scholarly journals Assessing the Age Specificity of Infection Fatality Rates for COVID-19: Systematic Review, Meta-Analysis, and Public Policy Implications

2020 ◽  
Author(s):  
Andrew T. Levin ◽  
William P. Hanage ◽  
Nana Owusu-Boaitey ◽  
Kensington B. Cochran ◽  
Seamus P. Walsh ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Meta Analysis ◽  
Age Groups ◽  
The Elderly ◽  
Specific Pattern ◽  
Policy Implications ◽  
Fatality Rate ◽  
Exponential Relationship ◽  
Geographical Locations

Structured AbstractObjectiveDetermine age-specific infection fatality rates for COVID-19 to inform public health policies and communications that help protect vulnerable age groups.MethodsStudies of COVID-19 prevalence were collected by conducting an online search of published articles, preprints, and government reports that were publicly disseminated prior to 18 September 2020. The systematic review encompassed 113 studies, of which 27 studies (covering 34 geographical locations) satisfied the inclusion criteria and were included in the meta-analysis. Age-specific IFRs were computed using the prevalence data in conjunction with reported fatalities four weeks after the midpoint date of the study, reflecting typical lags in fatalities and reporting. Meta-regression procedures in Stata were used to analyze the infection fatality rate (IFR) by age.ResultsOur analysis finds a exponential relationship between age and IFR for COVID-19. The estimated age-specific IFR is very low for children and younger adults (e.g., 0.002% at age 10 and 0.01% at age 25) but increases progressively to 0.4% at age 55, 1.4% at age 65, 4.6% at age 75, and 15% at age 85. Moreover, our results indicate that about 90% of the variation in population IFR across geographical locations reflects differences in the age composition of the population and the extent to which relatively vulnerable age groups were exposed to the virus.DiscussionThese results indicate that COVID-19 is hazardous not only for the elderly but also for middle-aged adults, for whom the infection fatality rate is two orders of magnitude greater than the annualized risk of a fatal automobile accident and far more dangerous than seasonal influenza. Moreover, the overall IFR for COVID-19 should not be viewed as a fixed parameter but as intrinsically linked to the age-specific pattern of infections. Consequently, public health measures to mitigate infections in older adults could substantially decrease total deaths.

scholarly journals Assessing the age specificity of infection fatality rates for COVID-19: systematic review, meta-analysis, and public policy implications

2020 ◽  
Vol 35 (12) ◽  
pp. 1123-1138 ◽  
Author(s):  
Andrew T. Levin ◽  
William P. Hanage ◽  
Nana Owusu-Boaitey ◽  
Kensington B. Cochran ◽  
Seamus P. Walsh ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Meta Analysis ◽  
Age Groups ◽  
The Elderly ◽  
Specific Pattern ◽  
Policy Implications ◽  
Fatality Rate ◽  
Exponential Relationship ◽  
Geographical Locations

AbstractDetermine age-specific infection fatality rates for COVID-19 to inform public health policies and communications that help protect vulnerable age groups. Studies of COVID-19 prevalence were collected by conducting an online search of published articles, preprints, and government reports that were publicly disseminated prior to 18 September 2020. The systematic review encompassed 113 studies, of which 27 studies (covering 34 geographical locations) satisfied the inclusion criteria and were included in the meta-analysis. Age-specific IFRs were computed using the prevalence data in conjunction with reported fatalities 4 weeks after the midpoint date of the study, reflecting typical lags in fatalities and reporting. Meta-regression procedures in Stata were used to analyze the infection fatality rate (IFR) by age. Our analysis finds a exponential relationship between age and IFR for COVID-19. The estimated age-specific IFR is very low for children and younger adults (e.g., 0.002% at age 10 and 0.01% at age 25) but increases progressively to 0.4% at age 55, 1.4% at age 65, 4.6% at age 75, and 15% at age 85. Moreover, our results indicate that about 90% of the variation in population IFR across geographical locations reflects differences in the age composition of the population and the extent to which relatively vulnerable age groups were exposed to the virus. These results indicate that COVID-19 is hazardous not only for the elderly but also for middle-aged adults, for whom the infection fatality rate is two orders of magnitude greater than the annualized risk of a fatal automobile accident and far more dangerous than seasonal influenza. Moreover, the overall IFR for COVID-19 should not be viewed as a fixed parameter but as intrinsically linked to the age-specific pattern of infections. Consequently, public health measures to mitigate infections in older adults could substantially decrease total deaths.

