scholarly journals Finding the real COVID-19 case-fatality rates for SAARC countries

Author(s):  
Md. Rafil Tazir Shah ◽  
Tanvir Ahammed ◽  
Aniqua Anjum ◽  
Anisa Ahmed Chowdhury ◽  
Afroza Jannat Suchana

AbstractCrude case fatality rate (CFR) is the most accurate when the pandemic is over. Adjustments to the crude CFR measure can better explain the pandemic situation by improving the CFR estimation. However, no study has thoroughly investigated COVID-19 adjusted CFR of the South Asian Association for Regional Cooperation (SAARC) countries. In this study, we estimated both survival interval and underreporting adjusted CFR of COVID-19 for the SAARC countries and observed the CFR changes due to the imposition of fees on COVID-19 tests in Bangladesh. Using the daily records up to 9th October, we implemented a statistical method to remove both the bias in crude CFR, i.e., the delay between disease onset and outcome bias and due to asymptomatic or mild symptomatic cases, reporting rates lower than 50% (95% CI: 10%-50%) bias. According to our findings, Afghanistan had the highest CFR, followed by Pakistan, India, Bangladesh, Nepal, Maldives, and Sri Lanka. Our estimated crude CFR varied from 3.71% to 0.29%, survival interval adjusted CFR varied from 3.77% to 0.3% and further underreporting adjusted CFR varied from 1.1% to 0.08%. We have also found that crude CFR increased from 1.261% to 1.572% after imposing the COVID-19 test fees in Bangladesh. Therefore, the authorities of countries with higher CFR should be looking for strategic counsel from the countries with lower CFR to equip themselves with the necessary knowledge to combat the pandemic. Moreover, caution is needed to report the CFR.

2020 ◽  
Author(s):  
Gang Hu ◽  
Jian Liu ◽  
Peng Yuan He ◽  
Li Juan Ouyang ◽  
Bao Jia Zou ◽  
...  

Abstract Background: Since December 2019, COVID-19 has been confirmed in more than18.8 million patients and leads to 0.70 million deaths worldwide. The mortality and disease severity predictors of COVID-19 have been investigated in many studies. However, they are based on early or partial datasets from high epidemic areas. Here, we retrospect benign clinical and epidemiological outcomes-associated factors from a solved epidemic in a low epidemic area. Methods: All 98 laboratory-confirmed COVID-19 patients in a local epidemic (Zhuhai, China) from January 17, 2020 to March 10, 2020 were enrolled. Data were updated until all patients having final outcomes. Results: Patients were all hospitalized. The case fatality rate was 1.0%. There were no local secondary infection cases. The median age was 46.3 years. Underlying diseases were found in 33.7% patients. The severe/critical rate was 19.4%. The mean period from disease onset to admission was 4.4 days. Compared with serious/critical cases, mild/common cases on admission were much younger, lacks of comorbidities and normal in functions of vital organs and indicators of secondary bacterial infections. The lymphocyte counts in serious/critical cases began to be significantly lower 3 days before their identification dates. The absence of lymphopenia before the eighth day from disease onset can exclude the possibility of 78.5% to be serious/critical ill. Most patients (88.8%) received antiviral treatments. Early antiviral treatment significantly shortened the viral RNA-negative conversion time. The delayed antiviral treatment was associated with critical patients.Conclusions: Younger age, lack of aging-related diseases and early hospitalization of all patients to conduct antiviral treatment and prevention of secondary epidemic were the important benign clinical and epidemiological outcomes-associated factors of COVID-19. In combating COVID-19, the active intervention strategies are crucial in low epidemic areas and the continuous monitoring of lymphocytes may be useful to sort patients reasonably in high epidemic areas.


1994 ◽  
Vol 52 (2) ◽  
pp. 153-160 ◽  
Author(s):  
Charles André ◽  
Sérgio A. P. Novis

