scholarly journals Country-level Determinants of the Severity of the First Global Wave of the COVID-19 Pandemic: An Ecological Study

2020 ◽  
Author(s):  
Tiberiu A Pana ◽  
Sohinee Bhattacharya ◽  
David T Gamble ◽  
Zahra Pasdar ◽  
Weronika A Szlachetka ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Study Design ◽  
Vaccination Coverage ◽  
Death Rate ◽  
Ecological Study ◽  
The Philippines ◽  
International Travel ◽  
Bcg Vaccination ◽  
Country Level ◽  
The Mean

ABSTRACTObjectiveWe aimed to identify the country-level determinants of the severity of the first wave of the COVID-19 pandemic.DesignAn ecological study design of publicly available data was employed. Countries reporting >25 COVID-related deaths until 08/06/2020 were included. The outcome was log mean mortality rate from COVID-19, an estimate of the country-level daily increase in reported deaths during the ascending phase of the epidemic curve. Potential determinants assessed were most recently published demographic parameters (population and population density, percentage population living in urban areas, median age, average body mass index, smoking prevalence), Economic parameters (Gross Domestic Product per capita); environmental parameters: pollution levels, mean temperature (January-May)), co-morbidities (prevalence of diabetes, hypertension and cancer), health system parameters (WHO Health Index and hospital beds per 10,000 population); international arrivals, the stringency index, as a measure of country-level response to COVID-19, BCG vaccination coverage, UV radiation exposure and testing capacity. Multivariable linear regression was used to analyse the data.Primary OutcomeCountry-level mean mortality rate: the mean slope of the COVID-19 mortality curve during its ascending phase.ParticipantsThirty-seven countries were included: Algeria, Argentina, Austria, Belgium, Brazil, Canada, Chile, Colombia, the Dominican Republic, Ecuador, Egypt, Finland, France, Germany, Hungary, India, Indonesia, Ireland, Italy, Japan, Mexico, the Netherlands, Peru, the Philippines, Poland, Portugal, Romania, the Russian Federation, Saudi Arabia, South Africa, Spain, Sweden, Switzerland, Turkey, Ukraine, the United Kingdom and the United States.ResultsOf all country-level predictors included in the multivariable model, total number of international arrivals (beta 0.033 (95% Confidence Interval 0.012,0.054)) and BCG vaccination coverage (−0.018 (−0.034,-0.002)), were significantly associated with the mean death rate.ConclusionsInternational travel was directly associated with the mortality slope and thus potentially the spread of COVID-19. Very early restrictions on international travel should be considered to control COVID outbreak and prevent related deaths.ARTICLE SUMMARYStrengths and limitationsA comparable and relevant outcome variable quantifying country-level increases in the COVID-19 death rate was derived which is largely independent of different testing policies adopted by each countryOur multivariable regression models accounted for public health and economic measures which were adopted by each country in response to the COVID-19 pandemic by adjusting for the Stringency IndexThe main limitation of the study stems from the ecological study design which does not allow for conclusions to be drawn for individual COVID-19 patientsOnly countries that had reported at least 25 daily deaths over the analysed period were included, which reduced our sample and consequently the power.

scholarly journals Country-level determinants of the severity of the first global wave of the COVID-19 pandemic: an ecological study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e042034
Author(s):  
Tiberiu A Pana ◽  
Sohinee Bhattacharya ◽  
David T Gamble ◽  
Zahra Pasdar ◽  
Weronika A Szlachetka ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Vaccination Coverage ◽  
Urban Areas ◽  
Ecological Study ◽  
Environmental Parameters ◽  
The Philippines ◽  
International Travel ◽  
Bcg Vaccination ◽  
Country Level ◽  
The Mean

