Mortality from COVID in Colombia and Peru: Analyses of Mortality Data and Statistical Forecasts

AbstractNational predictions of the course of COVID mortality can be used to plan for effective healthcare responses as well as to support COVID policymaking. We developed the Global COVID Assessment of Mortality (GCAM), a statistical model with continually improving precision that combines actual mortality counts with Bayesian inference, to predict COVID trends, currently until December 1, 2020. In Colombia, the GCAM analysis found the peak of COVID mortality around August 12 and an expected total of COVID deaths of 24,000-31,000, or 48%-92% over the total through August 21. In Peru, a first mortality peak occurred around May 24, and given the current trajectory, a second peak is predicted around September 6. Peru can expect 29,000-43,000 COVID deaths, representing an increase of 7%-55% over COVID deaths through August 21. GCAM projections are also used to estimate medical surge capacity needs. To gauge the reliability of COVID mortality forecasts, we compared all-cause mortality from January through June 2020 with average all-cause mortality in previous years in Colombia and Peru, and found that the excesses were consistent with GCAM forecast, most notably a doubling of overall mortality from May 25-June 7th of weeks in Peru. The GCAM results predict that as a percentage of all adult deaths in previous years, Colombia can expect about 13% excess from COVID deaths, whereas Peru can expect 34% excess. Comparisons of GCAM analyses of several other countries with Colombia and Peru demonstrate the extreme variability that characterizes COVID mortality around the world, emphasizing the need for country-specific analyses and ongoing monitoring as more mortality data become available.

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Fruit and Vegetable Intake and All-Cause Mortality in a Chinese Population: The China Health and Nutrition Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18010342 ◽

2021 ◽

Vol 18 (1) ◽

pp. 342

Author(s):

Yuxuan Gu ◽

Yansu He ◽

Shahmir H. Ali ◽

Kaitlyn Harper ◽

Hengjin Dong ◽

...

Keyword(s):

Vegetable Intake ◽

Total Mortality ◽

Negative Association ◽

Mortality Data ◽

Sample Population ◽

Fruit And Vegetable ◽

Nutrition Survey ◽

Related Factors ◽

Health And Nutrition ◽

All Cause Mortality

This study was to investigate the association of long-term fruit and vegetable (FV) intake with all-cause mortality. We utilized data from the China Health and Nutrition Survey (CHNS), a prospective cohort study conducted in China. The sample population included 19,542 adult respondents with complete mortality data up to 31 December 2011. Cumulative FV intake was assessed by 3 day 24 h dietary recalls. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause mortality. Covariates included sociodemographic characteristics, lifestyle factors, health-related factors, and urban index. A total of 1409 deaths were observed during follow-up (median: 14 years). In the fully adjusted model, vegetable intake of the fourth quintile (327~408 g/day) had the greatest negative association with death compared to the lowest quintile (HR = 0.63, 95% CI: 0.53–0.76). Fruit intake of the fifth quintile (more than 126 g/day) had the highest negative association (HR = 0.24, 95% CI: 0.15–0.40) and increasing general FV intake were also negatively associated with all-cause mortality which demonstrated the greatest negative association in the amount of fourth quintile (HR = 0.59, 95% CI: 0.49–0.70) compared to the lowest quintile. To conclude, greater FV intake is associated with a reduced risk of total mortality for Chinese adults. High intake of fruit has a stronger negative association with mortality than differences in intake of vegetables. Our findings support recommendations to increase the intake of FV to promote overall longevity.

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All-cause mortality and location of death in patients with established cardiovascular disease before, during, and after the COVID-19 lockdown: a Danish Nationwide Cohort Study

European Heart Journal ◽

10.1093/eurheartj/ehab028 ◽

2021 ◽

Cited By ~ 1

Author(s):

Jawad H Butt ◽

Emil L Fosbøl ◽

Thomas A Gerds ◽

Charlotte Andersson ◽

Kristian Kragholm ◽

...