PURPOSE AND METHODS: One-hundred-and-nine consecutive patients admitted during the acute phase of a CT-confirmed brain infarction (BI) were studied. Putative adverse influence of demographic and stroke risk factors, previous medical history, clinical presentation, initial and follow-up neurological examination, initial general evaluation, laboratory findings, chest X-ray and electrocardiographic findings, treatment, and topography and etiology of the ischemic insult was analysed. The end-point for assessment was early death (within 30 days). Statistical analysis was performed with univariate analysis and multiple regression. RESULTS: The main adverse factors related to an increased death risk during the first 30 days were, in decreasing order of importance: coma 48-72 hours after admission; stroke occuring in already hospitalized patients; Babinski sign on admission; minor degrees of impairment of consciousness 48-72 hours after admission; stroke related to large artery atherothrombosis and to embolism; a history of early impairment of consciousness; cardiac failure on admission. In 53 lucid patients on admission, only a history of congestive heart failure (CHF) was associated with a reduced survival rate. In 56 patients with impaired consciousness, the presence of a Babinski sign increased death risk, but the main factor predicting a high case-fatality rate was the persistence of consciousness disturbances after48-72 hours. CONCLUSIONS: The presence of impairment of consciousness, especially coma, 2-3 days after disease onset, and a history of CHF greatly increase the early case fatality rate in patients with acute BI presenting with or without consciousness disturbances at admission, respectively. The use of a prognostic algorythm considering these few variables seems to predict the approximate 30-day fatality rates.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Prajjval Pratap Singh ◽  
Anshika Srivastava ◽  
Gazi Nurun Nahar Sultana ◽  
Nargis Khanam ◽  
Abhishek Pathak ◽  
...  

AbstractWith the growing evidence on the variable human susceptibility against COVID-19, it is evident that some genetic loci modulate the severity of the infection. Recent studies have identified several loci associated with greater severity. More recently, a study has identified a 50 kb genomic segment introgressed from Neanderthal adding a risk for COVID-19, and this genomic segment is present among 16% and 50% people of European and South Asian descent, respectively. Our studies on ACE2 identified a haplotype present among 20% and 60% of European and South Asian populations, respectively, which appears to be responsible for the low case fatality rate among South Asian populations. This result was also consistent with the real-time infection rate and case fatality rate among various states of India. We readdressed this issue using both of the contrasting datasets and compared them with the real-time infection rates and case fatality rate in India. We found that the polymorphism present in the 50 kb introgressed genomic segment (rs10490770) did not show any significant correlation with the infection and case fatality rate in India.


2020 ◽  
Author(s):  
Ahmed Youssef Kada

BACKGROUND Covid-19 is an emerging infectious disease like viral zoonosis caused by new coronavirus SARS CoV 2. On December 31, 2019, Wuhan Municipal Health Commission in Hubei province (China) reported cases of pneumonia, the origin of which is a new coronavirus. Rapidly extendable around the world, the World Health Organization (WHO) declares it pandemic on March 11, 2020. This pandemic reaches Algeria on February 25, 2020, date on which the Algerian minister of health, announced the first case of Covid-19, a foreign citizen. From March 1, a cluster is formed in Blida and becomes the epicentre of the coronavirus epidemic in Algeria, its total quarantine is established on March 24, 2020, it will be smoothly alleviated on April 24. A therapeutic protocol based on hydroxychloroquine and azithromycin was put in place on March 23, for complicated cases, it was extended to all the cases confirmed on April 06. OBJECTIVE This study aimed to demonstrate the effectiveness of hydroxychloroquin/azithromycin protocol in Algeria, in particular after its extension to all patients diagnosed COVID-19 positive on RT-PCR test. We were able to illustrate this fact graphically, but not to prove it statistically because the design of our study, indeed in the 7 days which followed generalization of therapeutic protocol, case fatality rate decrease and doubling time increase, thus confirming the impact of wide and early prescription of hydroxychloroquin/azithromycin protocol. METHODS We have analyzed the data collected from press releases and follow-ups published daily by the Ministry of Health, we have studied the possible correlations of these data with certain events or decisions having a possible impact on their development, such as confinement at home and its reduction, the prescription of hydroxychloroquine/azithromycin combination for serious patients and its extension to all positive COVID subjects. Results are presented in graphics, the data collection was closed on 31/05/2020. RESULTS Covid-19 pandemic spreads from February 25, 2020, when a foreign citizen is tested positive, on March 1 a cluster is formed in the city of Blida where sixteen members of the same family are infected during a wedding party. Wilaya of Blida becomes the epicentre of coronavirus epidemic in Algeria and lockdown measures taken, while the number of national cases diagnosed begins to increases In any event, the association of early containment measures combined with a generalized initial treatment for all positive cases, whatever their degree of severity, will have contributed to a reduction in the fatality rate of COVID 19 and a slowing down of its doubling time. CONCLUSIONS In Algeria, the rapid combination of rigorous containment measure at home and early generalized treatment with hydroxychloroquin have demonstrated their effectiveness in terms of morbidity and mortality, the classic measures of social distancing and hygiene will make it possible to perpetuate these results by reducing viral transmission, the only unknown, the reopening procedure which can only be started after being surrounded by precautions aimed at ensuring the understanding of the population. CLINICALTRIAL Algeria, Covid-19, pandemic, hydroxychloroquin, azithromycin, case fatality rate


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Lei-Ke Zhang ◽  
Yuan Sun ◽  
Haolong Zeng ◽  
Qingxing Wang ◽  
Xiaming Jiang ◽  
...  

