporting 4015 patients were identified out of which 2651 (66%) were assessed during the pandemic. An excess mortality of 10% was seen for hip fractures treated during the pandemic (OR 2.00, p = 0.007), in comparison to the pre-pandemic controls (5%). Estimated mortality of COVID-19 positive hip fracture patients was four-fold (RR 4.59, p < 0.0001) and 30-day mortality was 38.0% (HR 4.73, p < 0.0001). The case fatality rate for COVID-19 positive patients was 34.74%. Between-study heterogeneity for the pooled analysis was minimal (I2 = 0.00) whereas, random effects metaregression identified subgroup heterogeneity for male gender (p < 0.001), diabetes (p = 0.002), dementia (p = 0.001) and extracapsular fractures (p = 0.01) increased risk of mortality in COVID-19 positive patients.

scholarly journals Clinical Characteristics and Outcomes of COVID-19–Infected Cancer Patients: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Hua Zhang ◽  
Han Han ◽  
Tianhui He ◽  
Kristen E Labbe ◽  
Adrian V Hernandez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Case Fatality Rate ◽  
Meta Analysis ◽  
Univariate Analysis ◽  
Case Fatality ◽  
The United States ◽  
Fatality Rate ◽  
Patients With Cancer ◽  
Increased Risk

Abstract Background Previous studies have indicated coronavirus disease 2019 (COVID-19) patients with cancer have a high fatality rate. Methods We conducted a systematic review of studies that reported fatalities in COVID-19 patients with cancer. A comprehensive meta-analysis that assessed the overall case fatality rate and associated risk factors was performed. Using individual patient data, univariate and multivariable logistic regression analyses were used to estimate odds ratios (OR) for each variable with outcomes. Results We included 15 studies with 3019 patients, of which 1628 were men; 41.0% were from the United Kingdom and Europe, followed by the United States and Canada (35.7%), and Asia (China, 23.3%). The overall case fatality rate of COVID-19 patients with cancer measured 22.4% (95% confidence interval [CI] = 17.3% to 28.0%). Univariate analysis revealed age (OR = 3.57, 95% CI = 1.80 to 7.06), male sex (OR = 2.10, 95% CI = 1.07 to 4.13), and comorbidity (OR = 2.00, 95% CI = 1.04 to 3.85) were associated with increased risk of severe events (defined as the individuals being admitted to the intensive care unit, or requiring invasive ventilation, or death). In multivariable analysis, only age greater than 65 years (OR = 3.16, 95% CI = 1.45 to 6.88) and being male (OR = 2.29, 95% CI = 1.07 to 4.87) were associated with increased risk of severe events. Conclusions Our analysis demonstrated that COVID-19 patients with cancer have a higher fatality rate compared with that of COVID-19 patients without cancer. Age and sex appear to be risk factors associated with a poorer prognosis.

scholarly journals Decreasing case fatality rate following invasive pneumococcal disease, North East England, 2006–2016

2019 ◽  
Vol 147 ◽  
Author(s):  
C. Houseman ◽  
K. E. Chapman ◽  
P. Manley ◽  
R. Gorton ◽  
D. Wilson ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Case Fatality Rate ◽  
Pneumococcal Disease ◽  
Demographic Data ◽  
Case Fatality ◽  
Risk Groups ◽  
Significant Decline ◽  
Fatality Rate ◽  
North East ◽  
Increased Risk

AbstractDeclining mortality following invasive pneumococcal disease (IPD) has been observed concurrent with a reduced incidence due to effective pneumococcal conjugate vaccines. However, with IPD now increasing due to serotype replacement, we undertook a statistical analysis to estimate the trend in all-cause 30-day case fatality rate (CFR) in the North East of England (NEE) following IPD. Clinical, microbiological and demographic data were obtained for all laboratory-confirmed IPD cases (April 2006–March 2016) and the adjusted association between CFR and epidemiological year estimated using logistic regression. Of the 2510 episodes of IPD included in the analysis, 486 died within 30 days of IPD (CFR 19%). Increasing age, male sex, a diagnosis of septicaemia, being in ⩾1 clinical risk groups, alcohol abuse and individual serotypes were independently associated with increased CFR. A significant decline in CFR over time was observed following adjustment for these significant predictors (adjusted odds ratio 0.93, 95% confidence interval 0.89–0.98; P = 0.003). A small but significant decline in 30-day all-cause CFR following IPD has been observed in the NEE. Nonetheless, certain population groups remain at increased risk of dying following IPD. Despite the introduction of effective vaccines, further strategies to reduce the ongoing burden of mortality from IPD are needed.

