scholarly journals BMI and future risk for COVID-19 infection and death across sex, age and ethnicity: preliminary findings from UK biobank

2020 ◽  
Author(s):  
Naveed Sattar ◽  
Frederick K Ho ◽  
Jason MR Gill ◽  
Nazim Ghouri ◽  
Stuart R Gray ◽  
...  
Keyword(s):  
Case Fatality ◽  
Positive Test ◽  
Lifestyle Interventions ◽  
Confounding Factors ◽  
Uk Biobank ◽  
Thin Plate Splines ◽  
Future Studies ◽  
Risk Of Death ◽  
Poisson Models ◽  
Future Risk

AbstractWe examined the link between BMI and risk of a positive test for SARS-CoV-2 and risk of COVID-19-related death among UK Biobank participants. Among 4855 participants tested for SARS-CoV-2 in hospital, 839 were positive and of these 189 died from COVID-19. Poisson models with penalised thin plate splines were run relating exposures of interest to test positivity and case-fatality, adjusting for confounding factors. BMI was associated strongly with positive test, and risk of death related to COVID-19. The gradient of risk in relation to BMI was steeper in those under 70, compared with those aged 70 years or older for COVID-19 related death (Pinteraction=0.03). BMI was more strongly related to test positivity (Pinteraction=0.010) and death (Pinteraction=0.002) in non-whites, compared with whites. These data add support for adiposity being more strongly linked to COVID-19-related deaths in younger people and non-white ethnicities. If future studies confirm causality, lifestyle interventions to improve adiposity status may be important to reduce the risk of COVID-19 in all, but perhaps particularly, non-white communities.

scholarly journals Characterizing a two-pronged epidemic in Mexico of non-communicable diseases and SARS-Cov-2: factors associated with increased case-fatality rates

2021 ◽  
Author(s):  
Eric Monterrubio-Flores ◽  
María D Ramírez-Villalobos ◽  
Juan Espinosa-Montero ◽  
Bernardo Hernandez ◽  
Simón Barquera ◽  
...  
Keyword(s):  
Case Fatality ◽  
Logistic Models ◽  
Communicable Diseases ◽  
Chronic Obstructive ◽  
Fatality Rate ◽  
Younger Adults ◽  
Obstructive Pulmonary Disease ◽  
Non Communicable Diseases ◽  
Risk Of Death ◽  
Mexican Adults

Abstract Background People with a previous diagnosis of non-communicable diseases (NCDs) are more likely to develop serious forms of COVID-19 or die. Mexico is the country with the fourth highest fatality rate from SARS-Cov-2, with high mortality in younger adults. Objectives To describe and characterize the association of NCDs with the case-fatality rate (CFR) adjusted by age and sex in Mexican adults with a positive diagnosis for SARS-Cov-2. Methods We studied Mexican adults aged ≥20 years who tested positive for SARS-Cov-2 during the period from 28 February to 31 July 2020. The CFR was calculated and associations with history of NCDs (number of diseases and combinations), severity indicators and type of institution that treated the patient were explored. The relative risk (RR) of death was estimated using Poisson models and CFR was adjusted using logistic models. Results We analysed 406 966 SARS-Cov-2-positive adults. The CFR was 11.2% (13.7% in men and 8.4% in women). The CFR was positively associated with age and number of NCDs (p trend <0.001). The number of NCDs increased the risk of death in younger adults when they presented three or more NCDs compared with those who did not have any NCDs [RR, 46.6; 95% confidence interval (CI), 28.2, 76.9 for women; RR, 16.5; 95% CI, 9.9, 27.3 for men]. Lastly, there was great heterogeneity in the CFR by institution, from 4.6% in private institutions to 18.9% in public institutions. Conclusion In younger adults, higher CFRs were associated with the total number of NCDs and some combinations of type 2 diabetes, chronic kidney disease, chronic obstructive pulmonary disease and cardiovascular disease.

scholarly journals Gout, Rheumatoid Arthritis, and the Risk of Death Related to Coronavirus Disease 2019: An Analysis of the UK Biobank

