scholarly journals Key to successful treatment of COVID-19: accurate identification of severe risks and early intervention of disease progression

2020 ◽  
Author(s):  
Meizhu Chen ◽  
Changli Tu ◽  
Cuiyan Tan ◽  
Xiaobin Zheng ◽  
Xiaohua Wang ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Early Intervention ◽  
Disease Progression ◽  
Case Fatality Rate ◽  
Severe Disease ◽  
Invasive Mechanical Ventilation ◽  
Case Fatality ◽  
List Type ◽  
Fatality Rate ◽  
Medical Burden

AbstractBackgroundCOVID-19 is a new and highly contagious respiratory disease that has caused global spread, high case fatality rate in severe patients, and a huge medical burden due to invasive mechanical ventilation. The current diagnosis and treatment guidelines are still need to be improved, and more excellent clinical experience is needed to provide reference.MethodsWe analyzed and summarized clinical data of 97 confirmed COVID-19 adult patients (including 26 severe cases) admitted to the Fifth Affiliated Hospital of Sun Yat-sen University from January 17, 2020 to March 10, 2020, included laboratory examination results, imaging findings, treatment effect, prognosis, etc, in order to put forward prediction index of severe COVID-19 patients, principles of early intervention and methylprednisolone usages in COVID-19 patients.ResultsHypoxemia, hyperlactic acid, hypoproteinemia, and hypokalemia were prevalent in COVID-19 patients. The significant low lymphocyte count, hypoproteinemia, hypokalemia, the persistent or worsen high CRP, high D-dimer, and high BNP, and the occurrence of hemoptysis and novel coronavirus (SARS-CoV-2) viremia were important indicators for early diagnosis and prediction of severe disease progression.Characteristic images of lung CT had a clear change in COVID-19, Ground-glass opacity (GGO) and high-density linear combinations may indicate different pathological changes. Rapid lobular progression of GGO suggests the possibility of severe disease.Basic principles of early intervention treatment of COVID-19: on the premise of no effective antiviral drugs, treatment is based on supportive and symptomatic therapy (albumin supplementation, supplement of potassium, supplement blood plasma, etc.) in order to maintain the stability of the intracellular environment and adequately reactivate body immunity to clean up SARS-CoV-2.According to severity, oxygenation index, body weight, age, underlying diseases, appropriate amount methylprednisolone application on severe/critical COVID-19 patients on demand, improved blood oxygen and reduced the utilization rate of invasive mechanical ventilation, case fatality rate and medical burden significantly. The most common indications for invasive mechanical ventilation should be strictly control in critical COVID-19 patients.ConclusionsAccurate and timely identification of clinical features in severe risks, and early and appropriate intervention can block disease progression. 2. Appropriate dose of methylprednisolone can effectively avoid invasive mechanical ventilation and reduce case fatality rate in critical COVID-19 patients.

scholarly journals Age and Infectious Dose Significantly Affect Disease Progression after RHDV2 Infection in Naïve Domestic Rabbits

Viruses ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1184
Author(s):  
Robyn N. Hall ◽  
Tegan King ◽  
Tiffany O’Connor ◽  
Andrew J. Read ◽  
Jane Arrow ◽  
...  
Keyword(s):  
New Zealand ◽  
Disease Progression ◽  
Case Fatality Rate ◽  
Low Dose ◽  
Case Fatality ◽  
Wild Rabbit ◽  
Fatality Rate ◽  
Infectious Dose ◽  
Welfare Impacts ◽  
Rabbit Haemorrhagic Disease

