scholarly journals Epidemiology of COVID-19

2020 ◽  
Vol 11 (01) ◽  
pp. 03-07
Author(s):  
Sudipta Dhar Chowdhury ◽  
Anu Mary Oommen
Keyword(s):  
Healthcare Workers ◽  
Severe Disease ◽  
Case Series ◽  
Case Fatality ◽  
Respiratory Illness ◽  
The Elderly ◽  
The United States ◽  
Health System Strengthening ◽  
Disease Spread ◽  
Limited Access

AbstractCOVID-19, an infectious respiratory illness caused by the severe acute respiratory syndrome–corona virus 2 (SARS-CoV2), has now spread to multiple countries including India. The pace at which the disease spread in the last 4 months, since it was first recognized from China, is unprecedented. This review of the epidemiology of COVID-19 summarizes the burden of infection, transmission dynamics, and other related epidemiological features. While countries such as China, Italy, and the United States have particularly high-rates of infection, the disease is gradually spreading in India as well, threatening the health and economy of the country. Transmission in asymptomatic cases, early symptomatic phase, as well as limited access to testing in different settings are factors that have led to the rapid spread of infection. A large case series from China revealed that 81% of cases had mild symptoms, 14% had severe disease, and 5% were afflicted with critical illness. While the mortality in China was reported as 2.3%, Italy, with a high-proportion of elderly, reported a case fatality report of 7.2% due to higher infection and mortality rates among the elderly. Being a highly infectious disease, with a basic reproduction number between 2 to 3, COVID-19 is affecting a large number of healthcare workers, as evidenced by the fact that a sizeable portion of reported infections in the US included healthcare workers. Delivering health care for both COVID-19 affected individuals, as well those with other acute and chronic conditions, with limited access to healthcare facilities and services, are challenges for the health systems in low- and middle-income countries, which require immediate measures for health system strengthening across sectors.

scholarly journals A Correlation of Kidney Changes and Sars Cov 2 in Covid Positive Patients –A Review Article

2020 ◽  
pp. 1-4
Author(s):  
Punit Gupta ◽  
◽  
Sulakshna D ◽  
Keyword(s):  
Spontaneous Recovery ◽  
Severe Disease ◽  
Respiratory Illness ◽  
The Elderly ◽  
Case Finding ◽  
Disease Spread ◽  
Contact Tracing ◽  
Shortness Of Breath ◽  
Seriously Ill ◽  
Dialysis Staff

COVID-19, a respiratory illness caused by a newly discovered coronavirus, has become a pandemic affecting over 1.9 million people with over 130,000 deaths in 210 countries.Some people become infected with the virus but do not develop symptoms. When they appear, symptoms are non-specific, with fever, cough, shortness of breath, sore throat, fatigue, and headache being the most common. Symptoms are usually mild and benign in a vast majority (>80%) and recede gradually, leading to a full spontaneous recovery. A small number become seriously ill, develop difficulty in breathing and complications related to other organs. They may require hospitalization and a smaller subset need ICU care. The mortality is relatively higher in the latter group. This risk goes up in the elderly and those with co-orbidities (such ashypertension, diabetes, cardiac disease, kidney failure). Still, it is essential to emphasize that everybody is at risk for severe disease (including the relatively young and healthy dialysis staff). The strategy of physical distancing, case finding, contact tracing and quarantine/isolation of positive cases and high-risk contacts is critical to controlling the spread of this infection. This strategy is being implemented through nationwide lockdown during the period of intense transmission. Still, physical distancing is likely to remain in force after the end of the current lockdown to prevent disease spread.

scholarly journals Mortality among the early cases of COVID-19 and its association with key comorbidities in a large state in South India

2020 ◽  
Vol 7 (10) ◽  
pp. 3882
Author(s):  
Suhas Bhat ◽  
Rohan Kolla ◽  
Shashank D. Shindhe ◽  
Surekha B. Munoli
Keyword(s):  
Case Fatality Rate ◽  
Severe Disease ◽  
Case Fatality ◽  
The Elderly ◽  
Median Number ◽  
Fatality Rate ◽  
Study Region ◽  
Large State ◽  
Death Time ◽  
The Impact