2021 ◽  
Author(s):  
Ruth K. Topless ◽  
Amanda Phipps‐Green ◽  
Megan Leask ◽  
Nicola Dalbeth ◽  
Lisa K. Stamp ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Uk Biobank ◽  
Risk Of Death ◽  
The Uk

scholarly journals Is asthma associated with COVID-19 infection? A UK Biobank analysis

2021 ◽  
pp. 00309-2021
Author(s):  
Caroline J. Lodge ◽  
Alice Doherty ◽  
Dinh Bui ◽  
Raisa Cassim ◽  
Adrian J. Lowe ◽  
...  
Keyword(s):  
Lung Function ◽  
Early Onset ◽  
Age At Onset ◽  
Forced Expiratory Volume ◽  
Normal Weight ◽  
Asthma Medication ◽  
Positive Test ◽  
Uk Biobank ◽  
Increased Risk ◽  
Health Related

BackgroundThe relationship between asthma and COVID-19 risk is not clear and may be influenced by level of airway obstruction, asthma medication, and known COVID risk factors. We aimed to investigate COVID-19 risk in people with asthma.MethodsWe used UK Biobank data from all participants tested for SARS-CoV-2 (n=107 412 (17 979 test positive)). Baseline questions at baseline defined ever asthma and asthma medications. Baseline Forced Expiratory Volume in the first second (FEV1) was categorized into quartiles. Logistic regression modelled relationships between asthma, and asthma categories (age at onset, medications, FEV1 quartiles), and risk of SARS-CoV-2 positive test. We investigated modification by sex, ethnic group, smoking, and BMI.ResultsThere was a reduced risk of a positive test associated with with early-onset asthma (<13 years), (OR 0.91(95% CI 0.84, 0.99). This was found for early-onset asthmatics in males (OR 0·87 [95% CI: 0·78, 0·98]), non-smokers (0·87 [0·78, 0·98]), overweight/obese (0.85 [0.77, 0.93]), and non-Black participants (0·90 [0·82, 0.98]). There was increased risk amongst early onset asthmatics in the highest compared to lowest quartile of lung function (1.44 [1.05, 1.72]).ConclusionAmongst males, non-smokers, overweight/obese, and non-Black participants, having early-onset asthma was associated with lower risk of a SARS-CoV-2 positive test. We found no evidence of a protective effect from asthma medication. Early-onset asthmatics of normal weight and with better lung function may have lifestyle differences placing them at higher risk. Further research is needed to elucidate the contribution of asthma pathophysiology and different health-related behaviour, across population groups, to the observed risks.

scholarly journals Impact of first-wave COronaVIrus disease 2019 infection in patients on haemoDIALysis in Alsace: the observational COVIDIAL study

2020 ◽  
Vol 35 (8) ◽  
pp. 1338-1411 ◽  
Author(s):  
Nicolas Keller ◽  
François Chantrel ◽  
Thierry Krummel ◽  
Dorothée Bazin-Kara ◽  
Anne Laure Faller ◽  
...  
Keyword(s):  
Laboratory Data ◽  
Case Fatality ◽  
Patient Characteristics ◽  
Complete Recovery ◽  
High Rate ◽  
Atypical Symptoms ◽  
Reactive Protein ◽  
Risk Of Death ◽  
Included Patient