scholarly journals The Seroprevalence of SARS-CoV-2 in Europe: A Systematic Review

2021 ◽  
Author(s):  
Natasha Marcella Vaselli ◽  
Daniel Hungerford ◽  
Ben Shenton ◽  
Arwa Khashkhusha ◽  
Nigel A. Cunliffe ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Meta Analysis ◽  
Grey Literature ◽  
Age Groups ◽  
Significant Heterogeneity ◽  
Community Studies ◽  
Past Infection ◽  
Significant Difference ◽  
The Impact

AbstractBackgroundA year following the onset of the COVID-19 pandemic, new infections and deaths continue to increase in Europe. Serological studies, through providing evidence of past infection, can aid understanding of the population dynamics of SARS-CoV-2 infection.ObjectivesThis systematic review of SARS-CoV-2 seroprevalence studies in Europe was undertaken to inform public health strategies including vaccination, that aim to accelerate population immunity.MethodsWe searched the databases Web of Science, MEDLINE, EMBASE, SCOPUS, Cochrane Database of Systematic Reviews and grey literature sources for studies reporting seroprevalence of SARS-CoV-2 antibodies in Europe published between 01/12/2019 - 30/09/20. We provide a narrative synthesis of included studies. Studies were categorized into subgroups including healthcare workers (HCWs), community, outbreaks, pregnancy and children/school. Due to heterogeneity in other subgroups, we only performed a random effects meta-analysis of the seroprevalence amongst HCWs stratified by their country.Results109 studies were included spanning 17 European countries, that estimated the seroprevalence of SAR-CoV2 from samples obtained between November 2019 – August 2020. A total of 53/109 studies included HCWs with a reported seroprevalence among HCWs ranging from 0.7% to 45.3%, which did not differ significantly by country. In community studies significant heterogeneity was reported in the seroprevalence among different age groups and the majority of studies reported there was no significant difference by gender.ConclusionThis review demonstrates a wide heterogeneity in reported seroprevalence of SARS-CoV-2 antibodies between populations. Continued evaluation of seroprevalence is required to understand the impact of public health measures and inform interventions including vaccination programmes.

scholarly journals Dental caries among the elderly in Iran: a meta-analysis

2020 ◽  
Author(s):  
Shervan Shoaee ◽  
Farshad Sharifi ◽  
Pooneh Ghavidel Parsa ◽  
Ahmad Sofi-Mahmudi
Keyword(s):  
Systematic Review ◽  
Oral Health ◽  
Dental Caries ◽  
Health Surveys ◽  
Meta Analysis ◽  
Grey Literature ◽  
Age Groups ◽  
The Elderly ◽  
Missing Teeth ◽  
Cross Sectional

Objectives: To conduct a systematic review and meta-analysis on dental caries among the elderly in Iran. Background: The prevalence of dental caries among elderly is high worldwide, and the major burden of oral diseases is caused by dental caries. Methods: Systematic review of the published and grey literature performed. Six international and local databases used to provide the most comprehensive population-based studies. National oral health surveys, as well as national disease and health surveys considered as other primary sources of data. Quality of remained studies was assessed by a modified tool designed based on STROBE statement checklist to evaluate the cross-sectional studies. The target population was 65+-year-olds Iranian population. Results: Overall, 917 English articles who those reported dental caries among all age groups were found in international databases and 2138 Persian articles were found in Iranian databases. After quality assessment, and excluding other age groups, 46 points of data with 10411 aged people ≥ 65 years, were included in the meta-analysis. Mean pooled decayed, missing, and filled teeth among the elderly was 26.84 (26.41-27.28). This index was 26.78 (26.12-27.43) in women and 26.91 (26.32-27.50) in men. Mean number of decayed teeth was 1.48 (1.32-1.65). Mean pooled missing teeth was 24.83 (24.20-25.46), and mean pooled filled teeth was 0.14 (0.12-0.17). The majority (92%) of DMFT was related to missing teeth. Conclusion: Dental caries has a very high burden on the oral health of the elderly in Iran, mainly responded by tooth extraction.