Rabbit haemorrhagic disease virus 2 (RHDV2 or GI.2, referring to any virus with lagovirus GI.2 structural genes) is a recently emerged calicivirus that causes generalised hepatic necrosis and disseminated intravascular coagulation leading to death in susceptible lagomorphs (rabbits and hares). Previous studies investigating the virulence of RHDV2 have reported conflicting results, with case fatality rates ranging from 0% to 100% even within a single study. Lagoviruses are of particular importance in Australia and New Zealand where they are used as biocontrol agents to manage wild rabbit populations, which threaten over 300 native species and result in economic impacts in excess of $200 million AUD annually to Australian agricultural industries. It is critically important that any pest control method is both highly effective (i.e., virulent, in the context of viral biocontrols) and has minimal animal welfare impacts. To determine whether RHDV2 might be a suitable candidate biocontrol agent, we investigated the virulence and disease progression of a naturally occurring Australian recombinant RHDV2 in both 5-week-old and 11-week-old New Zealand White laboratory rabbits after either high or low dose oral infection. Objective measures of disease progression were recorded through continuous body temperature monitoring collars, continuous activity monitors, and twice daily observations. We observed a 100% case fatality rate in both infected kittens and adult rabbits after either high dose or low dose infection. Clinical signs of disease, such as pyrexia, weight loss, and reduced activity, were evident in the late stages of infection. Clinical disease, i.e., welfare impacts, were limited to the period after the onset of pyrexia, lasting on average 12 h and increasing in severity as disease progressed. These findings confirm the high virulence of this RHDV2 variant in naïve rabbits. While age and infectious dose significantly affected disease progression, the case fatality rate was consistently 100% under all conditions tested.

scholarly journals Managing older adults’ fear of coronavirus disease: A new role for social work practice

2020 ◽  
pp. 147332502097329
Author(s):  
Hamed Mortazavi
Keyword(s):  
Older Adults ◽  
Case Fatality Rate ◽  
Severe Disease ◽  
Case Fatality ◽  
Social Work Practice ◽  
World Health ◽  
National Committee ◽  
Fatality Rate ◽  
Number Of Patients ◽  
Incidence And Mortality

As the number of patients infected with the 2019 novel coronavirus disease (nCOVID-19) increases, the number of deaths has also been increasing. According to World Health Organization (WHO), as of 4 October 2020, 34,804,348 cases had tested positive for nCOVID-19 globally, which among them, 1,030,738 confirmed deaths had occurred, equivalent to a case-fatality rate of 2.96%. However, in comparison with global statistics, the incidence and mortality of the nCOVID-19 infection are higher in Iran. As reported by the National Committee on COVID-19 Epidemiology of Ministry of Health of Iran, the total number of patients with confirmed COVID-19 infection has reached 468,119, of which 26,746 have died, equivalent to a case-fatality rate of 5.71%. Currently, there is solid evidence that older adults are at a higher risk of severe disease following infection from COVID-19.

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 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 COVID-19, Australia: Epidemiology Report 20. Fortnightly reporting period ending 5 July 2020

2020 ◽  
Vol 44 ◽  
Author(s):  
Keyword(s):  
Intensive Care ◽  
Vulnerable Populations ◽  
Small Proportion ◽  
Surveillance System ◽  
Case Fatality Rate ◽  
Severe Disease ◽  
Case Fatality ◽  
Fatality Rate ◽  
Notifiable Diseases ◽  
The Past

Notified cases of COVID-19 and associated deaths reported to the National Notifiable Diseases Surveillance System (NNDSS) to 5 July 2020. Cumulative confirmed cases in Australia notified up to 5 July 2020: notifications = 8,566, deaths = 106. Over the past fortnightly reporting period (22 June to 5 July), 897 cases were notified, with 4 deaths. The national incidence of COVID-19 remained low, with very few cases reported by most jurisdictions in this reporting period. The majority of the current cases reported over this fortnight are from Victoria, with an increasing number and proportion of cases reported as being locally acquired. Total case numbers have increased with an average of 54 cases reported on any one day, more than twice the average number reported in the previous reporting period. The number and proportion of deaths associated with COVID-19 remains low and it appears that vulnerable populations have not been disproportionately affected by COVID-19 overall. Testing rates continue to be high across all jurisdictions, with the nationwide positivity rate remaining very low at less than 0.3%. In this reporting period, the number of cases reported nationally has increased from 214 (8 June to 21 June) to 897 (22 June to 5 July). Of the cases notified in this reporting period, 87% (781 cases) were notified from Victoria and 89% of these cases were acquired locally. Of the remaining 116 cases reported from other jurisdictions only 6% were locally acquired. The increase in Victoria is attributable to multiple epidemiologically linked outbreaks across a range of settings and locations. A small proportion of cases have experienced severe disease, requiring hospitalisation or intensive care, with some fatalities. The crude case fatality rate amongst Australian cases is 1.2%. People who are older and have one or more comorbidities are more likely to experience severe disease.

scholarly journals Burden of COVID-19 pandemic in India: Perspectives from Health Infrastructure