Background: The mortality associated with the pandemic COVID-19 is a subject of intense scrutiny as COVID-19 can cause severe disease leading to hospitalization in ICU and potentially death, especially in the elderly with comorbidities. A statistical analysis is carried out to study the impact of age, gender and comorbidities on deaths among early one lakh infected population of Karnataka, a large state in south India.Methods: Daily case fatality rate and adjusted case fatality rate (CFR) (adjusted to median death time) are estimated. The impacts of age, gender and comorbidities on mortality outcomes of COVID patients are studied.Results: The daily CFR on 27th July for Karnataka is estimated from the dataset to be 1.93%. However, the adjusted CFR based on the median number of days from diagnosis to death was found to be 2.15% (95% confidence interval 2%-2.3%) on that day. The deaths among male patients outnumber those in females. As far as age of the patients is concerned, more than 50% of the deaths occurred in the age group 50-60 and 60-70 years. Majority of deaths reported in the state were associated with at least one of the comorbidity. Diabetes mellitus and hypertension were the most significant comorbidities.Conclusions: The daily adjusted CFR for the study region is found to be lower than the CFR of the whole nation. Also the age, gender and comorbidities were found to be associated with the deaths as opposed to the infection alone. It was also deduced that, patients with a history of diabetes or hypertension or ischemic heart disease or a combination of any of these were most likely to experience severe outcomes of the infection. 

scholarly journals The impact of Coronavirus disease 2019 (COVID-19) on health systems and household resources in Africa and South Asia

2020 ◽  
Author(s):  
Nicholas Davies ◽  
Sedona Sweeney ◽  
Sergio Torres-Rueda ◽  
Fiammetta Bozzani ◽  
Nichola Kitson ◽  
...  
Keyword(s):  
United States ◽  
Health Systems ◽  
Resource Use ◽  
Healthcare Workers ◽  
Addis Ababa ◽  
Severe Disease ◽  
The United States ◽  
Economic Implications ◽  
Hospital Beds ◽  
The Impact

AbstractBackgroundCoronavirus disease 2019 (COVID-19) epidemics strain health systems and households. Health systems in Africa and South Asia may be particularly at risk due to potential high prevalence of risk factors for severe disease, large household sizes and limited healthcare capacity.MethodsWe investigated the impact of an unmitigated COVID-19 epidemic on health system resources and costs, and household costs, in Karachi, Delhi, Nairobi, Addis Ababa and Johannesburg. We adapted a dynamic model of SARS-CoV-2 transmission and disease to capture country-specific demography and contact patterns. The epidemiological model was then integrated into an economic framework that captured city-specific health systems and household resource use.FindingsThe cities severely lack intensive care beds, healthcare workers and financial resources to meet demand during an unmitigated COVID-19 epidemic. A highly mitigated COVID-19 epidemic, under optimistic assumptions, may avoid overwhelming hospital bed capacity in some cities, but not critical care capacity.InterpretationViable mitigation strategies encompassing a mix of responses need to be established to expand healthcare capacity, reduce peak demand for healthcare resources, minimise progression to critical care and shield those at greatest risk of severe disease.FundingBill & Melinda Gates Foundation, European Commission, National Institute for Health Research, Department for International Development, Wellcome Trust, Royal Society, Research Councils UK.Research in contextEvidence before this studyWe conducted a PubMed search on May 5, 2020, with no language restrictions, for studies published since inception, combining the terms (“cost” OR “economic”) AND “covid”. Our search yielded 331 articles, only two of which reported estimates of health system costs of COVID-19. The first study estimated resource use and medical costs for COVID-19 in the United States using a static model of COVID 19. The second study estimated the costs of polymerase chain reaction tests in the United States. We found no studies examining the economic implications of COVID-19 in low- or middle-income settings.Added value of this studyThis is the first study to use locally collected data in five cities (Karachi, Delhi, Nairobi, Addis Ababa and Johannesburg) to project the healthcare resource and health economic implications of an unmitigated COVID-19 epidemic. Besides the use of local data, our study moves beyond existing work to (i) consider the capacity of health systems in key cities to cope with this demand, (ii) consider healthcare staff resources needed, since these fall short of demand by greater margins than hospital beds, and (iii) consider economic costs to health services and households.Implications of all the evidenceDemand for ICU beds and healthcare workers will exceed current capacity by orders of magnitude, but the capacity gap for general hospital beds is narrower. With optimistic assumptions about disease severity, the gap between demand and capacity for general hospital beds can be closed in some, but not all the cities. Efforts to bridge the economic burden of disease to households are needed.