Depressive morbidity and gender in community-dwelling Brazilian elderly: systematic review and meta-analysis

2010 ◽  
Vol 22 (5) ◽  
pp. 712-726 ◽  
Author(s):  
Ricardo Barcelos-Ferreira ◽  
Rafael Izbicki ◽  
David C. Steffens ◽  
Cássio M. C. Bottino
Keyword(s):  
Systematic Review ◽  
Depressive Symptoms ◽  
Cardiovascular Diseases ◽  
Major Depression ◽  
Depressive Disorders ◽  
Meta Analysis ◽  
Age Groups ◽  
The Elderly ◽  
Community Dwelling ◽  
And Gender

ABSTRACTBackground: Although studies indicate that community-dwelling elderly have a lower prevalence of major depression compared with younger age groups, prevalence estimates in Brazil show that clinically significant depressive symptoms (CSDS) and depression are frequent in the older population. However, a systematic review and meta-analysis of prevalence of and factors associated with depressive disorders and symptoms in elderly Brazilians has not previously been reported. The aims were (i) to perform a survey of studies dating from 1991 to 2009 on the prevalence of depressive disorders and CSDS in elderly Brazilians residing in the community; (ii) to determine depression prevalence and identify associated factors; and (iii) develop a meta-analysis to indicate the combined prevalence and the influence of gender on depressive morbidity in this population.Methods: Studies were selected from articles dated between January 1991 and May 2009, extracted from Medline, LILACS and SciELO databases.Results: A total of 17 studies were found, 13 with CSDS, 1 with major depression alone and 3 with major depression and dysthymia, involving the evaluation of 15,491 elderly people. The average age of participants varied between 66.5 and 84.0 years. Prevalence rates of 7.0% for major depression, 26.0% for CSDS, and 3.3% for dysthymia were found. The odds ratios for major depression and CSDS were greater among women. There was a significant association between major depression or CSDS and cardiovascular diseases.Conclusion: The review indicates greater prevalence of both major depression and CSDS compared to rates reported in the international literature, while the prevalence of dysthymia was found to be similar. The high prevalence of CSDS and its significant association with cardiovascular diseases reinforces the importance of evaluating subthreshold depressive symptoms in the elderly in the community.

scholarly journals Prevalence and mortality of Lung Comorbidities Among Patients with COVID-19: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Mohammed G Alkhathami ◽  
Shailesh M Advani ◽  
Adil A Abalkhail ◽  
Fahad M Alkhathami ◽  
Mohammed K Alshehri ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Meta Analysis ◽  
Age Groups ◽  
The Elderly ◽  
The United States ◽  
Mortality Rates ◽  
Cochrane Library ◽  
Original Research ◽  
Pooled Prevalence

AbstractBackgroundCOVID-19 infections are seen across all age groups but they have shown to have a predisposition for the elderly and those with underlying comorbidities. Patients with severe COVID-19 infections and comorbidities are more prone to respiratory distress syndrome (ARDS), mechanical ventilator use and ultimately succumb to these complications. Little evidence exists of the prevalence of underlying lung comorbidities among COVID-19 patients and associated mortality.MethodsWe performed a systematic review of the literature including PubMed (Medline), Embase (Ovid), Google Scholar and Cochrane Library. The last date for our search was 29th April 2020. We included all original research articles on COVID-19 and calculated prevalence of chronic lung disease patients among COVID-19 patients using random effects model. Further we assessed for mortality rates among COVID-19 patients associated with these lung comorbidities.ResultsThe authors identified 29 articles that reported prevalence of chronic lung conditions among COVID-19 patients. Among those, 26 were from China and 3 from the United States. The pooled prevalence of lung comorbidities including Asthma, COPD, and lung cancer was 3% (95% CI=0-14%), 2.2% (95% CI=0.02-0.03%) and 2.1% (95% CI=0.00-0.21%) respectively. Mortality rates associated with these comorbidities was 30% (41/137) for COPD and 19% (7/37) for lung cancer respectively. No mortality rates were reported for patients with asthma.ConclusionThis study offers latest evidence of prevalence of chronic lung conditions among patients with COVID-19. Asthma, followed by COPD and lung cancer, was the most common lung comorbidity associated with COVID-19, while the higher mortality rate was found in COPD. Future studies are needed to assess other lung comorbidities and associated mortality among patients diagnosed with COVID-19.

scholarly journals The seroprevalence of SARS-CoV-2 during the first wave in Europe 2020: A systematic review