ObjectiveWe aimed to identify the country-level determinants of the severity of the first wave of the COVID-19 pandemic.DesignEcological study of publicly available data. Countries reporting >25 COVID-19 related deaths until 8 June 2020 were included. The outcome was log mean mortality rate from COVID-19, an estimate of the country-level daily increase in reported deaths during the ascending phase of the epidemic curve. Potential determinants assessed were most recently published demographic parameters (population and population density, percentage population living in urban areas, population >65 years, average body mass index and smoking prevalence); economic parameters (gross domestic product per capita); environmental parameters (pollution levels and mean temperature (January–May); comorbidities (prevalence of diabetes, hypertension and cancer); health system parameters (WHO Health Index and hospital beds per 10 000 population); international arrivals; the stringency index, as a measure of country-level response to COVID-19; BCG vaccination coverage; UV radiation exposure; and testing capacity. Multivariable linear regression was used to analyse the data.Primary outcomeCountry-level mean mortality rate: the mean slope of the COVID-19 mortality curve during its ascending phase.ParticipantsThirty-seven countries were included: Algeria, Argentina, Austria, Belgium, Brazil, Canada, Chile, Colombia, the Dominican Republic, Ecuador, Egypt, Finland, France, Germany, Hungary, India, Indonesia, Ireland, Italy, Japan, Mexico, the Netherlands, Peru, the Philippines, Poland, Portugal, Romania, the Russian Federation, Saudi Arabia, South Africa, Spain, Sweden, Switzerland, Turkey, Ukraine, the UK and the USA.ResultsOf all country-level determinants included in the multivariable model, total number of international arrivals (beta 0.033 (95% CI 0.012 to 0.054)) and BCG vaccination coverage (−0.018 (95% CI −0.034 to –0.002)), were significantly associated with the natural logarithm of the mean death rate.ConclusionsInternational travel was directly associated with the mortality slope and thus potentially the spread of COVID-19. Very early restrictions on international travel should be considered to control COVID-19 outbreaks and prevent related deaths.

scholarly journals ACE-1 I/D Polymorphism Associated with COVID-19 Incidence and Mortality: An Ecological Study

2020 ◽  
Author(s):  
Chris Kenyon
Keyword(s):  
Literature Review ◽  
Angiotensin Converting Enzyme ◽  
Study Design ◽  
Ecological Study ◽  
High Income ◽  
Converting Enzyme ◽  
Country Level ◽  
Incidence And Mortality

A literature review was conducted to summarize the frequency of the D-allele of the angiotensin-converting enzyme-1 in all countries with available data. Using an ecological study design limited to high income countries, we found that the country-level frequency of the D-allele was associated with increased COVID-19 incidence and mortality.

scholarly journals Descriptive epidemiology of COVID-19 deaths in the North Indian district Kangra of Himachal Pradesh

2021 ◽  
Vol 8 (12) ◽  
pp. 5879
Author(s):  
Saurabh Rattan ◽  
Priya Sharma ◽  
Chahat Gupta ◽  
Vikram Katoch ◽  
Gurdarshan Gupta
Keyword(s):  
Infectious Disease ◽  
Mortality Rate ◽  
Retrospective Analysis ◽  
Death Rate ◽  
Rna Virus ◽  
Himachal Pradesh ◽  
Descriptive Epidemiology ◽  
Descriptive Data ◽  
The North ◽  
The Mean

Background: COVID-19 first reported in January 2020 in China has turned into a pandemic the kind that occurs only once in a century, with high mortality rate due to an infectious disease considered once as a thing of past. Caused by SARS-CoV-2 (an RNA virus) COVID-19 has caused over 170 million cases worldwide and around 3.8 million deaths worldwide. India alone has suffered the wrath of this nasty virus with cases approaching 30 million and over 0.4 million deaths till date. Occurring in various waves, the pandemic situation remains dynamic and evolving even today.Methods: We carried out retrospective analysis of all deaths due to COVID-19 occurring in district Kangra from March 2020 to June 2021. Descriptive data on all COVID-19 patients were collected and analysed including individuals who lost their life during the period.Results: From 20 March 2020 to 30 June 2021, a total of 45,871 cases and 1037 deaths (2.2%) were reported in Kangra district-33.8% of 3463 deaths that occurred in the entire state. The death rate per million population in Kangra was 64 compared to 47 for Himachal Pradesh and 30 for India as a whole. The mean age was 62.5 years (range 01 to 102 years); males 62.7 years and female 62.2 years.Conclusions: The biggest challenge for us as a country is that COVID-19 has penetrated into our densely placed population where practicing COVID-19 appropriate behaviour is merely an expectation that possibly can never be fulfilled despite most stringent of actions.

scholarly journals Determinants of COVID-19 Case and Death Rates: An Ecological Study

2021 ◽  
Author(s):  
Christopher El Mouhayyar ◽  
Luke T. Jaber ◽  
Matthias Bergmann ◽  
Bertrand Jaber
Keyword(s):  
Human Development ◽  
Population Health ◽  
Death Rate ◽  
Ecological Study ◽  
Case Fatality ◽  
Level Population ◽  
Death Rates ◽  
Development Indicators ◽  
Country Level ◽  
Case Rate

Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic has had a variable worldwide impact, likely related to country-level characteristics. In this ecological study, we explored the association of COVID-19 case rates (per 100,000 people) and death rates (per 100,000 people) with country-level population health characteristics, economic and human development indicators, and habitat-related variables. Methods: To calculate country-level COVID-19 case and death rates, the number of cases and deaths were extracted from the Johns Hopkins Coronavirus Resource Center for 2020. Country-level population health characteristics, economic and human development indicators, and habitat-related variables were extracted from several publicly available online sources of international organizations. Results were tabulated according to world zones and country economies. Univariate and multivariable linear regression analyses were performed to examine determinants of COVID-19 case rates and death rates. Results: A total of 187 countries and territories were analyzed, with an aggregate COVID-19 case rate of 779 per 100,000 people, a death rate of 19 per 100,000 people, and a case-fatality rate of 2.4%. For country-level population health characteristics, a higher percentage rate of adults with obesity and a higher percentage rate of adults with high blood pressure was independently associated with a higher COVID-19 case rate, and a higher percentage rate of adults with obesity was associated with a higher COVID-19 death rate. For country-level economic and human development indicators, only a higher gross domestic product percentage rate spent on total health expenditure and a higher human development index was independently associated with a higher COVID-19 case rate and death rate. A higher percentage of urban population was independently associated with a higher COVID-19 death rate, whereas a higher income per capita was independently associated with a lower COVID-19 death rate. For country-level habitat-related variables, a higher average household size and a higher percentage rate of population with primary reliance on polluting fuels and technologies was independently associated with a lower COVID-19 case rate and death rate whereas a higher percentage rate of households with at least one-member age 65 years or over was associated with a higher case rate and death rates. Conclusion: This ecological study informs the need to develop country-specific public health interventions to better target populations at high risk for COVID-19, and test environmental interventions to prevent indoor transmission of SARS-CoV-2, taking into consideration population health characteristics, economic and human development indicators, and habitat-related variables that are unique to each country.

scholarly journals Deaths of Irish Civilians Abroad: Analysis of National Mortality Data, 2016-2018

2018 ◽  
Vol 6 (4) ◽  
pp. 149-153 ◽  
Author(s):  
Milad Darrat ◽  
Gerard T. Flaherty
Keyword(s):  
Causes Of Death ◽  
Healthcare Professionals ◽  
International Travel ◽  
Foreign Affairs ◽  
Mortality Data ◽  
Medical Interventions ◽  
Country Level ◽  
Age Related ◽  
National Mortality ◽  
The Mean

Introduction: International travel is increasing, yet few studies have reported on country-level death rates among international travelers. The data regarding the death profiles of overseas Irish travelers are insufficient. The current study examined data obtained from the Irish Department of Foreign Affairs and Trade to profile these deaths. Methods: Data on Irish civilian citizen deaths occurring abroad were obtained from the Consular Division of the Irish Department of Foreign Affairs and Trade and analyzed based on age, gender, time of death, travel destination, and recorded cause of death. Results: Between January 2016 and April 2018, the Consular Division received 654 reports of Irish civilians dying abroad, of which 72% (n=469) were males and 23% (n=149) were females; in 6% (n=36) the sex was not recorded. The mean age at death was 58 ±5 years old (range from 1 to 110, median 62 years). Recorded causes of death were illness (25%; n=162), traumatic deaths including homicides and suicides (24%; n=151), and natural (age-related) (3%; n=19); the rest were classified as unidentified cause (47%; n=309). The majority of deaths (63%; n=309) occurred in European destinations followed by Asia (16%; n=102) and the Americas (12%; n=75). Conclusion: At least 25% of Irish deaths abroad can be considered preventable. More tailored pre-travel medical interventions may prevent further deaths. In the collection of data, consular services miss the opportunity to acquire valuable information for both travelers and healthcare professionals. The authors recommend the creation of a comprehensive database of international traveler deaths.

