scholarly journals Estimating the Case Fatality Risk of COVID-19 using Cases from Outside China

2020 ◽  
Author(s):  
Nick Wilson ◽  
Amanda Kvalsvig ◽  
Lucy Telfar Barnard ◽  
Michael G Baker
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Meta Analysis ◽  
Case Fatality ◽  
Large Uncertainty ◽  
Icu Patients ◽  
Fatality Risk ◽  
Case Fatality Risk ◽  
Respiratory Conditions

AbstractThere is large uncertainty around the case fatality risk (CFR) for COVID-19 in China. Therefore, we considered symptomatic cases outside of China (countries/settings with 20+ cases) and the proportion who are in intensive care units (4.0%, 14/349 on 13 February 2020). Given what is known about CFRs for ICU patients with severe respiratory conditions from a meta-analysis, we estimated a CFR of 1.37% (95%CI: 0.57% to 3.22%) for COVID- 19 cases outside of China.

scholarly journals Clinical Determinants of the Severity of Coronavirus Disease 2019 (COVID-19): A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Yanling Wu ◽  
Hu Li ◽  
Shengjin Li
Keyword(s):  
Risk Factors ◽  
Cerebrovascular Disease ◽  
Respiratory Disease ◽  
Meta Analysis ◽  
Case Fatality ◽  
Older Age ◽  
Fatality Risk ◽  
Male Sex ◽  
Case Fatality Risk ◽  
D Dimer

Abstract Background: SARS-CoV-2 is an emerging pathogen, and coronavirus disease 2019 (COVID-19) has been declared a global pandemic. We aim to summarize current evidence regarding the risk of death and the severity of COVID-19 as well as risk factors for severe COVID-19.Methods: The PubMed, Embase, and Web of Science databases as well as some Chinese databases were searched for clinical and epidemiological studies on COVID-19. We conducted a meta-analysis to examine COVID-19-related death and risk factors for the severity of COVID-19.Results: A total of 55 studies fulfilled the criteria for this review. The case fatality risk ranged from 0 to 61.5%, with a pooled estimate of 3.3%. The risks of ICU admission, acute respiratory distress syndrome (ARDS)and severe COVID-19 were 24.9%, 20.9% and 26.6%, respectively. Factors related to the risk of severe COVID-19 were older age (MD=10.09, 95% CI:7.03, 13.16), male sex (OR=1.62, 95% CI:1.32, 1.99), hypertension (OR=2.34, 95% CI:1.47, 3.73), diabetes (OR=2.25, 95% CI:1.68, 3.03), chronic renal disease (OR=3.60, 95% CI:1.53, 8.46), heart disease (OR=2.76, 95% CI:1.78, 4.30), respiratory disease (OR=3.74, 95% CI:2.15, 6.49), cerebrovascular disease (OR=2.21, 95% CI:1.23, 3.98), higher D-dimer levels (SMD=0.62, 95% CI:0.28, 0.96), and higher IL-6 levels (SMD=2.21, 95% CI:0.11, 4.31). However, liver disease (OR=0.63, 95% CI: 0.36, 1.10) was found to be a nonsignificant predictor of the severity of COVID-19.Conclusions: The case fatality risk of COVID-19 and the risk of severe manifestations were not very high, and variances in the study designs and regions led to high heterogeneity among the studies. Male sex, older age, comorbidities such as hypertension, diabetes, cardiovascular disease, respiratory disease and cerebrovascular disease could increase the risk of developing a severe case of COVID-19. Laboratory parameters, such as D-dimer and IL-6 levels, could affect the prognosis of COVID-19.

scholarly journals Estimating case fatality risk of severe Yellow Fever cases: systematic literature review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Joseph L. Servadio ◽  
Claudia Muñoz-Zanzi ◽  
Matteo Convertino
Keyword(s):  
Literature Review ◽  
South America ◽  
Yellow Fever ◽  
Systematic Literature Review ◽  
Meta Analysis ◽  
Case Fatality ◽  
Surveillance Data ◽  
Fatality Risk ◽  
Disease Case ◽  
Case Fatality Risk