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0250541
Author(s):  
Natasha Marcella Vaselli ◽  
Daniel Hungerford ◽  
Ben Shenton ◽  
Arwa Khashkhusha ◽  
Nigel A. Cunliffe ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Meta Analysis ◽  
Grey Literature ◽  
Age Groups ◽  
Significant Heterogeneity ◽  
Community Studies ◽  
Past Infection ◽  
Significant Difference ◽  
The Impact

Background A year following the onset of the COVID-19 pandemic, new infections and deaths continue to increase in Europe. Serological studies, through providing evidence of past infection, can aid understanding of the population dynamics of SARS-CoV-2 infection. Objectives This systematic review of SARS-CoV-2 seroprevalence studies in Europe was undertaken to inform public health strategies including vaccination, that aim to accelerate population immunity. Methods We searched the databases Web of Science, MEDLINE, EMBASE, SCOPUS, Cochrane Database of Systematic Reviews and grey literature sources for studies reporting seroprevalence of SARS-CoV-2 antibodies in Europe published between 01/12/2019–30/09/20. We provide a narrative synthesis of included studies. Studies were categorized into subgroups including healthcare workers (HCWs), community, outbreaks, pregnancy and children/school. Due to heterogeneity in other subgroups, we only performed a random effects meta-analysis of the seroprevalence amongst HCWs stratified by their country. Results 115 studies were included spanning 17 European countries, that estimated the seroprevalence of SARS-CoV-2 from samples obtained between November 2019 –August 2020. A total of 54/115 studies included HCWs with a reported seroprevalence among HCWs ranging from 0.7% to 45.3%, which did not differ significantly by country. In community studies significant heterogeneity was reported in the seroprevalence between different age groups and the majority of studies reported there was no significant difference by gender. Conclusion This review demonstrates a wide heterogeneity in reported seroprevalence of SARS-CoV-2 antibodies between populations. Continued evaluation of seroprevalence is required to understand the impact of public health measures and inform interventions including vaccination programmes.

scholarly journals Ethnicity and outcomes in COVID-19 in the United Kingdom: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Sania Siddiq ◽  
Saima Ahmed ◽  
Irfan Akram
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Policy Implications ◽  
Intensive Care Admission ◽  
Adjusted Analysis ◽  
The United Kingdom ◽  
Mortality Outcome ◽  
The Uk

This systematic review and meta-analysis evaluated the clinical outcomes of COVID-19 disease in the ethnic minorities of the UK in comparison to the White ethnic group. Medline, Embase, Cochrane, MedRxiv, and Prospero were searched for articles published between May 2020 to April 2021. PROSPERO ID: CRD42021248117. Fourteen studies (767177 participants) were included in the review. In the adjusted analysis, the pooled Odds Ratio (OR) for the mortality outcome was higher for the Black (1.83, 95% CI: 1.21-2.76), Asian (1.16, 95% CI: 0.85-1.57), and Mixed and Other (MO) groups (1.12, 95% CI: 1.04-1.20) compared to the White group. The adjusted and unadjusted ORs of intensive care admission were more than double for all ethnicities (OR Black 2.32, 95% CI: 1.73-3.11, Asian 2.34, 95% CI: 1.89-2.90, MO group 2.26, 95% CI: 1.64-3.11). In the adjusted analysis of mechanical ventilation need the ORs were similarly significantly raised (Black group 2.03, 95% CI: 1.80-2.29, Asian group 1.84, 95% CI: 1.20-2.80, MO 2.09, 95% CI: 1.35-3.22). This review confirmed that all ethnic groups in the UK suffered from increased disease severity and mortality with regards to COVID-19. This has urgent public health and policy implications to reduce the health disparities.

scholarly journals Effectiveness of Oral Nutritional Supplements on Older People with Anorexia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 835
Author(s):  
Mengqi Li ◽  
Si Zhao ◽  
Shuang Wu ◽  
Xiufen Yang ◽  
Hui Feng
Keyword(s):  
Systematic Review ◽  
Body Weight ◽  
Older People ◽  
Energy Intake ◽  
Meta Analysis ◽  
Nutritional Supplements ◽  
The Elderly ◽  
Randomized Controlled ◽  
Oral Nutritional Supplements ◽  
Positive Effect