scholarly journals Protection offered by COVID-19 vaccines in reducing SARS-CoV-2 infection frequency; severity and mortality, among Indian Healthcare Workers: Multicenter, pan-Fortis study

2021 ◽  
Author(s):  
Subrat Acharya ◽  
Gaurav Mahindra ◽  
Purushottam Nirala ◽  
Sulabh Tripathi ◽  
Bishnu Panigrahi ◽  
...  
Keyword(s):  
General Population ◽  
Healthcare Workers ◽  
Case Fatality Rate ◽  
Population Control ◽  
Real Life ◽  
Case Fatality ◽  
Infection Frequency ◽  
Fatality Rate ◽  
Indian States ◽  
Increased Risk

Abstract During COVID-19 pandemic, Healthcare Workers (HCWs) were at increased risk for exposure to SARS-CoV-2 virus and prioritized for early administration of COVID-19 vaccines in India. Real-life scenario information among vaccinated HCWs acquiring COVID-19 infection, is scarce. We retrospectively analyzed COVID-19 infection frequency, severity, and associated mortality among healthcare workers, immunized with either Covishield or Covaxin vaccines at 27 Fortis Hospitals across 11 Indian states. Positive cases were identified based on RT-PCR or rapid antigen tests for SARS-CoV-2 between 16th January 2021 till 15th May 2021. 20034 HCWs received vaccination. 3971 received 1 dose, 16063 received 2 doses. Post-vaccination, 1139 HCWs acquired COVID-19 infection, 180 (4.53%) and 959 (5.97%) among partially and fully vaccinated category, respectively. Breakthrough infection occurred among 913 (5.68%) HCWs. Concurrently, Case Positivity Rate was 11.9%, among general population (control). Among 1139 positive cases, mild, moderate, and severe infections were 1059 (93%), 71 (6.2%) and 9 (0.8%), respectively with Case Fatality Rate of 0.18%, compared to 0.92% among general population (p=0.0043). The Case Fatality Rate in vaccinated HCWs was found to be 80% less than that in general population (control). Hence, COVID-19 vaccines available in India seem to be effective against SARS-CoV-2 virus.

scholarly journals Global Epidemiology of First 90 Days into COVID-19 Pandemic: Disease Incidence, Prevalence, Case Fatality Rate and Their Association with Population Density, Urbanisation and Elderly Population

2020 ◽  
Vol 22 (2) ◽  
pp. 117-128 ◽  
Author(s):  
Shivam Gupta ◽  
Kamalesh Kumar Patel ◽  
Shobana Sivaraman ◽  
Abha Mangal
Keyword(s):  
Population Density ◽  
Case Fatality Rate ◽  
Elderly Population ◽  
Disease Incidence ◽  
Case Fatality ◽  
Population Level ◽  
Epidemiological Data ◽  
Fatality Rate ◽  
Global Epidemiology ◽  
First 90 Days

