scholarly journals Associations between ambient air pollutants exposure and case fatality rate of COVID-19: a multi-city ecological study in China

2020 ◽  
Author(s):  
Tiantian Zhang ◽  
Guoli Zhao ◽  
Li Luo ◽  
Yongzhen Li ◽  
Wenming Shi
Keyword(s):  
Air Pollutants ◽  
Case Fatality Rate ◽  
Model Fitting ◽  
Case Fatality ◽  
Ambient Air ◽  
Hubei Province ◽  
Fatality Rate ◽  
Ecological Analysis ◽  
Average Case ◽  
Ambient Air Pollutants

AbstractBackgroundEnvironmental factors, including air pollution, can strongly impact on spatio-temporal patterns of infectious diseases outbreak. In this study, we aimed to investigate the association and correlation between ambient air pollutants and case fatality rate (CFR) of the novel coronavirus disease (COVID-19) in China.MethodsPublicly accessible data on COVID-19 average CFR were utilized in the data analysis. The ambient daily air pollutants including fine particulate matter (PM2.5), inhalable particles (PM10) and nitrogen dioxide (NO2) during the period from December 25, 2019 to March 5, 2020 were obtained from National Air Quality Real-time Publishing System of China. Ecological analysis was performed to explore the association and correlation between the cumulative average exposure of ambient air pollutants at different lag days (14 and 28 days) and average CFR in China outside Hubei and cities in Hubei province via model fitting.ResultsThe average case fatality rate was highest in Wuhan city (4.53%) and the cumulative average exposure of ambient PM2.5, PM10 and NO2 at lag 28 days was 55.8±12.1μg/m3, 66.8±9.2μg/m3, 20.7±4.4μg/m3, respectively in Hubei province during the study period. Ecological analysis showed that ambient PM2.5, PM10 and NO2 exposure at both lag 14 and 28 days was positively correlated with average CFR in China outside Hubei (province-level). For city-level analysis in Hubei, significant associations were only found between cumulative ambient NO2 exposure and average CFR(r=0.693 for Lag0-14, r=0.697 for Lag0-28, respectively) during the same period.ConclusionOur findings suggested ambient PM2.5, PM10 and NO2 exposure, especially at 28 lag days, positively associated with the case fatality rate of COVID-19 in China. These results could help provide guidance for identifying potential exposure window and preventing and controlling the epidemic.

scholarly journals Association of COVID-19 case fatality rate with disease burden: an ecological analysis in Italy during the first wave

2021 ◽  
Vol 111 ◽  
pp. 186-189
Author(s):  
Laura Timelli ◽  
Giuseppina Liuzzi ◽  
Alessandro Cannavacciuolo ◽  
Nicola Petrosillo ◽  
Vincenzo Puro ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Disease Burden ◽  
Case Fatality ◽  
Fatality Rate ◽  
Ecological Analysis

scholarly journals COVID-19: Spatial Analysis of Hospital Case-Fatality Rate in France

2020 ◽  
Author(s):  
Marc SOURIS ◽  
Jean-Paul Gonzalez
Keyword(s):  
International Organizations ◽  
Rate Ratio ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Healthcare Systems ◽  
Fatality Rate ◽  
Average Case ◽  
Hospital Case ◽  
Reporting Systems ◽  
Overall Efficiency

When the population risk factors and reporting systems are similar, the assessment of the case-fatality (or lethality) rate (ratio of cases to deaths) represents a perfect tool for analyzing, understanding and improving the overall efficiency of the health system. The objective of this article is to estimate the influence of the hospital care system on lethality in metropolitan France during the inception of the COVID-19 epidemic, by analyzing the spatial variability of the hospital case-fatality rate between French districts (i.e. French departements). The results show that the higher case-fatality rates observed by districts are mostly related to the level of morbidity, therefore to the overwhelming of the healthcare systems during the acute phases of the epidemic. However, the magnitude of this increase of case-fatality rate represents less than 10 per cent of the average case-fatality rate and cannot explain the magnitude of the variations in case-fatality rate reported per country by international organizations or information sites. These differences can only be explained by the systems for reporting cases and deaths, which, indeed, vary greatly from country to country, and not attributed to the care or treatment of patients, even during hospital stress due to epidemic peaks.

scholarly journals Regional Differences in Epidemiological and Clinical Characteristics, Treatment, and Clinical Outcomes of COVID-19 in Wuhan and Remote Areas of Hubei Province