scholarly journals Targeted COVID-19 Vaccination (TAV-COVID) Considering Limited Vaccination Capacities—An Agent-Based Modeling Evaluation

Vaccines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 434
Author(s):  
Beate Jahn ◽  
Gaby Sroczynski ◽  
Martin Bicher ◽  
Claire Rippinger ◽  
Nikolai Mühlberger ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Occupational Safety ◽  
Severe Disease ◽  
The Elderly ◽  
Agent Based Modeling ◽  
Middle Aged ◽  
Agent Based ◽  
Vaccination Strategies ◽  
Sterilizing Immunity ◽  
Vulnerable Persons

(1) Background: The Austrian supply of COVID-19 vaccine is limited for now. We aim to provide evidence-based guidance to the authorities in order to minimize COVID-19-related hospitalizations and deaths in Austria. (2) Methods: We used a dynamic agent-based population model to compare different vaccination strategies targeted to the elderly (65 ≥ years), middle aged (45–64 years), younger (15–44 years), vulnerable (risk of severe disease due to comorbidities), and healthcare workers (HCW). First, outcomes were optimized for an initially available vaccine batch for 200,000 individuals. Second, stepwise optimization was performed deriving a prioritization sequence for 2.45 million individuals, maximizing the reduction in total hospitalizations and deaths compared to no vaccination. We considered sterilizing and non-sterilizing immunity, assuming a 70% effectiveness. (3) Results: Maximum reduction of hospitalizations and deaths was achieved by starting vaccination with the elderly and vulnerable followed by middle-aged, HCW, and younger individuals. Optimizations for vaccinating 2.45 million individuals yielded the same prioritization and avoided approximately one third of deaths and hospitalizations. Starting vaccination with HCW leads to slightly smaller reductions but maximizes occupational safety. (4) Conclusion: To minimize COVID-19-related hospitalizations and deaths, our study shows that elderly and vulnerable persons should be prioritized for vaccination until further vaccines are available.

scholarly journals Covid-19 Infection in Elderly with Comorbids

2021 ◽  
Vol 7 (2) ◽  
pp. 383-387
Author(s):  
Edo Yudistira ◽  
Roza Mulyana
Keyword(s):  
United States ◽  
Geriatric Patients ◽  
Severe Disease ◽  
The Elderly ◽  
The United States ◽  
Family Education ◽  
Physiological Changes ◽  
The Family ◽  
Patient Assistance ◽  
Senior Population

The senior population has a higher risk of contracting Covid-19 and is at risk ofdeveloping more severe disease. This is due to physiological changes in old age,which causes a decrease in immune function accompanied by an increase incomorbid disorders such as diabetes, hypertension, heart disease, lung disease,and dementia. WHO reports that the mortality rate for Covid-19 patients in theelderly above 80 years in China is around 21.9%, Italy is about 89% at the ageabove 70 years, and the United States is 85% at the age of 65 years and over.Delirium syndrome often appears as the primary complaint or infrequently; itoccurs on the first day the patient is treated and shows fluctuating symptoms.Symptoms of delirium, such as disorientation, difficulty concentrating, andinattention, often occur in the elderly and are associated with a poor prognosis.Management of geriatric patients with covid 19 must be carried out thoroughlyand completely, especially in geriatric patients with comorbidities. Managementincludes primary diseases, namely Covid-19 infection, delirium, nutritionaltherapy, blood sugar, family education for patient assistance, maintaining thepatient's body and environment cleanliness, oral hygiene, and, last but not least,moral support from the family for the patient. With complete management, elderlypatients with various comorbid can survive the Covid-19 infection.