Background: Nutrition plays an important role in maintaining the overall health of older people. Inadequate intake may lead to impaired body function, higher morbidity, and mortality. Oral nutritional supplements (ONS) showed positive effect on the nutritional status of the elderly; however, systematic evidence is currently lacking on the effect of ONS on the elderly with anorexia. Aims: The current systematic review and meta-analysis included randomized controlled trial (RCT) articles to investigate the effectiveness of ONS on the main aspects of anorexia of aging (AA). Methods: By using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method, researchers independently searched PubMed/MEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Library, China National Knowledge Infrastructure (CNKI) and other gray literature resources for publications that met the inclusion criteria by October 2020. The Cochrane Risk of Bias Tools were used for quality assessment. The inverse-variance method was used for the fixed model (FM) while the DerSimonian–Laird method was used for the random model (RM). Respective 95% confidence intervals (95% CIs), mean difference (MD) or standardized mean difference (SMD) was used for indices in terms of effect size (ES). Results: 2497 records were found through the systematic search, while 17 RCTs (n = 1204) were included, with a mean age of 81.9 years (range: 74–87 years). Supplementation occurred in the morning, mid-day, and evening, while the times varied from one to three times a day. The results of meta-analysis showed that, generally, ONS had a positive effect on the overall appetite, MD = 0.18, 95% CI (0.03, 0.33), p = 0.02, and consumption, MD = 1.43, 95% CI (0.01, 2.86), p = 0.05; but not significant in terms of other aspects of appetite: hunger, p = 0.73; fullness, p = 0.60; desire to eat, p = 0.80; preoccupation, p = 0.15. Additionally, it showed an increase in the overall energy intake, SMD = 0.46, 95% CI (0.29, 0.63), p < 0.001, in protein intake, SMD = 0.59, 95% CI (0.16, 1.02), p = 0.007, and in fat intake, MD = 3.47, 95% CI (1.98, 4.97), p < 0.001, while no positive effect was found on carbohydrates intake, p = 0.06. Significance differences were also found in the body weight, SMD = 0.53, 95% CI (0.41, 0.65), p < 0.001, and body mass index (BMI), MD = 0.53, 95% CI (0.12, 0.95), p = 0.01. Moreover, subgroup analyses were conducted according to the nutrient density with no positive results showed except for the low-density ONS on overall energy intake. Conclusions: The results of the present study indicated that ONS had beneficial effects on overall appetite, energy intake, body weight and BMI.

scholarly journals Influenza-associated disease burden in mainland China: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jing Li ◽  
Yinzi Chen ◽  
Xiling Wang ◽  
Hongjie Yu
Keyword(s):  
Systematic Review ◽  
Publication Bias ◽  
Fixed Effects ◽  
Disease Burden ◽  
Outpatient Visit ◽  
Meta Analysis ◽  
Age Groups ◽  
Mainland China ◽  
Mortality And Morbidity ◽  
All Cause Mortality

AbstractInfluenza causes substantial morbidity and mortality. Many original studies have been carried out to estimate disease burden of influenza in mainland China, while the full disease burden has not yet been systematically reviewed. We did a systematic review and meta-analysis to assess the burden of influenza-associated mortality, hospitalization, and outpatient visit in mainland China. We searched 3 English and 4 Chinese databases with studies published from 2005 to 2019. Studies reporting population-based rates of mortality, hospitalization, or outpatient visit attributed to seasonal influenza were included in the analysis. Fixed-effects or random-effects model was used to calculate pooled estimates of influenza-associated mortality depending on the degree of heterogeneity. Meta-regression was applied to explore the sources of heterogeneity. Publication bias was assessed by funnel plots and Egger’s test. We identified 30 studies eligible for inclusion with 17, 8, 5 studies reporting mortality, hospitalization, and outpatient visit associated with influenza, respectively. The pooled influenza-associated all-cause mortality rates were 14.33 and 122.79 per 100,000 persons for all ages and ≥ 65 years age groups, respectively. Studies were highly heterogeneous in aspects of age group, cause of death, statistical model, geographic location, and study period, and these factors could explain 60.14% of the heterogeneity in influenza-associated mortality. No significant publication bias existed in estimates of influenza-associated all-cause mortality. Children aged < 5 years were observed with the highest rates of influenza-associated hospitalizations and ILI outpatient visits. People aged ≥ 65 years and < 5 years contribute mostly to mortality and morbidity burden due to influenza, which calls for targeted vaccination policy for older adults and younger children in mainland China.

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