As the COVID-19 pandemic marches exponentially, epidemiological data is of high importance to analyse the current situation and guide intervention strategies. This study analyses the epidemiological data of COVID-19 from 17 countries, representing 85 per cent of the total cases within first 90 days of lockdown in Wuhan, China. It follows a population-level observational study design and includes countries with 20,000 cases (or higher) as of 21 April 2020. We sourced the data for these 17 countries from worldometers. info, a digital platform being used by several media and reputed academic institutions worldwide. We calculated the prevalence, incidence, case fatality rate and trends in the epidemiology of COVID-19, and its correlation with population density, urbanisation and elderly population. The analysis represents 85 per cent ( N = 2,183,661) of all cases within the first 90 days of the pandemic. Across the analysed period, the burden of the pandemic primarily focused on high- and middle-income countries of Asia, Europe and North America. While the total number of cases and deaths are highest in USA, the prevalence, incidence and case fatality rates are higher in the European countries. The prevalence and incidence vary widely among countries included in the analysis, and the number of cases per million and the case fatality rate are correlated with the proportion of the elderly population and to a lesser extent with the proportion of the urban population.

Morbidity, mortality and spatial distribution of meningococcal disease, 1974–2007

2009 ◽  
Vol 137 (11) ◽  
pp. 1631-1640 ◽  
Author(s):  
M. HOWITZ ◽  
L. LAMBERTSEN ◽  
J. B. SIMONSEN ◽  
J. J. CHRISTENSEN ◽  
K. MØLBAK
Keyword(s):  
Risk Factors ◽  
Spatial Distribution ◽  
Meningococcal Disease ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Incidence Rates ◽  
Fatality Rate ◽  
Risk Of Death ◽  
Increased Risk ◽  
High Age

SUMMARYTo identify determinants for mortality and sequelae and to analyse the spatial distribution of meningococcal disease, we linked four national Danish registries. In the period 1974–2007, 5924 cases of meningococcal disease were registered. Our analysis confirms known risk factors for a fatal meningococcal disease outcome, i.e. septicaemia and high age (>50 years). The overall case-fatality rate was 7·6%; two phenotypes were found to be associated with increased risk of death; C:2a:P1.2,5 and B:15:P1.7,16. B:15:P1.7,16 was also associated with excess risk of perceptive hearing loss. The incidence rates of meningococcal disease were comparable between densely and less densely populated areas, but patients living further from a hospital were at significantly higher risk of dying from the infection. To improve control of meningococcal disease, it is important to understand the epidemiology and pathogenicity of virulent ‘successful clones’, such as C:2a:P1.2,5 and B:15:P1.7,16, and, eventually, to develop vaccines against serogroup B.

scholarly journals Risk factors for mortality in hospitalized patients with COVID-19 at the start of the pandemic in Belgium: a retrospective cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Karlijn van Halem ◽  
Robin Bruyndonckx ◽  
Jeroen van der Hilst ◽  
Janneke Cox ◽  
Paulien Driesen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Case Fatality Rate ◽  
Clinical Characteristics ◽  
Severe Disease ◽  
Univariate Analysis ◽  
Case Fatality ◽  
Fatality Rate ◽  
Risk Of Death ◽  
Increased Risk

Abstract Background Belgium was among the first countries in Europe with confirmed coronavirus disease 2019 (COVID-19) cases. Since the first diagnosis on February 3rd, the epidemic has quickly evolved, with Belgium at the crossroads of Europe, being one of the hardest hit countries. Although risk factors for severe disease in COVID-19 patients have been described in Chinese and United States (US) cohorts, good quality studies reporting on clinical characteristics, risk factors and outcome of European COVID-19 patients are still scarce. Methods This study describes the clinical characteristics, complications and outcomes of 319 hospitalized COVID-19 patients, admitted to a tertiary care center at the start of the pandemic in Belgium, and aims to identify the main risk factors for in-hospital mortality in a European context using univariate and multivariate logistic regression analysis. Results Most patients were male (60%), the median age was 74 (IQR 61–83) and 20% of patients were admitted to the intensive care unit, of whom 63% needed invasive mechanical ventilation. The overall case fatality rate was 25%. The best predictors of in-hospital mortality in multivariate analysis were older age, and renal insufficiency, higher lactate dehydrogenase and thrombocytopenia. Patients admitted early in the epidemic had a higher mortality compared to patients admitted later in the epidemic. In univariate analysis, patients with obesity did have an overall increased risk of death, while overweight on the other hand showed a trend towards lower mortality. Conclusions Most patients hospitalized with COVID-19 during the first weeks of the epidemic in Belgium were admitted with severe disease and the overall case fatality rate was high. The identified risk factors for mortality are not easily amenable at short term, underscoring the lasting need of effective therapeutic and preventative measures.