scholarly journals Infection and mortality of healthcare workers worldwide from COVID-19: a scoping review

2020 ◽  
Author(s):  
Soham Bandyopadhyay ◽  
Ronnie E Baticulon ◽  
Murtaza Kadhum ◽  
Muath Alser ◽  
Daniel K Ojuka ◽  
...  
Keyword(s):  
Scoping Review ◽  
Healthcare Workers ◽  
Case Fatality Rate ◽  
Eastern Mediterranean ◽  
Case Fatality ◽  
The United States ◽  
Global Perspective ◽  
World Population ◽  
Fatality Rate ◽  
Specific Data

AbstractObjectivesTo estimate COVID-19 infections and deaths in healthcare workers (HCWs) from a global perspective.DesignScoping review.MethodsTwo parallel searches of academic bibliographic databases and grey literature were undertaken. Governments were also contacted for further information where possible. Due to the time-sensitive nature of the review and the need to report the most up-to-date information for an ever-evolving situation, there were no restrictions on language, information sources utilised, publication status, and types of sources of evidence. The AACODS checklist was used to appraise each source of evidence.Outcome measuresPublication characteristics, country-specific data points, COVID-19 specific data, demographics of affected HCWs, and public health measures employedResultsA total of 152,888 infections and 1413 deaths were reported. Infections were mainly in women (71.6%) and nurses (38.6%), but deaths were mainly in men (70.8%) and doctors (51.4%). Limited data suggested that general practitioners and mental health nurses were the highest risk specialities for deaths. There were 37.17 deaths reported per 100 infections for healthcare workers aged over 70. Europe had the highest absolute numbers of reported infections (119628) and deaths (712), but the Eastern Mediterranean region had the highest number of reported deaths per 100 infections (5.7).ConclusionsHCW COVID-19 infections and deaths follow that of the general world population. The reasons for gender and speciality differences require further exploration, as do the low rates reported from Africa and India. Although physicians working in certain specialities may be considered high-risk due to exposure to oronasal secretions, the risk to other specialities must not be underestimated. Elderly HCWs may require assigning to less risky settings such as telemedicine, or administrative positions. Our pragmatic approach provides general trends, and highlights the need for universal guidelines for testing and reporting of infections in HCWs.Summary BoxWhat is already known on this topicIn China, studies documented over 3,300 confirmed cases of infected healthcare workers in early March. In the United States, as high as 19% of patients had been identified as healthcare workers. There are no studies that perform a global examination of COVID-19 infections and deaths in the health workforce.What this study addsTo our knowledge, this is the first study assessing the number of healthcare workers who have been infected with or died from COVID-19 globally. The data from our study suggest that although infections were mainly in women and nurses, COVID-19 related deaths were mainly in men and doctors; in addition, our study found that Europe had the highest numbers of infection and death, but the lowest case-fatality-rate, while the Eastern Mediterranean had the highest case-fatality-rate.

scholarly journals Safe tracheostomy in COVID-19 patients: a case series

2020 ◽  
Vol 7 (8) ◽  
pp. 2702
Author(s):  
Melissa K. Meghpara ◽  
Bhavana Devanabanda ◽  
Mercy Jimenez ◽  
Martine A. Louis ◽  
Neil Mandava
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Healthcare Workers ◽  
Case Series ◽  
The Elderly ◽  
Optimal Timing ◽  
Hispanic Males ◽  
Prolonged Intubation ◽  
Operating Room Staff