Keyword(s):

Cardiovascular Disease ◽

Mortality Rate ◽

Hospital Mortality ◽

Location Of Death ◽

All Cause Mortality ◽

History Of ◽

Adjusted Incidence Rate ◽

Artery Disease ◽

Adjusted Incidence ◽

Overall Mortality

Abstract Background On 13 March 2020, the Danish authorities imposed extensive nationwide lockdown measures to prevent the spread of the coronavirus disease 2019 (COVID-19) and reallocated limited healthcare resources. We investigated mortality rates, overall and according to location, in patients with established cardiovascular disease before, during, and after these lockdown measures. Methods and results Using Danish nationwide registries, we identified a dynamic cohort comprising all Danish citizens with cardiovascular disease (i.e. a history of ischaemic heart disease, ischaemic stroke, heart failure, atrial fibrillation, or peripheral artery disease) alive on 2 January 2019 and 2020. The cohort was followed from 2 January 2019/2020 until death or 16/15 October 2019/2020. The cohort comprised 340 392 and 347 136 patients with cardiovascular disease in 2019 and 2020, respectively. The overall, in-hospital, and out-of-hospital mortality rate in 2020 before lockdown was significantly lower compared with the same period in 2019 [adjusted incidence rate ratio (IRR) 0.91, 95% confidence interval (CI) CI 0.87–0.95; IRR 0.95, 95% CI 0.89–1.02; and IRR 0.87, 95% CI 0.83–0.93, respectively]. The overall mortality rate during and after lockdown was not significantly different compared with the same period in 2019 (IRR 0.99, 95% CI 0.97–1.02). However, the in-hospital mortality rate was lower and out-of-hospital mortality rate higher during and after lockdown compared with the same period in 2019 (in-hospital, IRR 0.92, 95% CI 0.88–0.96; out-of-hospital, IRR 1.04, 95% CI1.01–1.08). These trends were consistent irrespective of sex and age. Conclusions Among patients with established cardiovascular disease, the in-hospital mortality rate was lower and out-of-hospital mortality rate higher during lockdown compared with the same period in the preceding year, irrespective of age and sex.

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Association of mushroom consumption with all-cause and cause-specific mortality among American adults: prospective cohort study findings from NHANES III

Nutrition Journal ◽

10.1186/s12937-021-00691-8 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Djibril M. Ba ◽

Xiang Gao ◽

Joshua Muscat ◽

Laila Al-Shaar ◽

Vernon Chinchilli ◽

...

Keyword(s):

Lower Risk ◽

Proportional Hazards ◽

Total Mortality ◽

Cox Proportional Hazards ◽

Dietary Factors ◽

Mortality Data ◽

Nhanes Iii ◽

Dietary Recall ◽

All Cause Mortality ◽

Specific Mortality

Abstract Background Whether mushroom consumption, which is rich in several bioactive compounds, including the crucial antioxidants ergothioneine and glutathione, is inversely associated with low all-cause and cause-specific mortality remains uncertain. This study aimed to prospectively investigate the association between mushroom consumption and all-cause and cause-specific mortality risk. Methods Longitudinal analyses of participants from the Third National Health and Nutrition Examination Survey (NHANES III) extant data (1988–1994). Mushroom intake was assessed by a single 24-h dietary recall using the US Department of Agriculture food codes for recipe foods. All-cause and cause-specific mortality were assessed in all participants linked to the National Death Index mortality data (1988–2015). We used Cox proportional hazards regression models to calculate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for all-cause and cause-specific mortality. Results Among 15,546 participants included in the current analysis, the mean (SE) age was 44.3 (0.5) years. During a mean (SD) follow-up duration of 19.5 (7.4) years , a total of 5826 deaths were documented. Participants who reported consuming mushrooms had lower risk of all-cause mortality compared with those without mushroom intake (adjusted hazard ratio (HR) = 0.84; 95% CI: 0.73–0.98) after adjusting for demographic, major lifestyle factors, overall diet quality, and other dietary factors including total energy. When cause-specific mortality was examined, we did not observe any statistically significant associations with mushroom consumption. Consuming 1-serving of mushrooms per day instead of 1-serving of processed or red meats was associated with lower risk of all-cause mortality (adjusted HR = 0.65; 95% CI: 0.50–0.84). We also observed a dose-response relationship between higher mushroom consumption and lower risk of all-cause mortality (P-trend = 0.03). Conclusion Mushroom consumption was associated with a lower risk of total mortality in this nationally representative sample of US adults.