Abstract Background There are only scarce data regarding the presentation, incidence, severity and outcomes of coronavirus disease 2019 (COVID-19) in patients undergoing long-term haemodialysis (HD). A prospective observational study was conducted in eight HD facilities in Alsace, France, to identify clinical characteristics of HD patients with COVID-19 and to assess the determinants of the risk of death. Methods All HD patients tested positive for COVID-19 from 5 March to 28 April 2020 were included. Collected data included patient characteristics, clinical features at diagnosis, laboratory data, treatments and outcomes. Results Among 1346 HD patients, 123 tested positive for COVID-19. Patients had a median age of 77 years (interquartile range 66–83), with a high number of comorbidities (3.2 ± 1.6 per patient). Symptoms were compatible in 63% of patients. Asthenia (77%), diarrhoea (34%) and anorexia (32%) were frequent at diagnosis. The delay between the onset of symptoms and diagnosis, death or complete recovery was 2 (0–5), 7 (4–11) and 32 (26.5–35) days, respectively. Treatment, including lopinavir/ritonavir, hydroxychloroquine and corticosteroids, was administered in 23% of patients. The median C-reactive protein (CRP) and lymphocyte count at diagnosis was 55 mg/L (IQR 25–106) and 690 Ly/µL (IQR 450–960), respectively. The case fatality rate was 24% and determinants associated with the risk of death were body temperature {hazard ratio [HR] 1.96 [95% confidence interval (CI) 1.11–3.44]; P = 0.02} and CRP at diagnosis [HR 1.01 (95% CI 1.005–1.017); P &lt; 0.0001]. Conclusions HD patients were found to be at high risk of developing COVID-19 and exhibited a high rate of mortality. While patients presented severe forms of the disease, they often displayed atypical symptoms, with the CRP level being highly associated with the risk of death.

Increasing Resistance to Reserve Antibiotics: The Experience of a Tertiary Level Neonatal Intensive Care Unit

2020 ◽  
Author(s):  
Anushya Annamalai ◽  
Varsha Gupta ◽  
Suksham Jain ◽  
Priya Datta
Keyword(s):  
Risk Factors ◽  
Neonatal Intensive Care ◽  
Population Attributable Risk ◽  
Case Fatality ◽  
Antibiotic Sensitivity ◽  
Attributable Risk ◽  
Coagulase Negative Staphylococcus ◽  
Extended Spectrum Beta Lactamase ◽  
Risk Of Death ◽  
Culture Positivity

Abstract Background Blood stream infections are considered as a major cause of morbidity and mortality in neonates. Recent trend shows increasing resistance to commonly used antibiotics. Aims and objectives The aim of this study is to find the antibiotic susceptibility pattern of various bacteria from blood samples in neonates and associated risk factors. Methods All consecutive cases of intramural neonatal sepsis were enrolled for &gt;12 months. Before starting or changing antibiotic, blood sample under all aseptic precautions was taken for culture. Clinical and demographic details were recorded to analyze risk factors for sepsis. Antibiotic sensitivity tests were done as per CLSI 2019 guidelines. Results Of the 898 participants, 107 showed culture positivity. Klebsiella pneumoniae (25.2%) and Coagulase-negative Staphylococcus (23.3%). The blood culture positivity rate was 11.9%. Approximately 79% of isolates were multidrug-resistant: extended-spectrum beta-lactamase 90%, carbapenemase-resistant Enterobacteriaceae 27.7% and MRSA 43%. The risk factors found to be associated with sepsis were period of gestation ≤37 weeks, meconium-stained liquor, birth weight &lt;1500 g, mechanical ventilation, partial exchange transfusion, duration of antibiotics for &gt;10 days and duration of both NICU stay and hospital stay for &gt;10 days. The case fatality rate (CFR) was more due to K. pneumoniae (19.2%) and the relative risk of death was 2.53 in culture-positive cases with an attributable risk of 60% and the population attributable risk of 15.4%. Conclusion Increase in antibiotic resistance organisms can lead to an increase in the neonatal CFR, so regular surveillance is needed.

scholarly journals Undernourished children presenting to an urban emergency department of a tertiary hospital in Tanzania: a prospective descriptive study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Prosper J. Bashaka ◽  
Hendry R. Sawe ◽  
Victor Mwafongo ◽  
Juma A. Mfinanga ◽  
Michael S. Runyon ◽  
...  
Keyword(s):  
Emergency Department ◽  
Case Fatality ◽  
Descriptive Study ◽  
High Rate ◽  
World Health ◽  
Mortality Data ◽  
Children Under Five ◽  
Under Five ◽  
Risk Of Death ◽  
Increased Risk