2021 ◽  
Vol 8 ◽  
Author(s):  
Honggang Ren ◽  
Xingyi Guo ◽  
Antonio Palazón-Bru ◽  
Pengcheng Yang ◽  
Nan Huo ◽  
...  
Keyword(s):  
Regional Differences ◽  
Case Fatality Rate ◽  
Clinical Characteristics ◽  
Case Fatality ◽  
Cross Sectional Study ◽  
Hubei Province ◽  
Fatality Rate ◽  
Cross Sectional ◽  
Suburban Areas

Background: The Coronavirus disease 2019 (COVID-19) pandemic has been a major threat to global health. Regional differences in epidemiological and clinical characteristics, treatment and outcomes of patients have not yet been investigated. This study was conducted to investigate these differences amongCOVID-19 patients in Hubei Province, China.Methods: This retrospective cross-sectional study analyzed data on 289 COVID-19 patients from designated hospitals in three regions:Urban (Wuhan Union West Hospital), Suburban areas of Wuhan (Hannan Hospital) and Enshi city, between February 8 and 20, 2020. The final date of follow-up was December 14th, 2020. The outcomes were case fatality rate and epidemiological and clinical data.Results: Urban Wuhan experienced a significantly higher case fatality rate (21.5%) than suburban Wuhan (5.23%) and rural area of Enshi (3.51%). Urban Wuhan had a higher proportion of patients on mechanical ventilation (24.05%) than suburban Wuhan (0%) and rural Enshi (3.57%). Treatment with glucocorticoids was equivalent in urban and suburban Wuhan (46.84 and 45.75%, respectively) and higher than Enshi (25.00%). Urban Wuhan had a higher proportion of patients with abnormal tests including liver function and serum electrolytes and a higher rate of pneumonia (p < 0.01 for all). Urban Wuhan also had a higher incidence of respiratory failure, heart disease, liver disease and shock, compared with the other two regions (all p < 0.05).Conclusions: Our findings revealed that there are regional differences in COVID-19. These findings provide novel insights into the distribution of appropriate resources for the prevention, control and treatment of COVID-19 for the global community.

scholarly journals Estimating the real-time case fatality rate of COVID-19 using Poisson mixtures model

2020 ◽  
Author(s):  
Paul H. Lee
Keyword(s):  
Real Time ◽  
Case Fatality Rate ◽  
Early Stage ◽  
Case Fatality ◽  
Hubei Province ◽  
Fatality Rate ◽  
The Real ◽  
Poisson Mixtures

ABSTRACTWe proposed using Poisson mixtures model that utilized data of deaths, recoveries, and total confirmed cases in each day since the outbreak. We demonstrated that our CFR estimates for Hubei Province and other parts of China were superior to the simple CFR estimators in the early stage of COVID-19 outbreak.

scholarly journals Urban Air Pollution May Enhance COVID-19 Case-Fatality and Mortality Rates in the United States

2020 ◽  
Author(s):  
Donghai Liang ◽  
Liuhua Shi ◽  
Jingxuan Zhao ◽  
Pengfei Liu ◽  
Joel Schwartz ◽  
...  
Keyword(s):  
Air Pollution ◽  
Mortality Rate ◽  
Case Fatality Rate ◽  
Urban Air Pollution ◽  
Case Fatality ◽  
Ambient Air ◽  
County Level ◽  
Fatality Rate ◽  
P Values

