Case fatality rate in COVID-19: a systematic review and meta-analysis

AbstractBackgroundEstimating the prevalence of severe or critical illness and case fatality of COVID-19 outbreak in December, 2019 remains a challenge due to biases associated with surveillance, data synthesis and reporting. We aimed to address this limitation in a systematic review and meta-analysis and to examine the clinical, biochemical and radiological risk factors in a meta-regression.MethodsPRISMA guidelines were followed. PubMed, Scopus and Web of Science were searched using pre-specified keywords on March 07, 2020. Peer-reviewed empirical studies examining rates of severe illness, critical illness and case fatality among COVID-19 patients were examined. Numerators and denominators to compute the prevalence rates and risk factors were extracted. Random-effects meta-analyses were performed. Results were corrected for publication bias. Meta-regression analyses examined the moderator effects of potential risk factors.ResultsThe meta-analysis included 29 studies representing 2,090 individuals. Pooled rates of severe illness, critical illness and case fatality among COVID-19 patients were 15%, 5% and 0.8% respectively. Adjusting for potential underreporting and publication bias, increased these estimates to 26%, 16% and 7.4% respectively. Increasing age and elevated LDH consistently predicted severe / critical disease and case fatality. Hypertension; fever and dyspnea at presentation; and elevated CRP predicted increased severity.ConclusionsRisk factors that emerged in our analyses predicting severity and case fatality should inform clinicians to define endophenotypes possessing a greater risk. Estimated case fatality rate of 7.4% after correcting for publication bias underscores the importance of strict adherence to preventive measures, case detection, surveillance and reporting.

Download Full-text

Severity and case fatality rates of COVID-19: a systematic review, meta-analysis and an exploratory meta-regression of risk factors

The Southwest Respiratory and Critical Care Chronicles ◽

10.12746/swrccc.v9i41.921 ◽

2021 ◽

Vol 9 (41) ◽

pp. 8-19

Author(s):

Chathurika Samudani Dhanasekara ◽

Shao-Hua Chin ◽

Chanaka N. Kahathuduwa

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Critical Illness ◽

Publication Bias ◽

Meta Analysis ◽

Case Fatality ◽

Severe Illness ◽

Small Scale ◽

Regression Analyses ◽

Meta Regression

Background: We aimed to estimate prevalence of severe or critical illness and case fatality of COVID-19 in a systematic review and meta-analysis and to examine clinical, biochemical and radiological risk factors in a meta-regression. Methods: PRISMA guidelines were followed. PubMed, Scopus and Web of Science were searched using pre-specified keywords. Peer-reviewed empirical studies examining rates of severe illness, critical illness and case fatality among COVID-19 patients were examined. Random-effects meta-analyses were performed and adjusted for publication bias. Meta-regression analyses examined the moderator effects of risk factors. Results: The meta-analysis included 29 studies representing 2,090 individuals. Pooled prevalence rates of severe illness, critical illness and case fatality among COVID-19 patients were 15%, 5% and 0.8% respectively. There were significant heterogeneity and publication bias related with the studies. Meta-regression analyses revealed that increasing age and elevated LDH consistently predicted severe / critical disease and case fatality. Moreover, hypertension; fever and dyspnea at presentation; and elevated CRP predicted increased severity. Conclusions: Emerged predictors of severity and case fatality should inform clinicians to define at-risk endophenotypes. Differences in un-adjusted vs. adjusted pooled estimates indicates limited utility of small-scale studies and underscores the importance of multi-national studies to establish the morbidity and mortality rates in pandemics.

Download Full-text

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

JNCI Journal of the National Cancer Institute ◽

10.1093/jnci/djaa168 ◽

2020 ◽

Cited By ~ 3

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.