Abstract Background Case fatality risk (CFR), commonly referred to as a case fatality ratio or rate, represents the probability of a disease case being fatal. It is often estimated for various diseases through analysis of surveillance data, case reports, or record examinations. Reported CFR values for Yellow Fever vary, offering wide ranges. Estimates have not been found through systematic literature review, which has been used to estimate CFR of other diseases. This study aims to estimate the case fatality risk of severe Yellow Fever cases through a systematic literature review and meta-analysis. Methods A search strategy was implemented in PubMed and Ovid Medline in June 2019 and updated in March 2021, seeking reported severe case counts, defined by fever and either jaundice or hemorrhaging, and the number of those that were fatal. The searches yielded 1,133 studies, and title/abstract review followed by full text review produced 14 articles reporting 32 proportions of fatal cases, 26 of which were suitable for meta-analysis. Four studies with one proportion each were added to include clinical case data from the recent outbreak in Brazil. Data were analyzed through an intercept-only logistic meta-regression with random effects for study. Values of the I2 statistic measured heterogeneity across studies. Results The estimated CFR was 39 % (95 % CI: 31 %, 47 %). Stratifying by continent showed that South America observed a higher CFR than Africa, though fewer studies reported estimates for South America. No difference was seen between studies reporting surveillance data and studies investigating outbreaks, and no difference was seen among different symptom definitions. High heterogeneity was observed across studies. Conclusions Approximately 39 % of severe Yellow Fever cases are estimated to be fatal. This study provides the first systematic literature review to estimate the CFR of Yellow Fever, which can provide insight into outbreak preparedness and estimating underreporting.

scholarly journals Meta-analysis and adjusted estimation of COVID-19 case fatality risk in India and its association with the underlying comorbidities

One Health ◽  
2021 ◽  
pp. 100283
Author(s):  
Balbir B. Singh ◽  
Michael P. Ward ◽  
Mark Lowerison ◽  
Ryan T. Lewinson ◽  
Isabelle A. Vallerand ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Case Fatality ◽  
Fatality Risk ◽  
Case Fatality Risk

scholarly journals Meta-analysis and adjusted estimation of COVID-19 case fatality risk in India and its association with the underlying comorbidities

2020 ◽  
Author(s):  
Balbir B. Singh ◽  
Michael P Ward ◽  
Mark Lowerison ◽  
Ryan T. Lewinson ◽  
Isabelle A. Vallerand ◽  
...  
Keyword(s):  
Fixed Effects ◽  
Respiratory Infections ◽  
Meta Analysis ◽  
Social Indicators ◽  
Case Fatality ◽  
Health Indicators ◽  
Acute Respiratory Infections ◽  
Fatality Risk ◽  
Country Level ◽  
Case Fatality Risk

AbstractThere is a lack of COVID-19 adjusted case fatality risk (aCFR) estimates and information on states with high aCFR. State-specific aCFRs were estimated, using 13-day lag for fatality. To estimate country-level aCFR, state estimates were meta-analysed. Multiple correspondence analyses (MCA), followed by univariable logistic regression, were conducted to understand the association between aCFR and geodemographic, health and social indicators. Based on health indicators, states likely to report a higher aCFR were identified. Using random- and fixed-effects models, the aCFRs in India were 1.42 (95% CI 1.19 – 1.70) and 2.97 (95% CI 2.94 – 3.00), respectively. The aCFR was grouped with the incidence of diabetes, hypertension, cardiovascular diseases and acute respiratory infections in the first and second dimensions of MCA. The current study demonstrated the value of using meta-analysis to estimate aCFR. To decrease COVID-19 associated fatalities, states estimated to have a high aCFR must take steps to reduce co-morbidities.Article Summary LineMeta-analysis and the COVID-19 adjusted case fatality risks (aCFRs) in India are reported and states likely to report a higher aCFR have been identified.

scholarly journals Mortality in Escherichia coli bloodstream infections: a multinational population-based cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Melissa C. MacKinnon ◽  
Scott A. McEwen ◽  
David L. Pearl ◽  
Outi Lyytikäinen ◽  
Gunnar Jacobsson ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Mortality Rate ◽  
Case Fatality ◽  
Population Based ◽  
Day Case ◽  
Fatality Risk ◽  
E Coli ◽  
Factors Associated ◽  
Case Fatality Risk ◽  
Age And Sex