The coronavirus (COVID-19) pandemic has led to a critical need in treating severe respiratory disease while providing adequate protection to healthcare workers. Critically ill COVID-19 patients have required prolonged intubation and mechanical ventilation, not limited to those with multiple comorbidities or the elderly. At the height of the pandemic in New York City; our institution intubated 192 COVID-19 patients. Many institutions have avoided performing tracheostomy in this population due to high risk of virus aerosolization. This study is a retrospective, IRB approved, single center case series of 14 consecutive tracheostomies in COVID-19 patients at a community hospital in Flushing, New York City. Data from 1 March to 31 May 2020 was collected from electronic medical records. All COVID-19 positive patients undergoing tracheostomy were included; patients undergoing tracheostomy that were not COVID-19 positive were excluded. Fourteen patients underwent tracheostomy during the study period. Average age was 62 and 64.3% were male (n=9). Hispanic males represented 50% of patients undergoing tracheostomy and 71.4% were from home. Average days from initial intubation to tracheostomy was 20.6, ranging from 12 to 43 days. With the exception of two patients, all underwent a single intubation. No involved operating room staff became ill during or after these procedures. Tracheostomy may be safely performed in COVID-19 patients while minimizing risk to staff; however, patient outcomes may not be significantly altered. Further research is needed to determine the optimal timing and overall benefit of tracheostomy in this population.

Differing Clot Distribution in Black Compared to White Patients Presenting with Acute Lower Extremity Deep Venous Thrombosis

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 3819-3819
Author(s):  
Tyler W Buckner ◽  
Soham Puvvada ◽  
Chirag Amin ◽  
Nigel S. Key
Keyword(s):  
Lower Extremity ◽  
Case Series ◽  
Factor V Leiden ◽  
Case Fatality ◽  
The United States ◽  
Factor V ◽  
Racial Groups ◽  
Retrospective Case ◽  
Black Patients ◽  
Incidence And Mortality

Abstract Venous thromboembolism (VTE) is a major cause of morbidity and mortality in the United States. There is growing evidence that VTE incidence and mortality rates differ among ethnic/racial groups. Specifically, it has been demonstrated previously that blacks with VTE have a higher proportional rate of pulmonary embolism (PE), as well as a higher case fatality rate from PE compared to whites (Arch Int Med2003;163(15):1843–8). We therefore compared the location of DVT (proximal vs. distal) in blacks and whites at the time of diagnosis. The null hypothesis was that there is no difference in the location of DVT between white and black patients at the time of diagnosis. We reviewed all lower extremity Doppler ultrasound studies that were positive for acute DVT at our Institution over a 3-year period to create a retrospective case series of 941 patients. Subjects were further classified by self-reported race (black or white), disposition at diagnosis (inpatient or outpatient), and clot location (proximal or distal). Distal DVT was defined as thrombus in one or more deep veins distal to -- but not including -- the popliteal vein. Results were analyzed using Stata version 10. We found that the rate of any proximal (proximal or both proximal and distal) DVT compared with distal only was significantly higher in black patients (OR = 1.4; 95%CI: 1.03, 1.8; P = 0.032), both for 637 inpatients (OR = 1.3; (0.94, 1.9); P = 0.11) and for 304 outpatients (OR = 2.0; (1.01, 3.8); P = 0.048). These differences persisted after controlling for sex and age. We conclude that blacks with acute lower extremity DVT are more likely to present with proximal DVT than whites. These results confirm earlier suggestions that the proportion of proximal lower extremity DVT is higher in blacks, which might account in part for the higher rate of PE (Arch Int Med2004;164(12):1348–9). We are further examining the possible causes of this disparity. Possibilities include genetic factors (such as factor V Leiden which is associated with more distal DVT presentation and is rare in blacks), co-morbid conditions (such as diabetes which is more prevalent in blacks), and access to healthcare and diagnostic services, which may lead to more delayed evaluation. Efforts will also be made to determine rates of idiopathic and provoked DVT in these sub-groups.

scholarly journals Fulminant Acute Kidney Injury in a Young Patient with Novel Coronavirus 2019