Download Full-text

Faculty Opinions recommendation of Case fatality rate and risk factors for Nipah virus encephalitis: A systematic review and meta-analysis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.735840148.793588333 ◽

2021 ◽

Author(s):

Alexander Freiberg

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Case Fatality Rate ◽

Meta Analysis ◽

Nipah Virus ◽

Case Fatality ◽

Fatality Rate ◽

Virus Encephalitis

Download Full-text

Case fatality rate and risk factors for Nipah virus encephalitis: A systematic review and meta-analysis

Journal of Clinical Virology ◽

10.1016/j.jcv.2019.05.009 ◽

2019 ◽

Vol 117 ◽

pp. 19-26

Author(s):

Sebastien Kenmoe ◽

Maurice Demanou ◽

Jean Joel Bigna ◽

Cyprien Nde Kengne ◽

Abdou Fatawou Modiyinji ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Case Fatality Rate ◽

Meta Analysis ◽

Nipah Virus ◽

Case Fatality ◽

Fatality Rate ◽

Virus Encephalitis

Download Full-text

Global epidemiology of septic shock: a protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-032289 ◽

2019 ◽

Vol 9 (11) ◽

pp. e032289

Author(s):

Frank Leonel Tianyi ◽

Joel Noutakdie Tochie ◽

Celestin Danwang ◽

Aime Mbonda ◽

Mazou N Temgoua ◽

...

Keyword(s):

Systematic Review ◽

Septic Shock ◽

Case Fatality Rate ◽

Hospital Admissions ◽

Meta Analysis ◽

Case Fatality ◽

Primary Study ◽

Fatality Rate ◽

Cross Sectional ◽

Global Epidemiology

BackgroundSeptic shock is a life-threatening infection frequently responsible for hospital admissions or may be acquired as nosocomial infection in hospitalized patients with resultant significant morbidity and mortality . There is a dearth of data on a résumé and meta-analysis on the global epidemiology of this potentially deadly condition. Therefore, we propose the first systematic review to synthesize existing data on the global incidence, prevalence and case fatality rate of septic shock worldwide.MethodsWe will include cross-sectional, case-control and cohort studies reporting on the incidence, and case fatality rate of septic shock. Electronic databases including PubMed, Embase, WHO Global Health Library and Web of Science will be searched for relevant records published between 1 January 2000 and 31 August 2019. Independents reviewers will perform study selection and data extraction, as well as assessment of methodological quality of included studies. Appropriate meta-analysis will then be used to pool studies judged to be clinically homogenous. Egger’s test and funnel plots will be used to detect publication bias. Findings will be reported and compared by human development level of countries.Ethics and disseminationBeing a review, ethical approval is not required as it was obtained in the primary study which will make up the review. This review is expected to provide relevant data to help in evaluating the burden of septic shock in the general population. The overall findings of this research will be published in a peer-reviewed journal.PROSPERO registration numberCRD42019129783.

Download Full-text

Bacterial pathogens and resistance causing community acquired paediatric bloodstream infections in low- and middle-income countries: a systematic review and meta-analysis

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-019-0673-5 ◽

2019 ◽

Vol 8 (1) ◽

Cited By ~ 3

Author(s):

Nina Droz ◽

Yingfen Hsia ◽

Sally Ellis ◽

Angela Dramowski ◽

Mike Sharland ◽

...

Keyword(s):