Abstract Background Escherichia coli is the most common cause of bloodstream infections (BSIs) and mortality is an important aspect of burden of disease. Using a multinational population-based cohort of E. coli BSIs, our objectives were to evaluate 30-day case fatality risk and mortality rate, and determine factors associated with each. Methods During 2014–2018, we identified 30-day deaths from all incident E. coli BSIs from surveillance nationally in Finland, and regionally in Sweden (Skaraborg) and Canada (Calgary, Sherbrooke, western interior). We used a multivariable logistic regression model to estimate factors associated with 30-day case fatality risk. The explanatory variables considered for inclusion were year (2014–2018), region (five areas), age (< 70-years-old, ≥70-years-old), sex (female, male), third-generation cephalosporin (3GC) resistance (susceptible, resistant), and location of onset (community-onset, hospital-onset). The European Union 28-country 2018 population was used to directly age and sex standardize mortality rates. We used a multivariable Poisson model to estimate factors associated with mortality rate, and year, region, age and sex were considered for inclusion. Results From 38.7 million person-years of surveillance, we identified 2961 30-day deaths in 30,923 incident E. coli BSIs. The overall 30-day case fatality risk was 9.6% (2961/30923). Calgary, Skaraborg, and western interior had significantly increased odds of 30-day mortality compared to Finland. Hospital-onset and 3GC-resistant E. coli BSIs had significantly increased odds of mortality compared to community-onset and 3GC-susceptible. The significant association between age and odds of mortality varied with sex, and contrasts were used to interpret this interaction relationship. The overall standardized 30-day mortality rate was 8.5 deaths/100,000 person-years. Sherbrooke had a significantly lower 30-day mortality rate compared to Finland. Patients that were either ≥70-years-old or male both experienced significantly higher mortality rates than those < 70-years-old or female. Conclusions In our study populations, region, age, and sex were significantly associated with both 30-day case fatality risk and mortality rate. Additionally, 3GC resistance and location of onset were significantly associated with 30-day case fatality risk. Escherichia coli BSIs caused a considerable burden of disease from 30-day mortality. When analyzing population-based mortality data, it is important to explore mortality through two lenses, mortality rate and case fatality risk.

scholarly journals Experiences of Patients With COVID-19 Admitted to the Intensive Care Units: A Qualitative Study

2021 ◽  
Vol 8 ◽  
pp. 237437352110073
Author(s):  
Reza Norouzadeh ◽  
Mohammad Abbasinia ◽  
Zahra Tayebi ◽  
Ehsan Sharifipour ◽  
Alireza Koohpaei ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Health Care Providers ◽  
Spiritual Support ◽  
Care Providers ◽  
Structured Interviews ◽  
Icu Patients ◽  
Life Challenges ◽  
Care Models ◽  
The Face

This study aimed to describe the experiences of patients with COVID-19 admitted to the intensive care units (ICU). The data were analyzed by content analysis on 16 ICU patients with COVID-19. Data were collected by semi-structured interviews. Three categories were identified: (a) captured by a challenging incident with subcategories: perceived sudden and challenging death, fear of carelessness in overcrowding, worry about the family, and frustration with stigmatizing; (b) the flourishing of life with subcategories: spiritual-awakening, resilience in the face of life challenges, promoting health behaviors, and striving for recovery; and (c) honoring the blessings with subcategories: understanding the importance of nurses, realizing the value of family, and realizing the value of altruism. COVID-19 survivors experienced both positive and negative experiences. The results of this study could help health care providers identify the needs of ICU patients with COVID-19, including psychological, social, and spiritual support and design care models.

scholarly journals Handwash versus hand-rub practices for preventing nosocomial infection in hospital intensive care units: A systematic review and meta-analysis

2020 ◽  
pp. 82-90
Author(s):  
S Bello ◽  
EA Bamgboye ◽  
DT Ajayi ◽  
EN Ossai ◽  
EC Aniwada ◽  
...  
Keyword(s):  
Systematic Review ◽  
Intensive Care ◽  
Adverse Events ◽  
Nosocomial Infection ◽  
Intensive Care Units ◽  
Meta Analysis ◽  
Healthcare Providers ◽  
Length Of Hospital Stay ◽  
Clinical Effectiveness ◽  
Infection Rates