The global dynamics of stochastic Holling type II predator-prey models with non constant mortality rate

Filomat ◽  
2017 ◽  
Vol 31 (18) ◽  
pp. 5811-5825
Author(s):  
Xinhong Zhang
Keyword(s):  
Mortality Rate ◽  
Stochastic Model ◽  
Sufficient Conditions ◽  
Positive Periodic Solution ◽  
Global Dynamics ◽  
Type Ii ◽  
Predator Prey ◽  
Persistence In The Mean ◽  
The Mean ◽  
Predator Prey Models

In this paper we study the global dynamics of stochastic predator-prey models with non constant mortality rate and Holling type II response. Concretely, we establish sufficient conditions for the extinction and persistence in the mean of autonomous stochastic model and obtain a critical value between them. Then by constructing appropriate Lyapunov functions, we prove that there is a nontrivial positive periodic solution to the non-autonomous stochastic model. Finally, numerical examples are introduced to illustrate the results developed.

scholarly journals COVID-19 Infection and Previous BCG Vaccination Coverage in the Ecuadorian Population

Vaccines ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 91
Author(s):  
Daniel Garzon-Chavez ◽  
Jackson Rivas-Condo ◽  
Adriana Echeverria ◽  
Jhoanna Mozo ◽  
Emmanuelle Quentin ◽  
...  
Keyword(s):  
Vaccination Coverage ◽  
Vaccine Coverage ◽  
National Level ◽  
Kendall Test ◽  
Amino Acid Sequences ◽  
Bcg Vaccination ◽  
High Prevalence ◽  
Health Organization ◽  
Low Coverage ◽  
Homologous Amino Acid

The Bacillus Calmette–Guérin (BCG) is a well-known vaccine with almost a century of use, with the apparent capability to improve cytokine production and epigenetics changes that could develop a better response to pathogens. It has been postulated that BCG protection against SARS-CoV-2 has a potential role in the pandemic, through the presence of homologous amino acid sequences. To identify a possible link between BCG vaccination coverage and COVID-19 cases, we used official epidemic data and Ecuadorian Ministry of Health and Pan American Health Organization vaccination information. BCG information before 1979 was available only at a national level. Therefore, projections based on the last 20 years were performed, to compare by specific geographic units. We used a Mann–Kendall test to identify BCG coverage variations, and mapping was conducted with a free geographic information system (QGIS). Nine provinces where BCG vaccine coverage was lower than 74.25% show a significant statistical association (χ2 Pearson’s = 4.800, df = 1, p = 0.028), with a higher prevalence of cases for people aged 50 to 64 years than in younger people aged 20 to 49 years. Despite the availability of BCG vaccination data and the mathematical models needed to compare these data with COVID-19 cases, our results show that, in geographic areas where BCG coverage was low, 50% presented a high prevalence of COVID-19 cases that were young; thus, low-coverage years were more affected.

scholarly journals Early mortality in hip fracture patients admitted during first wave of the COVID-19 pandemic in Northern Italy: a multicentre study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Dante Dallari ◽  
Luigi Zagra ◽  
Pietro Cimatti ◽  
Nicola Guindani ◽  
Rocco D’Apolito ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Mortality Rate ◽  
Multicentre Study ◽  
Proximal Femur ◽  
Femur Fracture ◽  
Northern Italy ◽  
Proximal Femur Fracture ◽  
Time To Surgery ◽  
Fracture Management ◽  
The Mean

Abstract Background Treatment of hip fractures during the coronavirus disease 2019 (COVID-19) pandemic has posed unique challenges for the management of COVID-19-infected patients and the maintenance of standards of care. The primary endpoint of this study is to compare the mortality rate at 1 month after surgery in symptomatic COVID-positive patients with that of asymptomatic patients. A secondary endpoint of the study is to evaluate, in the two groups of patients, mortality at 1 month on the basis of type of fracture and type of surgical treatment. Materials and methods For this retrospective multicentre study, we reviewed the medical records of patients hospitalised for proximal femur fracture at 14 hospitals in Northern Italy. Two groups were formed: COVID-19-positive patients (C+ group) presented symptoms, had a positive swab for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and received treatment for COVID-19; COVID-19-negative patients (C− group) were asymptomatic and tested negative for SARS-CoV-2. The two groups were compared for differences in time to surgery, survival rate and complications rate. The follow-up period was 1 month. Results Of the 1390 patients admitted for acute care for any reason, 477 had a proximal femur fracture; 53 were C+ but only 12/53 were diagnosed as such at admission. The mean age was > 80 years, and the mean American Society of Anesthesiologists (ASA) score was 3 in both groups. There was no substantial difference in time to surgery (on average, 2.3 days for the C+ group and 2.8 for the C− group). As expected, a higher mortality rate was recorded for the C+ group but not associated with the type of hip fracture or treatment. No correlation was found between early treatment (< 48 h to surgery) and better outcome in the C+ group. Conclusions Hip fracture in COVID-19-positive patients accounted for 11% of the total. On average, the time to surgery was > 48 h, which reflects the difficulty of maintaining normal workflow during a medical emergency such as the present pandemic and notwithstanding the suspension of non-urgent procedures. Hip fracture was associated with a higher 30-day mortality rate in COVID-19-positive patients than in COVID-19-negative patients. This fact should be considered when communicating with patients and/or their family. Our data suggest no substantial difference in hip fracture management between patients with or without COVID-19 infection. In this sample, the COVID-19-positive patients were generally asymptomatic at admission; therefore, routine screening is recommended. Level of evidence Therapeutic study, level 4.