Abstract Background: Childhood undernutrition causes significant morbidity and mortality in low- and middle-income countries (LMICs). In Tanzania, the in-hospital prevalence of undernutrition in children under five years of age is approximated to be 30% with a case fatality rate of 8.8%. In Tanzania, the burden of undernourished children under five years of age presenting to emergency departments (EDs) and their outcomes are unknown. This study describes the clinical profiles and outcomes of this population presenting to the emergency department of Muhimbili National Hospital (ED-MNH), a large, urban hospital in Dar es Salaam, Tanzania. Methods This was a prospective descriptive study of children aged 1–59 months presenting to the ED-MNH over eight weeks in July and August 2016. Enrolment occurred through consecutive sampling. Children less than minus one standard deviation below World Health Organization mean values for Weight for Height/Length, Height for Age, or Weight for Age were recruited. Structured questionnaires were used to document primary outcomes of patient demographics and clinical presentations, and secondary outcomes of 24-h and 30-day mortality. Data was summarised using descriptive statistics and relative risks (RR). Results A total of 449 children were screened, of whom 34.1% (n = 153) met criteria for undernutrition and 95.4% (n = 146) of those children were enrolled. The majority of these children, 56.2% (n = 82), were male and the median age was 19 months (IQR 10–31 months). They presented most frequently with fever 24.7% (n = 36) and cough 24.0% (n = 35). Only 6.7% (n = 9) were diagnosed with acute undernutrition by ED-MNH physicians. Mortality at 24 h and 30 days were 2.9% (n = 4) and 12.3% (n = 18) respectively. A decreased level of consciousness with Glasgow Coma Scale below fifteen on arrival to the ED and tachycardia from initial vital signs were found to be associated with a statistically significant increased risk of death in undernourished children, with mortality rates of 16.1% (n = 23), and 24.6% (n = 35), respectively. Conclusions In an urban ED of a tertiary referral hospital in Tanzania, undernutrition remains under-recognized and is associated with a high rate of in-hospital mortality.

scholarly journals Clinical predictors of poor outcomes in patients with sickle cell disease and COVID-19 infection

2021 ◽  
Vol 5 (1) ◽  
pp. 207-215
Author(s):  
Caterina P. Minniti ◽  
Ahmar U. Zaidi ◽  
Mehdi Nouraie ◽  
Deepa Manwani ◽  
Gary D. Crouch ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Lactate Dehydrogenase ◽  
Sickle Cell Disease ◽  
Kidney Disease ◽  
Sickle Cell ◽  
Case Fatality ◽  
Acute Chest Syndrome ◽  
Cell Disease ◽  
Risk Of Death ◽  
D Dimer

Abstract We aimed to identify predictors of outcomes and survival in patients living in 4 major metropolitan areas who had sickle cell disease (SCD) and COVID-19 to inform best approaches to prevention and care. Data were collected at baseline and during the clinical course in SCD patients diagnosed with COVID-19 in four COVID-19 epicenters. Patients were followed up posthospital discharge for up to 3 months. Of sixty-six SCD patients with COVID-19, fifty patients (75%) required hospitalization, and seven died (10.6%). Patients with preexisting kidney disease (chronic kidney disease) were more likely to be hospitalized. The most common presenting symptom was vaso-occlusive pain. Acute chest syndrome occurred in 30 (60%) of the 50 hospitalized patients and in all who died. Older age and histories of pulmonary hypertension, congestive heart failure, chronic kidney disease, and stroke were more prevalent in patients who died, as were higher creatinine, lactate dehydrogenase, and D-dimer levels. Anticoagulation use while inpatient was twice less common in patients who died. All deaths occurred in individuals not taking hydroxyurea or any other SCD-modifying therapy. Patients with SCD and COVID-19 exhibited a broad range of disease severity. We cannot definitively state that the overall mortality is higher in patients with SCD, although our case fatality rate was ∼10% compared with ∼3% in the general population, despite a median age of 34 years. Individuals with SCD aged &gt;50 years, with preexisting cardiopulmonary, renal disease, and/or stroke not receiving hydroxyurea, who present with high serum creatinine, lactate dehydrogenase, and D-dimer levels, are at higher risk of death, irrespective of genotype or sex.

scholarly journals The prognostic value of gender in gastric gastrointestinal stromal tumors: A propensity score matching analysis.