AbstractBackgroundThe novel human coronavirus disease 2019 (COVID-19) pandemic has claimed more than 240,000 lives worldwide, causing tremendous public health, social, and economic damages. While the risk factors of COVID-19 are still under investigation, environmental factors, such as urban air pollution, may play an important role in increasing population susceptibility to COVID-19 pathogenesis.MethodsWe conducted a cross-sectional nationwide study using zero-inflated negative binomial models to estimate the association between long-term (2010-2016) county-level exposures to NO2, PM2.5 and O3 and county-level COVID-19 case-fatality and mortality rates in the US. We used both single and multipollutant models and controlled for spatial trends and a comprehensive set of potential confounders, including state-level test positive rate, county-level healthcare capacity, phase-of-epidemic, population mobility, sociodemographic, socioeconomic status, behavior risk factors, and meteorological factors.Results1,027,799 COVID-19 cases and 58,489 deaths were reported in 3,122 US counties from January 22, 2020 to April 29, 2020, with an overall observed case-fatality rate of 5.8%. Spatial variations were observed for both COVID-19 death outcomes and long-term ambient air pollutant levels. County-level average NO2 concentrations were positively associated with both COVID-19 case-fatality rate and mortality rate in single-, bi-, and tri-pollutant models (p-values<0.05). Per inter-quartile range (IQR) increase in NO2 (4.6 ppb), COVID-19 case-fatality rate and mortality rate were associated with an increase of 7.1% (95% CI 1.2% to 13.4%) and 11.2% (95% CI 3.4% to 19.5%), respectively. We did not observe significant associations between long-term exposures to PM2.5 or O3 and COVID-19 death outcomes (p-values>0.05), although per IQR increase in PM2.5 (3.4 ug/m3) was marginally associated with 10.8% (95% CI: −1.1% to 24.1%) increase in COVID-19 mortality rate.Discussions and ConclusionsLong-term exposure to NO2, which largely arises from urban combustion sources such as traffic, may enhance susceptibility to severe COVID-19 outcomes, independent of longterm PM2.5 and O3 exposure. The results support targeted public health actions to protect residents from COVID-19 in heavily polluted regions with historically high NO2 levels. Moreover, continuation of current efforts to lower traffic emissions and ambient air pollution levels may be an important component of reducing population-level risk of COVID-19 deaths.

Ambient Air Pollutants and Acute Case-Fatality of Cerebro-Cardiovascular Events: Takashima Stroke and AMI Registry, Japan (1988–2004)

2012 ◽  
Vol 34 (2) ◽  
pp. 130-139 ◽  
Author(s):  
Tanvir Chowdhury Turin ◽  
Yoshikuni Kita ◽  
Nahid Rumana ◽  
Yasuyuki Nakamura ◽  
Kayo Ueda ◽  
...  
Keyword(s):  
Air Pollutants ◽  
Cardiovascular Events ◽  
Case Fatality ◽  
Ambient Air ◽  
Acute Case ◽  
Ambient Air Pollutants

scholarly journals COVID-19: Spatial analysis of hospital case-fatality rate in France

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243606
Author(s):  
Marc Souris ◽  
Jean-Paul Gonzalez
Keyword(s):  
Healthcare System ◽  
Case Fatality Rate ◽  
Healthcare Access ◽  
Case Fatality ◽  
Fatality Rate ◽  
System Quality ◽  
Hospital Data ◽  
Average Case ◽  
Hospital Case ◽  
Age Related

When the population risk factors and reporting systems are similar, the assessment of the case-fatality (or lethality) rate (ratio of cases to deaths) represents a perfect tool for analyzing, understanding and improving the overall efficiency of the health system. The objective of this article is to estimate the influence of the hospital care system on lethality in metropolitan France during the inception of the COVID-19 epidemic, by analyzing the spatial variability of the hospital case-fatality rate (CFR) between French districts. In theory, the hospital age-standardized CFR should not display significant differences between districts, since hospital lethality depends on the virulence of the pathogen (the SARS-CoV-2 virus), the vulnerability of the population (mainly age-related), the healthcare system quality, and cases and deaths definition and the recording accuracy. We analyzed hospital data on COVID-19 hospitalizations, severity (admission to intensive care units for reanimation or endotracheal intubation) and mortality, from March 19 to May 8 corresponding to the first French lockdown. All rates were age-standardized to eliminate differences in districts age structure. The results show that the higher case-fatality rates observed by districts are mostly related to the level of morbidity. Time analysis shows that the case-fatality rate has decreased over time, globally and in almost all districts, showing an improvement in the management of severe patients during the epidemic. In conclusion, it appears that during the first critical phase of COVID-19 ramping epidemic in metropolitan France, the higher case-fatality rates were generally related to the higher level of hospitalization, then potentially related to the overload of healthcare system. Also, low hospitalization with high case-fatality rates were mostly found in districts with low population density, and could due to some limitation of the local healthcare access. However, the magnitude of this increase of case-fatality rate represents less than 10 per cent of the average case-fatality rate, and this variation is small compared to much greater variation across countries reported in the literature.

We Have the Solution: Now What's the Problem?