scholarly journals Protection offered by COVID-19 vaccines in reducing SARS-CoV-2 infection frequency; severity and mortality, among Indian Healthcare Workers: Multicenter, pan-Fortis study

2021 ◽  
Author(s):  
Subrat Acharya ◽  
Gaurav Mahindra
Keyword(s):  
General Population ◽  
Healthcare Workers ◽  
Case Fatality Rate ◽  
Population Control ◽  
Real Life ◽  
Case Fatality ◽  
Infection Frequency ◽  
Fatality Rate ◽  
Indian States ◽  
Increased Risk

Abstract During COVID-19 pandemic, Healthcare Workers (HCWs) were at increased risk for exposure to SARS-CoV-2 virus and prioritized for early administration of COVID-19 vaccines in India. Real-life scenario information among vaccinated HCWs acquiring COVID-19 infection, is scarce. We retrospectively analyzed COVID-19 infection frequency, severity, and associated mortality among healthcare workers, immunized with either Covishield or Covaxin vaccines at 27 Fortis Hospitals across 11 Indian states. Positive cases were identified based on RT-PCR or rapid antigen tests for SARS-CoV-2 between 16th January 2021 till 15th May 2021. 20034 HCWs received vaccination. 3971 received 1 dose, 16063 received 2 doses. Post-vaccination, 1139 HCWs acquired COVID-19 infection, 180 (4.53%) and 959 (5.97%) among partially and fully vaccinated category, respectively. Breakthrough infection occurred among 913 (5.68%) HCWs. Concurrently, Case Positivity Rate was 11.9%, among general population (control). Among 1139 positive cases, mild, moderate, and severe infections were 1059 (93%), 71 (6.2%) and 9 (0.8%), respectively with Case Fatality Rate of 0.18%, compared to 0.92% among general population (p=0.0043). The Case Fatality Rate in vaccinated HCWs was found to be 80% less than that in general population (control). Hence, COVID-19 vaccines available in India seem to be effective against SARS-CoV-2 virus.

scholarly journals Patient and strain characteristics in relation to the outcome of meningococcal disease: a multivariate analysis

1994 ◽  
Vol 112 (1) ◽  
pp. 115-124 ◽  
Author(s):  
R. J. P. M. Scholten ◽  
H. A. Bijlmer ◽  
H. A. Valkenburg ◽  
J. Dankert
Keyword(s):  
The Netherlands ◽  
Meningococcal Disease ◽  
Case Fatality Rate ◽  
Fatal Outcome ◽  
Age Groups ◽  
Case Fatality ◽  
Surface Characteristics ◽  
Fatality Rate ◽  
Increased Risk ◽  
Meningococcal Strain

SummaryTo investigate the joint association of patient and strain characteristics with the outcome of meningococcal disease (MD), data were collected on 563 consecutive cases of MD reported between 1989 and 1990 in The Netherlands. The meningococcal isolates were characterized with regard to their surface characteristics. Sequelae occurred in 8.5% of the patients, and were only associated with the presence of bacteraemia. The case-fatality rate was 7.7%. Infants aged ≤ 5 months and patients in the age-groups of 10–19 years and ≥ 50 years had an increased risk for a fatal outcome compared with children from 6 months to 9 years old (Odds Ratios [ORs]: 5.1, 3.4 and 9.8, respectively). The OR for females versus males was 2.3. The ORs for patients with bacteraemia, or a combination of bacteraemia and meningitis, compared with meningitic patients, were 2.3 and 3.1. Meningococcal strain characteristics did not influence the case-fatality rate substantially. In conclusion, host factors were found to be determinants for a fatal outcome of MD in The Netherlands from 1989 to 1990.

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