scholarly journals Vaccination Coverage for Routine Vaccines and Herd Immunity Levels against Measles and Pertussis in the World in 2019

Vaccines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 256
Author(s):  
Pedro Plans-Rubió
Keyword(s):  
Vaccination Coverage ◽  
Action Plan ◽  
Herd Immunity ◽  
World Health ◽  
Immunization Programs ◽  
National Immunization ◽  
The World ◽  
Measles Vaccination ◽  
The Mean ◽  
Health Organization

In 2012, the World Health Organization (WHO) established the Global Vaccine Action Plan with the objective to promote essential vaccinations in all countries and achieve at least 90% vaccination coverage for all routine vaccines by 2020. The study assessed the mean percentages of vaccination coverage in 2019 for 13 routine vaccines, vaccination coverage variation from 2015 to 2019, and herd immunity levels against measles and pertussis in 2019 in countries and regions of WHO. In 2019, the mean percentages of vaccination coverage were lower than 90% for 10 (78.9%) routine vaccines. The mean percentages of vaccination coverage also decreased from 2015 to 2019 for six (46.2%) routine vaccines. The prevalence of individuals with vaccine-induced measles immunity in the target measles vaccination population was 88.1%, and the prevalence of individuals with vaccine-induced pertussis immunity in the target pertussis vaccination population was 81.1%. Herd immunity against measles viruses with Ro = 18 was established in 63 (32.5%) countries but not established in any region. Herd immunity against pertussis agents was not established in any country and in any region of WHO. National immunization programs must be improved to achieve ≥90% vaccination coverage in all countries and regions. Likewise, it is necessary to achieve ≥95% vaccination coverage with two doses of measles vaccines and three doses of pertussis vaccines in all countries and regions.

scholarly journals Liquidity Synchronization, Its Determinants and Outcomes under Economic Growth Volatility: Evidence from Emerging Asian Economies

Risks ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 43
Author(s):  
Syeda Hina Zaidi ◽  
Ramona Rupeika-Apoga
Keyword(s):  
Economic Growth ◽  
Emerging Markets ◽  
Interest Rates ◽  
Emerging Market ◽  
The Philippines ◽  
Country Level ◽  
Market Index ◽  
High Inflation ◽  
Asian Emerging Markets ◽  
Growth Volatility

This study investigates the country-level determinants of liquidity synchronization and degrees of liquidity synchronization during economic growth volatility. As a non-diversifiable risk factor, liquidity co-movement shock spreads market-wide and thus disrupts the overall functioning of the financial market. Firms in Asian markets operate in legal and regulatory environments distinct from those of firms analyzed in the previous literature. Comprehensive analyses of liquidity synchronicity in emerging markets are limited. A major knowledge gap pertaining to Asian emerging markets serves as the primary motivation for this study. Seven Asian emerging economies are selected from the MSCI emerging market index: Bangladesh, China, India, Indonesia, Malaysia, Pakistan and the Philippines for analysis from 2010 to 2019. The empirical findings show high levels of liquidity synchronicity in weaker economic and financial environments with low GDP growth, high inflation and interest rates and underdeveloped financial systems taking the form of low levels of private credit. Liquidity synchronicity is also affected by poor investor protection, political instability, weak rule of law and government ineffectiveness. Moreover, levels of liquidity synchronicity are higher in a period of economic growth volatility.

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