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Excess Mortality During the COVID-19 Pandemic in Philadelphia

American Journal of Public Health ◽

10.2105/ajph.2021.306285 ◽

2021 ◽

pp. e1-e6

Author(s):

Megan Todd ◽

Meagan Pharis ◽

Sam P. Gulino ◽

Jessica M. Robbins ◽

Cheryl Bettigole

Keyword(s):

Public Health ◽

Excess Mortality ◽

Poisson Model ◽

People Of Color ◽

Mortality Data ◽

Registration System ◽

Vital Registration System ◽

All Cause Mortality ◽

Race Ethnicity ◽

Excess Deaths

Objectives. To estimate excess all-cause mortality in Philadelphia, Pennsylvania, during the COVID-19 pandemic and understand the distribution of excess mortality in the population. Methods. With a Poisson model trained on recent historical data from the Pennsylvania vital registration system, we estimated expected weekly mortality in 2020. We compared these estimates with observed mortality to estimate excess mortality. We further examined the distribution of excess mortality by age, sex, and race/ethnicity. Results. There were an estimated 3550 excess deaths between March 22, 2020, and January 2, 2021, a 32% increase above expectations. Only 77% of excess deaths (n=2725) were attributed to COVID-19 on the death certiﬁcate. Excess mortality was disproportionately high among older adults and people of color. Sex differences varied by race/ethnicity. Conclusions. Excess deaths during the pandemic were not fully explained by COVID-19 mortality; ofﬁcial counts signiﬁcantly undercount the true death toll. Far from being a great equalizer, the COVID-19 pandemic has exacerbated preexisting disparities in mortality by race/ethnicity. Public Health Implications. Mortality data must be disaggregated by age, sex, and race/ethnicity to accurately understand disparities among groups. (Am J Public Health. Published online ahead of print June 10, 2021: e1–e6. https://doi.org/10.2105/AJPH.2021.306285 )

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Using the Multidimensional Prognostic Index to Predict Clinical Outcomes of Hospitalized Older Persons: A Prospective, Multicenter, International Study

The Journals of Gerontology Series A ◽

10.1093/gerona/gly239 ◽

2018 ◽

Vol 74 (10) ◽

pp. 1643-1649 ◽

Cited By ~ 12

Author(s):

Alberto Pilotto ◽

Nicola Veronese ◽

Julia Daragjati ◽

Alfonso J Cruz-Jentoft ◽

Maria Cristina Polidori ◽

...

Keyword(s):

Home Care ◽

Older Patients ◽

Risk Group ◽

Prognostic Index ◽

Home Care Services ◽

Cognitive Status ◽

Public Hospitals ◽

Mortality Data ◽

Care Services ◽

Overall Mortality

Abstract Background Multidimensional Prognostic Index (MPI) is useful as a prognostic tool in hospitalized older patients, but our knowledge is derived from retrospective studies. We therefore aimed to evaluate in a multicenter, longitudinal, cohort study whether the MPI at hospital admission is useful to identify groups with different mortality risk and whether MPI at discharge may predict institutionalization, rehospitalization, and use of home care services during 12 months. Methods This longitudinal study, carried out between February 2015 and August 2017, included nine public hospitals in Europe and Australia. A standardized comprehensive geriatric assessment including information on functional, nutritional, cognitive status, risk of pressure sores, comorbidities, medications, and cohabitation status was used to calculate the MPI and to categorize participants in low, moderate, and severe risk of mortality. Data regarding mortality, institutionalization, rehospitalization, and use of home care services were recorded through administrative information. Results Altogether, 1,140 hospitalized patients (mean age 84.1 years, women = 60.8%) were included. In the multivariable analysis, compared to patients with low risk group at admission, patients in moderate (odds ratio [OR] = 3.32; 95% CI: 1.79–6.17; p < .001) and severe risk (OR = 10.72, 95% CI: 5.70–20.18, p < .0001) groups were at higher risk of overall mortality. Among the 984 older patients with follow-up data available, those in the severe-risk group experienced a higher risk of overall mortality, institutionalization, rehospitalization, and access to home care services. Conclusions In this cohort of hospitalized older adults, higher MPI values are associated with higher mortality and other negative outcomes. Multidimensional assessment of older people admitted to hospital may facilitate appropriate clinical and postdischarge management.