2020 ◽  
Author(s):  
Jian fang Rong ◽  
Si hai Chen ◽  
Cong hua Song ◽  
Huan Wang ◽  
Qiao yun Zhao ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Gastrointestinal Stromal Tumors ◽  
Gastric Gist ◽  
Confounding Factors ◽  
Cox Regression Analysis ◽  
Stromal Tumors ◽  
Female Patients ◽  
Risk Of Death ◽  
Male Patients

Abstract Background Gastrointestinal stromal tumors (GISTs) of the stomach are the most common GISTs. The risk, incidence and outcome of cancer are different between the sexes. Whether gender is related to the prognosis of gastric stromal tumors is unclear. Therefore, this study aims to explore the relationship between gender and gastric GIST prognosis. Methods Data from gastric GIST patients were collected from the Surveillance, Epidemiology, and End Results (SEER) database. After propensity score matching (PSM) was performed to reduce confounding factors, the clinicopathological features and prognosis of GIST patients were comprehensively evaluated. Results There were 512 male patients and 538 female patients with gastric GIST. The gender of gastric GIST patients was associated with marital status, surgical treatment, tumor size, and mitotic index (P < 0.05). The Kaplan-Meier analysis and log-rank test revealed that male patients had a higher mortality rate than female patients (P = 0.0024). After matching all the potential confounding factors, the survival of the female gastric GIST patients was better than that of the male gastric GIST patients (P = 0.042). Cox regression analysis revealed that gender was an independent risk factor for overall survival. The risk of death was higher for males than for females (HR: 1.539, 95% CI: 1.066–2.222, P = 0.021). Conclusion Gender could be a prognostic factor for gastric GIST survival, and male patients had a higher risk of death.

scholarly journals Epidemiological characteristics of COVID-19 cases in non-Italian nationals notified to the Italian surveillance system

2020 ◽  
Author(s):  
Massimo Fabiani ◽  
Alberto Mateo-Urdiales ◽  
Xanthi Andrianou ◽  
Antonino Bella ◽  
Martina Del Manso ◽  
...  
Keyword(s):  
Surveillance System ◽  
Negative Binomial ◽  
Healthcare Access ◽  
Delayed Diagnosis ◽  
Case Fatality ◽  
Negative Binomial Regression ◽  
Adjusted Relative Risk ◽  
Risk Of Death ◽  
Increased Risk ◽  
Epidemiological Characteristics

Background International literature suggests that disadvantaged groups are at higher risk of morbidity and mortality from SARS-CoV-2 infection due to poorer living/working conditions and barriers to healthcare access. Yet, to date, there is no evidence of this disproportionate impact on non-national individuals, including economic migrants, short-term travellers, and refugees. Methods We analysed data from the Italian surveillance system of all COVID-19 laboratory-confirmed cases tested positive from the beginning of the outbreak (20th of February) to the 19th of July 2020. We used multilevel negative-binomial regression models to compare the case-fatality rate and the rate of admission to hospital and intensive care unit (ICU) between Italian and non-Italian nationals. The analysis was adjusted for differences in demographic characteristics, pre-existing comorbidities, and period of diagnosis. Results We analysed 213,180 COVID-19 cases, including 15,974 (7.5%) non-Italian nationals. We found that, compared to Italian cases, non-Italian cases were diagnosed at a later date and were more likely to be hospitalised [(adjusted relative risk (ARR)=1.39, 95% confidence interval (CI): 1.33-1.44)] and admitted to ICU (ARR=1.19, 95% CI: 1.07-1.32), with differences being more pronounced in those coming from countries with lower HDI. We also observed an increased risk of death in non-Italian cases from low-HDI countries (ARR=1.32, 95% CI: 1.01-1.75). Conclusions A delayed diagnosis in non-Italian cases could explain their worse outcomes compared to Italian cases. Ensuring early access to diagnosis and treatment to non-Italians could facilitate the control of SARS-CoV-2 transmission and improve health outcomes in all people living in Italy, regardless of nationality.

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