Systematic Review ◽

Blood Culture ◽

Case Fatality Rate ◽

Bacterial Pathogens ◽

Meta Analysis ◽

Case Fatality ◽

Bloodstream Infections ◽

Fatality Rate ◽

Middle Income ◽

Middle Income Countries

Abstract Background Despite a high mortality rate in childhood, there is limited evidence on the causes and outcomes of paediatric bloodstream infections from low- and middle-income countries (LMICs). We conducted a systematic review and meta-analysis to characterize the bacterial causes of paediatric bloodstream infections in LMICs and their resistance profile. Methods We searched Pubmed and Embase databases between January 1st 1990 and October 30th 2019, combining MeSH and free-text terms for “sepsis” and “low-middle-income countries” in children. Two reviewers screened articles and performed data extraction to identify studies investigating children (1 month-18 years), with at least one blood culture. The main outcomes of interests were the rate of positive blood cultures, the distribution of bacterial pathogens, the resistance patterns and the case-fatality rate. The proportions obtained from each study were pooled using the Freeman-Tukey double arcsine transformation, and a random-effect meta-analysis model was used. Results We identified 2403 eligible studies, 17 were included in the final review including 52,915 children (11 in Africa and 6 in Asia). The overall percentage of positive blood culture was 19.1% [95% CI: 12.0–27.5%]; 15.5% [8.4–24.4%] in Africa and 28.0% [13.2–45.8%] in Asia. A total of 4836 bacterial isolates were included in the studies; 2974 were Gram-negative (63.9% [52.2–74.9]) and 1858 were Gram-positive (35.8% [24.9–47.5]). In Asia, Salmonella typhi (26.2%) was the most commonly isolated pathogen, followed by Staphylococcus aureus (7.7%) whereas in Africa, S. aureus (17.8%) and Streptococcus pneumoniae (16.8%) were predominant followed by Escherichia coli (10.7%). S. aureus was more likely resistant to methicillin in Africa (29.5% vs. 7.9%), whereas E. coli was more frequently resistant to third-generation cephalosporins (31.2% vs. 21.2%), amikacin (29.6% vs. 0%) and ciprofloxacin (36.7% vs. 0%) in Asia. The overall estimate for case-fatality rate among 8 studies was 12.7% [6.6–20.2%]. Underlying conditions, such as malnutrition or HIV infection were assessed as a factor associated with bacteraemia in 4 studies each. Conclusions We observed a marked variation in pathogen distribution and their resistance profiles between Asia and Africa. Very limited data is available on underlying risk factors for bacteraemia, patterns of treatment of multidrug-resistant infections and predictors of adverse outcomes.

Download Full-text

Global epidemiology of acute generalised peritonitis: a protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-034326 ◽

2020 ◽

Vol 10 (1) ◽

pp. e034326

Author(s):

Joel Noutakdie Tochie ◽

Ndip Valirie Agbor ◽

Tianyi Tianyi Frank Leonel ◽

Aime Mbonda ◽

Desmond Aji Abang ◽

...

Keyword(s):

Systematic Review ◽

Case Fatality Rate ◽

Data Extraction ◽

Meta Analysis ◽

Case Fatality ◽

Published Data ◽

Fatality Rate ◽

Global Epidemiology ◽

Ethical Approval ◽

Registration Number

IntroductionGlobally, acute generalised peritonitis (AGP) is a common medical and surgical emergency which is a major contributor to non-trauma deaths despite improvements in diagnosis and surgical and intensive care management. In order to determine the global burden of AGP, geared at tailoring key interventions to curb its morbidity and mortality, we proposed this first ever systematic review and meta-analysis to estimate the contemporary prevalence, and to determine the most frequent AGP and the case fatality rate of AGP, at the global scene.Methods and analysisWe intend to searchAfricanJournalsOnline, Americana em Ciências da Saúde, Citation index, EMBASE, Global Index Medicus, Literatura Latino Africa Index Medicus, Medline and Scientific Electronic Library Online databases from 1 January 2009 to 31 July 2019 to identify studies that reported the prevalence, types of AGP, and case fatality rate of AGP in the global population without any language restrictions. Study selection, data extraction and risk of bias assessment will be conducted independently at each level by a pair of independent investigators. Random-effects meta-analysis will be used to pool studies judged to be clinically homogeneous. The presence of heterogeneity will be evaluated using the χ² test on Cochrane’s Q statistic and quantified with the I² statistics. Publication bias will be evaluated statistically and visually using the Egger’s test and funnel plots, respectively. Findings will be reported and compared by countries, WHO regions and globally.Ethics and disseminationSince this study will be based on published data, it does will not require an ethical approval. The findings will be published in a scientific peer-reviewed journal. They will also be presented at scientific conferences and to relevant public health actors.PROSPERO registration numberCRD42019143331.

Download Full-text