2020 ◽  
Vol 10 (4) ◽  
pp. 217-222 ◽  
Author(s):  
Akshaya Gopalakrishnan ◽  
Ali Mossaid ◽  
Kevin Bryan Lo ◽  
Viswanath Vasudevan ◽  
Peter A. McCullough ◽  
...  
Keyword(s):  
United States ◽  
Acute Kidney Injury ◽  
Renal Function ◽  
Clinical Status ◽  
Case Series ◽  
Kidney Injury ◽  
Respiratory Illness ◽  
The United States ◽  
Acute Onset ◽  
Fatal Course

Coronavirus disease 2019 (COVID-19) is a global pandemic affecting more than 200 countries and 180,000 cases in the United States. While the outbreak began in China, the number of cases outside of China exceeded those in China on March 15, 2020 and are currently rising at an exponential rate. The number of fatalities in the United States are expected to exceed more than Italy and China. The disease is characterized predominantly as an acute respiratory illness. However, preliminary data suggests that kidney is a target for the virus and deterioration of renal function was associated with poor outcomes including in-hospital mortality. We pre­sent a report of a patient with COVID-19 who presented with acute onset of symptoms and normal renal function at baseline but rapidly deteriorated resulting in death. The timing of decline in renal function correlated with his worsening clinical status. He was started on continuous veno-venous hemofiltration without signs of clinical benefit. We also present the possible mechanisms for acute kidney injury in these patients. We performed a review of the emerging literature by searching PubMed, Google Scholar, and EMBASE for studies and/or case series published on this topic. Acute kidney injury might help risk stratify critically ill patients on a fatal course of COVID-19.

scholarly journals COVID-19, Australia: Epidemiology Report 19 (Fortnightly reporting period ending 21 June 2020)

2020 ◽  
Vol 44 ◽  
Author(s):  
Keyword(s):  
Case Fatality Rate ◽  
Severe Disease ◽  
Case Fatality ◽  
The United States ◽  
International Travel ◽  
Fatality Rate ◽  
Case Identification ◽  
The Pacific ◽  
Overseas Travel ◽  
Early Case

Notified cases of COVID-19 and associated deaths reported to the National Notifiable Diseases Surveillance System (NNDSS) to 21 June 2020. Confirmed cases in Australia notified up to 7 June 2020: notifications = 7,491; deaths = 102. Over the past fortnightly reporting period, the number of new cases in most Australian states remains low; however, an increase in locally-acquired cases is observed for Victoria. Testing rates continue to be high across all jurisdictions, with the nationwide positivity rate remaining very low at less than 0.1%. The incidence of COVID-19 has markedly reduced since a peak in mid-March (Figure 1). A combination of early case identification, physical distancing, public health measures and a reduction in international travel have been effective in slowing the spread of disease in Australia. Of the 215 cases notified between 8 and 21 June, 75% (163 cases) were notified from Victoria. Most of these cases were acquired locally, in contrast with cases notified from other states (NSW, Qld and WA) where most new cases have been overseas-acquired. Of locally-acquired cases in Victoria in this period, 54% were associated with contacts of a confirmed case or in a known outbreak, while 46% were unable to be linked to another case. In response, the Victorian Government has re-introduced restrictions for household and outdoor gatherings and has delayed plans to ease other restrictions. A small proportion of overall cases have experienced severe disease, requiring hospitalisation or intensive care, with some fatalities. The crude case fatality rate amongst Australian cases is 1.4%. People who are older and have one or more comorbidities are more likely to experience severe disease. The highest rate of COVID-19 continues to be among people aged 65–79 years. Three-quarters of all cases in this age group have been associated with overseas travel, including several outbreaks linked to cruise ships. The lowest rate of disease is in children under 18 years, a pattern reflected in international reports. Internationally, as of 21 June 2020, the largest numbers of both cases and deaths have been reported in the United States. Of the confirmed cases reported globally, the case fatality rate is approximately 5.3%. Other countries in the Americas region, such as Brazil and Chile, are seeing rapid growth in case numbers. Case numbers in Europe remain relatively steady, while there is significant growth in the South East Asia region, including in India and Bangladesh. Reported cases are increasing in Africa, although the numbers are much smaller. In the Pacific there are few new cases reported daily.

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