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Indications for healthcare surge capacity in European countries facing an exponential increase in COVID19 cases

10.1101/2020.03.14.20035980 ◽

2020 ◽

Cited By ~ 1

Author(s):

Frederik Verelst ◽

Elise Kuylen ◽

Philippe Beutels

Keyword(s):

Healthcare Workers ◽

Healthcare Expenditure ◽

Healthcare Systems ◽

System Capacity ◽

Extreme Pressure ◽

Composite Measure ◽

Surge Capacity ◽

Exponential Increase ◽

European Healthcare ◽

Country Specific

AbstractEuropean healthcare systems face extreme pressure from COVID-19. We estimate such pressure by relating both country-specific accumulated COVID-19 deaths (intensity-approach) and active COVID-19 cases (magnitude-approach) to measures of healthcare system capacity: hospital beds, healthcare workers and healthcare expenditure. On March 25, 2020 - relative to Italy on March 11- we found Spain, The Netherlands and France to experience the highest pressure using the intensity-approach with a composite measure for healthcare capacity. For updates see www.covid-hcpressure.org

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Predictors of three-month mortality among hospitalized older adults in Togo

10.21203/rs.3.rs-38973/v2 ◽

2020 ◽

Author(s):

Fifonsi Adjidossi GBEASOR-KOMLANVI ◽

Martin Kouame TCHANKONI ◽

Akila Wimima BAKOUBAYI ◽

Matthieu Yaovi LOKOSSOU ◽

Arnold SADIO ◽

...

Keyword(s):

Older Adults ◽

Hospital Mortality ◽

Cox Regression ◽

Sub Saharan Africa ◽

Mortality Data ◽

Kaplan Meier ◽

All Cause Mortality ◽

Hospitalized Older Adults ◽

Sub Saharan

Abstract Background: Assessing hospital mortality and its predictors is important as some of these can be prevented through appropriate interventions. Few studies have reported hospital mortality data among older adults in sub-Saharan Africa. The objective of this study was to assess the mortality and associated factors among hospitalized older adults in Togo.Methods: We conducted a prospective cohort study from February 2018 to September 2019 among patients ≥50 years admitted in medical and surgical services of six hospitals in Togo. Data were recorded during hospitalization and through telephone follow-up survey within 90 days after admission. The main outcome was all-cause mortality at 3 months. Survival curves were estimated using the Kaplan-Meier method and Cox regression analyses were performed to assess predictors of mortality.Results: The median age of the 650 older adults included in the study period was 61 years, IQR: [55-70] and at least one comorbidity was identified in 59.7% of them. The all-cause mortality rate of 17.2% (95%CI: 14.4-20.4) and the majority of death (93.7%) occurred in hospital. Overall survival rate was 85.5% and 82.8% after 30 and 90 days of follow-up, respectively. Factors associated with 3-month mortality were the hospital level in the health pyramid, hospitalization service, length of stay, functional impairment, depression and malignant diseases.Conclusion: Togolese health system needs to adjust its response to an aging population in order to provide the most effective care.

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All-Cause and Cancer Mortality Trends in Macheng, China (1984–2013): An Age-Period-Cohort Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15102068 ◽

2018 ◽

Vol 15 (10) ◽

pp. 2068

Author(s):

Chunhui Li ◽

Songbo Hu ◽

Chuanhua Yu

Keyword(s):

Cancer Mortality ◽

Disease Surveillance ◽

Cohort Analysis ◽

Cohort Effect ◽

Age Effect ◽

Mortality Data ◽

Period Effect ◽

Mortality Trends ◽

All Cause Mortality ◽

Males And Females

The aim was to study the variation trends of all-cause and cancer mortality during 1984–2013 in Macheng City, China. The mortality data were collected from Macheng City disease surveillance points system and Hubei Center for Disease Control and Prevention. The model life table system was used to adjust mortality rates due to an under-reporting problem. An age-period-cohort model and intrinsic estimator algorithm were used to estimate the age effect, period effect, and cohort effect of all-cause mortality and cancer mortality for males and females. Age effect of all-cause mortality for both sexes increased with age, while the age effect of cancer mortality for both sexes reached a peak at the age group of 55–59 years old and then decreased. The relative risks (RRs) of all-cause mortality for males and females declined with the period and decreased by 51.13% and 63.27% during the whole study period, respectively. Furthermore, the period effect of cancer mortality in both sexes decreased at first and then increased. The cohort effect of all-cause and cancer mortality for both sexes born after 1904 presented the pattern of “rise first and then fall,” and decreased by 82.18% and 90.77% from cohort 1904–1908 to 1989–1993, respectively; especially, the risk of all-cause and cancer mortality for both sexes born before 1949 was much higher than that for those born after 1949.

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Abstract 967: Parathyroidectomy Reduces Cardiovascular Events And All-cause Mortality In Renal Hyperparathyroidism

Circulation ◽

10.1161/circ.116.suppl_16.ii_191-b ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Jose Lima ◽

Valeria Costa-Hong ◽

Vanda Jorgetti ◽

Luis Henrique W Gowdak ◽

Rosa Maria A Moyses ◽

...