2020 ◽  
Author(s):  
Harihar Sahoo ◽  
Chaitali Mandal ◽  
Suyash Mishra ◽  
Snigdha Banerjee
Keyword(s):  
High Throughput ◽  
Recovery Rate ◽  
Tamil Nadu ◽  
Case Fatality Rate ◽  
Testing Machine ◽  
Case Fatality ◽  
List Type ◽  
Fatality Rate ◽  
Health Infrastructure ◽  
Positive Rate

AbstractThe coronavirus (COVID-19) is spreading rapidly across the country but India’s testing regime is far from the global standards. It is important to identify the states where testing needs expansion and the magnitudes of active COVID cases are higher focusing on current health infrastructure to meet the pandemic. The data on COVID-19 was extracted from the Application Programming Interface. Test positive rate, test per confirmed case, recovery rate, case fatality rate, and percent distribution of active cases were computed. Availability of hospitals, hospital beds, intensive care unit and ventilators per lakh population was also computed by public and private sector. The result revealed that, Maharashtra constitutes more than one-third positive cases in the country. More than a quarter of the active cases in India belonged to the Mumbai district of Maharashtra, followed by the Chennai district (9.4%) and Ahmedabad district (9.1%). Further, about 40 percent of the active cases in India belonged to the 11 districts of Maharashtra. The increased test positive rate in Maharashtra and Gujarat to almost double in last one month is a concern. In order to bring the states and the country in right track, the test positive rate need to be brought down to below 2 percent. The procurement of higher number of high throughput machine, the Cobas 6800 testing machine, is need of the hour. Only few states have adequate health infrastructure. The priority should be the laid on expansion of more laboratories and hospitals, storage of PPE kit, testing kit, and indigenously developed vaccines.HighlightsMaharashtra is having the highest number of positive cases followed by Gujarat and Tamil Nadu. Maharashtra constitutes more than one-third positive cases in the country, but the test per confirmed cases (8) is much lower than the other states.More than a quarter of the active cases in India belonged to the Mumbai district (26.1%) of Maharashtra, followed by the Chennai district (9.4%) and Ahmedabad district (9.1%). Further, about 40 percent of the active cases in India belonged to the 11 districts of Maharashtra.The test positive rate is higher in Maharashtra, Gujarat and Delhi is a concern.The recovery rate in India increased substantially by 26.5 percent point from 11.9 percent on April 14 to 38.4 percent on May 17, 2020.The case fatality rate of Covid-19 in India declined by 0.2 percent from 3.4 percent on April 14 to 3.2 percent on May 17 in India.The number of Dedicated Covid Hospitals is not sufficient in India.The available ventilators in the country will deficit in near future to cater to a growing number of active Covid-19 patients and the burden of other communicable and non-communicable diseases.India has only 569 testing laboratories (396 govt. and 173 private) against its 1.35 billion population. The procurement of higher number of high throughput machine, the Cobas 6800 testing machine, is need of the hour.

scholarly journals An Outbreak of Ovine Listeriosis in Qassim Region, Saudi Arabia: Epidemiological, Clinical and Treatment Outcomes

2021 ◽  
Vol 10 (4) ◽  
pp. 312-316
Keyword(s):  
Saudi Arabia ◽  
Early Intervention ◽  
Treatment Outcomes ◽  
Case Fatality Rate ◽  
Clinical Signs ◽  
Head Tilt ◽  
Case Fatality ◽  
Morbidity Rate ◽  
Fatality Rate ◽  
Flunixin Meglumine

This study was carried out to describe the epidemiological, clinical and treatment outcomes of an outbreak of listeriosis in a sheep flock at Qassim Region, central of Saudi Arabia during January 2020. The flock consisted of 700 sheep of different age and sex. The overall morbidity rate was 57.14%, while the mortality rate was 50% and the case fatality rate was 87.5%. The morbidity rate was statistically lower (P=0.0001) in sheep having age less than 6 months (16.66%) than those over 6 months (74.48%). On the contrary, the case fatality rate was not statistically different (P=0.9) in young sheep (97.14%) compared to adult animals (86.57%). The clinical signs observed were acute deaths, nervous manifestation in the form of staggers, ataxia, head tilt and circling. Initial diagnosis was made on the basis of the typical clinical signs, while confirmatory diagnosis was made on the basis of bacteriological examination. Treatment using penicillin as antibiotic in addition to flunixin meglumine as anti-inflammatory gave good results in case of early intervention whereas late-stage treatment gave bad prognosis. So, early intervention is the key to treatment success.