A Correction to this paper has been published: https://doi.org/10.1038/s41421-021-00267-0


Author(s):  
Abdulla Salem Bin Ghouth ◽  
Ali Ahmed Al-Waleedi ◽  
Marhami Fahriani ◽  
Firzan Nainu ◽  
Harapan Harapan

Abstract Objectives: To determine the case-fatality rate (CFR) of coronavirus disease 2019 (COVID-19) and its associated determinants in order to understand the true magnitude of the problem during ongoing conflict in Yemen. Methods: The CFR among confirmed COVID-19 cases in Yemen was calculated. The data was retrieved from national COVID-19 surveillance between April 10, when the first COVID-19 case reported, and May 31, 2020. Results: A total of 419 confirmed COVID-19 cases were reported. There were 14.1% and 5.7% of cases who required intensive care and mechanical ventilators, respectively. Out of total cases, 95 deaths were reported, giving CFR of 22.6% which is much higher compared to other countries. CFR was significantly higher among elderly compared to young adults and varied between governorates. Mortality was associated with preexisting hypertension (OR: 2.30; 95%CI: 1.58, 3.54) and diabetes (OR: 1.68; 95%CI: 1.08, 2.61). Conclusions: Elderly and those with comorbidities, in particular hypertension and diabetes, have higher risk for poor outcomes and therefore should receive more attention in the clinical setting. Preventive measures should also be prioritized to protect those groups in order to reduce the severe cases and deaths-associated COVID-19 in armed-conflict.


Author(s):  
Eunha Shim

A total of 475,214 COVID-19 cases, including 13,659 deaths, had been recorded in Canada as of 15 December 2020. The daily reports of confirmed cases and deaths in Canada prior to 15 December 2020 were obtained from publicly available sources and used to examine regional variations in case fatality rate (CFR). Based on a factor of underestimation and the duration of time from symptom onset to death, the time-delay adjusted CFR for COVID-19 was estimated in the four most affected provinces (Quebec, Ontario, Alberta, and British Columbia) and nationwide. The model-based adjusted CFR was higher than the crude CFR throughout the pandemic, primarily owing to the incorporation in our estimation of the delay between case reports and deaths. The adjusted CFR in Canada was estimated to be 3.36% nationwide. At the provincial level, the adjusted CFR was the highest in Quebec (5.13%)—where the proportion of deaths among older individuals was also the highest among the four provinces—followed by Ontario (3.17%), British Columbia (1.97%), and Alberta (1.13%). Provincial-level variations in CFR were considerable, suggesting that public health interventions focused on densely populated areas and elderly individuals can ameliorate the mortality burden of the COVID-19 pandemic.


Viruses ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1184
Author(s):  
Robyn N. Hall ◽  
Tegan King ◽  
Tiffany O’Connor ◽  
Andrew J. Read ◽  
Jane Arrow ◽  
...  

Rabbit haemorrhagic disease virus 2 (RHDV2 or GI.2, referring to any virus with lagovirus GI.2 structural genes) is a recently emerged calicivirus that causes generalised hepatic necrosis and disseminated intravascular coagulation leading to death in susceptible lagomorphs (rabbits and hares). Previous studies investigating the virulence of RHDV2 have reported conflicting results, with case fatality rates ranging from 0% to 100% even within a single study. Lagoviruses are of particular importance in Australia and New Zealand where they are used as biocontrol agents to manage wild rabbit populations, which threaten over 300 native species and result in economic impacts in excess of $200 million AUD annually to Australian agricultural industries. It is critically important that any pest control method is both highly effective (i.e., virulent, in the context of viral biocontrols) and has minimal animal welfare impacts. To determine whether RHDV2 might be a suitable candidate biocontrol agent, we investigated the virulence and disease progression of a naturally occurring Australian recombinant RHDV2 in both 5-week-old and 11-week-old New Zealand White laboratory rabbits after either high or low dose oral infection. Objective measures of disease progression were recorded through continuous body temperature monitoring collars, continuous activity monitors, and twice daily observations. We observed a 100% case fatality rate in both infected kittens and adult rabbits after either high dose or low dose infection. Clinical signs of disease, such as pyrexia, weight loss, and reduced activity, were evident in the late stages of infection. Clinical disease, i.e., welfare impacts, were limited to the period after the onset of pyrexia, lasting on average 12 h and increasing in severity as disease progressed. These findings confirm the high virulence of this RHDV2 variant in naïve rabbits. While age and infectious dose significantly affected disease progression, the case fatality rate was consistently 100% under all conditions tested.


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