Keyword(s):

Cardiovascular Events ◽

Mineral Metabolism ◽

Cardiovascular Complications ◽

Maintenance Hemodialysis ◽

Major Cardiovascular Events ◽

All Cause Mortality ◽

Phosphate Product ◽

Cardiovascular Variables ◽

Overall Mortality

Background: Secondary hyperparathyroidism (SHPT) and its associated abnormalities in mineral metabolism increase the risk of cardiovascular morbidity and death in chronic kidney disease (CKD). The effect of parathyroidectomy (PTX) on the incidence of major cardiovascular events in CKD patients with SHPT is unknown. We tested the hypothesis that PTX reduces the incidence of cardiovascular complications and death in CKD patients with severe SHPT scheduled for PTX, comparing the outcome of patients treated or not treated by surgery. Methods: The study comprised 118 CKD patients with SHPT on maintenance hemodialysis, unresponsive to medical treatment, and scheduled for PTX. Patients underwent comprehensive cardiovascular evaluations at baseline. They were followed up until death, occurrence of major cardiovascular events, or kidney transplantation. Results: No deaths related to surgery occurred. After a median follow-up of 30 months, 50 patients (42.4%) had undergone PTX while 68 (57.9%) had not. The groups were comparable in terms of age, sex, race, parathyroid hormone (PTH), calcium, phosphate, calcium x phosphate product, and all major cardiovascular variables, except diastolic blood pressure. PTX was associated with a reduced incidence of major cardiovascular events (log-rank= 0.02) and overall mortality (log-rank= 0.001). Cox proportional multivariate analysis showed that variables significantly and independently associated with events were PTX (RR=2.36, CI 1.11–6.32, p=0.02) and age (RR=1.07, IC 1.02–1.14, p=0.009). All-cause mortality was related to PTX (RR=2.34, CI 1.25–5.14, p=0.007) and hematocrit (RR=1.15, CI 1.03–1.29, p=0.01). Conclusion: PTX confers protection against future major cardiovascular events and death in select CKD patients with severe refractory SHPT.

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Before, During, and After the First Wave of COVID-19: Mortality Analyses Reveal Relevant Trends in Germany and its States until June 2020

Das Gesundheitswesen ◽

10.1055/a-1531-5507 ◽

2021 ◽

Vol 83 (08/09) ◽

pp. e41-e48

Author(s):

Peter Morfeld ◽

Barbara Timmermann ◽

J. Valérie Groß ◽

Philip Lewis ◽

Thomas C Erren

Keyword(s):

Population Data ◽

Mitigation Strategies ◽

Trend Detection ◽

Mortality Data ◽

The Public ◽

Federal States ◽

Statistical Institute ◽

All Cause Mortality ◽

Mortality Ratio ◽

Standardized Mortality Ratios

ABSTRACT Objective Well-established mortality ratio methodology can contribute to a fuller picture of the SARS-CoV-2/COVID-19 burden of disease by revealing trends and informing mitigation strategies. This work examines respective data from Germany by way of example. Methods Using monthly and weekly all-cause mortality data from January 2016 to June 2020 (published by the German Federal Statistical Institute) for all ages,<65 years and≥65 years, and specified for Germany’s federal states, we explored mortality as sequela of COVID-19. We analysed standardized mortality ratios (SMRs) comparing 2020 with 2016–2019 as reference years with a focus on trend detection. Results In Germany as a whole, elevated mortality in April (most pronounced for Bavaria) declined in May. The states of Hamburg and Bremen had increased SMRs in all months under study. In Mecklenburg-Western Pomerania, decreased SMRs in January turned monotonically to increased SMRs by June. Irrespective of age group, this trend was pronounced and significant. Conclusions Increased SMRs in Hamburg and Bremen must be interpreted with caution because of potential upward distortions due to a “catchment bias”. A pronounced excess mortality in April across Germany was confirmed and a hitherto undetected trend of increasing SMRs for Mecklenburg-Western Pomerania was revealed. To meet the pandemic challenge and to benefit from research based on data collected in standardized ways, national authorities should regularly conduct SMR analyses. For independent analyses, national authorities should also expedite publishing raw mortality and population data, including detailed information on age, sex, and cause of death, in the public domain.

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