PEDIATRICS ◽  
1992 ◽  
Vol 90 (1) ◽  
pp. 113-115 ◽  
Author(s):  
RONALD E. KLEINMAN
Keyword(s):  
Replacement Therapy ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Western Hemisphere ◽  
Watery Diarrhea ◽  
Fatality Rate ◽  
Years Of Experience ◽  
Average Case ◽  
Electrolyte Replacement

The largest outbreak of the current cholera pandemic and the first to strike the Western hemisphere in this century began in Peru in January of 1991. Two hundred seventy-four thousand, seven hundred sixty-eight cases were reported as of August 7, 1991, with an average case-fatality rate of just over 1%.1 For more than 30 years cholera has served as the paradigm for watery diarrhea, fully treatable by fluid and electrolyte replacement therapy. More than 20 years of experience, including this most recent epidemic in our own hemisphere, has proven the effectiveness of this therapy when given by mouth. It is hard to imagine a more impressive benefit from a cheap and simple therapy.

scholarly journals Did Patients With COVID-19 Receive Timely Treatment in the Early Epidemic? A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Peipei Du ◽  
Weixiang Chen ◽  
Xufei Luo ◽  
Yaolong Chen ◽  
Qianling Shi ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Early Stage ◽  
Meta Analysis ◽  
Case Fatality ◽  
Hubei Province ◽  
Cochrane Library ◽  
Time Interval ◽  
Fatality Rate ◽  
Significant Difference ◽  
Timely Treatment

Abstract Background: COVID-19 showed a significant difference in case fatality rate between different regions at the early stage of the epidemic. In addition to the well-known factors such as age structure, detection efficiency, and race, there was also a possibility that medical resource shortage caused the increase of the case fatality rate in some regions. Methods: Medline, Cochrane Library, Embase, Web of Science, CBM, CNKI, and Wan fang of identified articles were searched through 29 June 2020. Cohort studies and case series with duration information on COVID-19 patients were included. Two independent reviewers extracted the data using a standardized data collection form and assessed the risk of bias. Data were synthesized through description and analysis methods including a meta-analysis.Results: A total of 109 articles were retrieved. The time interval from onset to the first medical visit of COVID-19 patients in China was 3.38±1.55 days (corresponding intervals in Hubei province, non-Hubei provinces, Wuhan, Hubei provinces without Wuhan were 4.22±1.13 days, 3.10±1.57 days, 4.20±0.97 days, and 4.34±1.72 days, respectively). The time interval from onset to the hospitalization of COVID-19 patients in China was 8.35±6.83 days (same corresponding intervals were 12.94±7.43 days, 4.17±1.45 days, 14.86±7.12 days, and 5.36±1.19 days, respectively), and when it was outside China, this interval was 5.27±1.19 days. Conclusion: In the early stage of the COVID-19 epidemic, patients with COVID-19 did not receive timely treatment, resulting in a higher case fatality rate in Hubei province, partly due to the relatively insufficient and unequal medical resources. This research suggested that additional deaths caused by the out-of-control epidemic can be avoided if prevention and control work is carried out at the early stage of the epidemic.PROSPERO registration number CRD42020195606.

scholarly journals Impact of Long-Term Air Pollution on the Case Fatality Rate of COVID-19

2020 ◽  
Author(s):  
Chang-kai Hou ◽  
Ya-fei Qin ◽  
Quan-lei Liu ◽  
Xin-yu Yang ◽  
Hao Wang
Keyword(s):  
Air Pollution ◽  
Air Quality ◽  
Predictive Value ◽  
Air Pollutants ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Fatality Rate ◽  
Correlation Relationship ◽  
Pollution Indicator

Abstract Background There is preliminary evidence of the long-term exposure to air pollution will affect the outcome of patients with COVID-19. More information is needed about relationship between long-term exposure to air pollution and case fatality rate (CFR) of patients with COVID-19.Methods In this study, we have collected the data of Air Quality Index (AQI), PM2.5, PM10, SO2, NO2 and O3 from 14 representative cities in China in the past 5 years, and calculated the case fatality rate of COVID-19 in the corresponding city. First, we explored correlation relationship between CFR and long-term air quality indicators. Then, we try to point out the air pollutants that affect the level of CFR and evaluated their predictive value.Results We have observed a positive correlation between the CFR and AQI (1-year, 3-year, 5-year), PM2.5 (1-year, 3-year, 5-year), and PM10 (1-year, 3-year, 5-year). Meanwhile, AQI (3-year, 5-year) and PM2.5 (1-year, 3-year, 5-year) were significantly higher in the high CFR group. Moderate predictive value of air pollution indicator to CFR such as AQI (1-year, 3-year, 5-year), PM2.5 (1-year, 3-year, 5-year) have been found.Conclusions Our results indicate that long-term exposure to the environment with severe air pollution is associated with CFR of COVID-19. Air pollutants such as PM2.5 may have potential ability to predict the CFR of COVID-19.

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