Background: Compliance with handwashing in busy healthcare facilities, such as intensive care units (ICUs), is suboptimal and alcohol hand-rub preparations have been suggested to improve compliance. There is no evidence on the comparative effectiveness between handwash and hand-rub strategies. This systematic review was to assess the effectiveness of handwash versus hand-rub strategies for preventing nosocomial infection in ICUs. Methods Studies conducted in ICUs and indexed in PubMed comparing the clinical effectiveness and adverse events between handwash and hand-rub groups were included in a systematic review. The primary outcome was nosocomial infection rates. Secondary outcomes included microbial counts on healthcare providers’ hands, mortality rates, patient/hospital cost of treatment of healthcare-associated infections (HCAIs), length of ICU/hospital stays, and adverse events. Studies were independently screened and data extracted by at least two authors. Meta-analyses of risk ratios (RR), incidence rate ratios (IRR), odds ratios (OR) and mean differences (MD), were conducted using the RevMan 5.3 software. Results: Seven studies published between 1992-2009 and involving a total of 11,663 patients were included. Five studies (10,981 patients) contributed data to the ICU acquired nosocomial infection rates. The pooled IRR was 0.71 (95% CI 0.61, 0.82; I2 = 94%). On sensitivity analysis, pooled IRR was 0.39 (95% CI 0.32, 0.48; 4 studies; 8,247 patients; I2 = 0%) in favour of hand rub. The pooled OR for mortality was 0.95 (95% CI 0.78, 1.61; 4 studies; 3,475 patients; I2 = 39%). The pooled MD for length of hospital stay was -0.74 (95% CI -2.83, 1.34; 3 studies; 741 patients; I2 = 0%). The pooled OR for an undesirable skin effect was 0.37 (95% CI 0.23, 0.60; 3 studies;1504 patients; I2 = 0%) in favour of hand rub. Overall quality of evidence was low. Conclusion: Hand rub appeared more effective when compared to handwash in ICUs.

scholarly journals Colonization of central venous catheter in the intensive care units at the Institute of Cardiovascular Disease "Dedinje": One year study

2005 ◽  
Vol 52 (3) ◽  
pp. 33-37
Author(s):  
Ivana Cirkovic ◽  
Vera Mijac ◽  
Milena Svabic-Vlahovic ◽  
S. Dukic ◽  
I. Ilic ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Antimicrobial Agents ◽  
Microbial Colonization ◽  
Central Venous ◽  
Candida Spp ◽  
Icu Patients ◽  
Gram Negative ◽  
Microbiological Methods ◽  
Increased Risk

Objectives: The application of Central Venous Catheters (CVC) is associated with increased risk of microbial colonization and infection. The aim of present study was to assess the frequency of pathogens colonizing CVC and to determine their susceptibility pattern to various antimicrobial agents. Materials and methods: A total of 253 samples of CVC from intensive care units (ICU) patients were received for culture during 2003. All microorganisms were identified by standard microbiological methods and the susceptibility to antimicrobial agents was determined according to NCCLS recommendations. Results: A total of 184 (72.7%) cultures were positive and 223 pathogens were isolated. Coagulase negative staphylococci (CNS) were the dominant isolates (24.7%), followed by Enterobacter spp. (12.1%), Pseudomonas spp. (11.7%), Enterococcus spp. (9.9%), Klebsiella spp. (8.6%), Candida spp. (7.6%), Acinetobacter spp. (7.6%), other Gram negative nonfermentative bacilli (5.8%), Serratia spp. (4.5%), Staphylococcus aureus (2.6%), Proteus mirabilis (2.2%), E. coli (1.8%) and Citrobacter spp. (0.9%). Meropenem (84.5%) and vancomycin (100%) remain the most effective antimicrobial agents against Gram negative and Gram positive bacteria, respectively. Conclusion: Gram negative bacilli and CNS are the commonest microorganisms colonizing CVC from ICU patients. The increasing resistance of the bacteria to antimicrobial agents is the major problem in spite of restricted policy of using antimicrobial agents in ICU.

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