VENTILATOR ASSOCIATED PNEUMONIA IN INTENSIVE CARE UNIT OF A TERTIARY LEVEL HOSPITAL

2021 ◽  
pp. 21-24
Author(s):  
J. D. Bhalerao ◽  
R.M. Tambey
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Case Fatality Rate ◽  
Prolonged Mechanical Ventilation ◽  
Case Fatality ◽  
Tertiary Level ◽  
Ventilator Associated Pneumonia ◽  
Fatality Rate ◽  
Level Hospital

Background: Ventilator associated pneumonia (VAP) is the most common nosocomial infection diagnosed in the intensive care units (ICUs). Hence the present study was undertaken to study the incidence, risk factors, case fatality rate of ventilator associated events (VAE) and VAP in ICU of a tertiary level hospital. Method: Total 100 patient of either sex, having the age of >18 years and who was received mechanical ventilation more than 48 hrs for any indication over a period of 12-18 months in an ICU of a tertiary level hospital were studied. Results: The incidence of VAP was 38.0% and VAP rate was 59.6/1000 ventilator days. Post op status (71%) and trauma (22%) were the most common risk factors which lead to VAP and VAE. Acinetobacter spp (19%) and Klebsiella spp (12%) were the two most common microorganisms causing VAP. Mortality or case fatality rate was 42.10%. In ventilator associated events, 45% patients developed VAC (Ventilator associated condition), 44% patients developed IVAC ( Infection related Ventilator associated condition) and 38% patients developed possible VAP. Conclusion: VAP is a serious problem in the ICU leading to longer hospital stay higher treatment costs and increased mortality and morbidity. Prolonged mechanical ventilation is an important risk factor.

scholarly journals Pre-existing comorbidity, the highest risk factor for poor prognosis of COVID-19 among the Mexican population

Nova Scientia ◽  
2021 ◽  
Vol 13 ◽  
Author(s):  
Basilio Calixto-Calderón ◽  
María F. Vázquez-González ◽  
Rafael Martínez Peláez ◽  
Josué R. Bermeo-Escalona ◽  
Vicente García ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Severe Disease ◽  
Case Fatality ◽  
Mexican Population ◽  
Age Group ◽  
Fatality Rate ◽  
Medical Comorbidity ◽  
Factors Associated ◽  
Risk Of Death ◽  
Prevalence Of Obesity

The coronavirus disease 2019 (COVID-19) pandemic represents a challenge for public health and a high risk for patients with pre-existing comorbidity. As of July 20, 2020, the Case Fatality Rate (CFR) was 11.30% and the Mortality Rate (MR) was 31.28 deaths per 100,000 population. In Mexico, the prevalence of obesity, diabetes mellitus, and hypertension among the adult Mexican population is 30%, 9.2%, and 40%, respectively. The objective of this research was to identify the risk factors associated with eight comorbidities and their dependency on age for death caused by COVID-19. Method: This study used the dataset published on July 20, 2020, by the General Directorate of Epidemiology of the Ministry of Health of Mexico. From this dataset, we analysed 130,896 positive COVID-19 cases, where 35,483 (27.107%) patients had one comorbidity, and 95,413 (72.892%) patients had not medical comorbidity. Statistical analyses include the Case Fatality Rate (CFR), the estimation of the Odds Ratio (OR), and its 95% Confidence Interval (CI). Results: The highest CFR was 14.382% for COPD, 10.266% for CKD, 10.126% for diabetes, and 8.954% for hypertension. The obesity CFR was 3.535%. Moreover, we detected a higher risk for patients with COPD, diabetes, and CKD, resulting in OR of 4.443 (95% CI: 3.404-5.799), 3.283 (95% CI: 3.018-3.570), and 3.016 (95% CI: 2.248-4.047), respectively.   Conclusion: This study corroborates that the highest risk for severe disease and death caused by COVID-19 among the Mexican population are pre-existing comorbidities. Findings show that COPD, CKD, diabetes, hypertension, and cardiovascular disease increase the risk of death for patients older than 54 years. The most vulnerable age group is older than 65 years.

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