scholarly journals Case fatality risk of the SARS-CoV-2 variant of concern B.1.1.7 in England

2021 ◽  
Author(s):  
Daniel J Grint ◽  
Kevin Wing ◽  
Elizabeth Williamson ◽  
Helen I McDonald ◽  
Krishnan Bhaskaran ◽  
...  
Keyword(s):  
Disease Severity ◽  
Absolute Risk ◽  
Case Fatality ◽  
Accurate Estimation ◽  
Fatality Risk ◽  
Risk Of Death ◽  
Increased Risk ◽  
Pandemic Planning ◽  
Case Fatality Risk

AbstractThe B.1.1.7 variant of concern (VOC) is increasing in prevalence across Europe. Accurate estimation of disease severity associated with this VOC is critical for pandemic planning. We found increased risk of death for VOC compared with non-VOC cases in England (HR: 1.67 (95% CI: 1.34 - 2.09; P<.0001)). Absolute risk of death by 28-days increased with age and comorbidities. VOC has potential to spread faster with higher mortality than the pandemic to date.

scholarly journals Case fatality risk of the SARS-CoV-2 variant of concern B.1.1.7 in England, 16 November to 5 February

2021 ◽  
Vol 26 (11) ◽  
Author(s):  
Daniel J Grint ◽  
Kevin Wing ◽  
Elizabeth Williamson ◽  
Helen I McDonald ◽  
Krishnan Bhaskaran ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Disease Severity ◽  
Absolute Risk ◽  
Case Fatality ◽  
Accurate Estimation ◽  
Fatality Risk ◽  
Risk Of Death ◽  
Increased Risk ◽  
Pandemic Planning ◽  
Case Fatality Risk

The SARS-CoV-2 B.1.1.7 variant of concern (VOC) is increasing in prevalence across Europe. Accurate estimation of disease severity associated with this VOC is critical for pandemic planning. We found increased risk of death for VOC compared with non-VOC cases in England (hazard ratio: 1.67; 95% confidence interval: 1.34–2.09; p < 0.0001). Absolute risk of death by 28 days increased with age and comorbidities. This VOC has potential to spread faster with higher mortality than the pandemic to date.

scholarly journals Mortality in Escherichia coli bloodstream infections: a multinational population-based cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Melissa C. MacKinnon ◽  
Scott A. McEwen ◽  
David L. Pearl ◽  
Outi Lyytikäinen ◽  
Gunnar Jacobsson ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Mortality Rate ◽  
Case Fatality ◽  
Population Based ◽  
Day Case ◽  
Fatality Risk ◽  
E Coli ◽  
Factors Associated ◽  
Case Fatality Risk ◽  
Age And Sex

Abstract Background Escherichia coli is the most common cause of bloodstream infections (BSIs) and mortality is an important aspect of burden of disease. Using a multinational population-based cohort of E. coli BSIs, our objectives were to evaluate 30-day case fatality risk and mortality rate, and determine factors associated with each. Methods During 2014–2018, we identified 30-day deaths from all incident E. coli BSIs from surveillance nationally in Finland, and regionally in Sweden (Skaraborg) and Canada (Calgary, Sherbrooke, western interior). We used a multivariable logistic regression model to estimate factors associated with 30-day case fatality risk. The explanatory variables considered for inclusion were year (2014–2018), region (five areas), age (< 70-years-old, ≥70-years-old), sex (female, male), third-generation cephalosporin (3GC) resistance (susceptible, resistant), and location of onset (community-onset, hospital-onset). The European Union 28-country 2018 population was used to directly age and sex standardize mortality rates. We used a multivariable Poisson model to estimate factors associated with mortality rate, and year, region, age and sex were considered for inclusion. Results From 38.7 million person-years of surveillance, we identified 2961 30-day deaths in 30,923 incident E. coli BSIs. The overall 30-day case fatality risk was 9.6% (2961/30923). Calgary, Skaraborg, and western interior had significantly increased odds of 30-day mortality compared to Finland. Hospital-onset and 3GC-resistant E. coli BSIs had significantly increased odds of mortality compared to community-onset and 3GC-susceptible. The significant association between age and odds of mortality varied with sex, and contrasts were used to interpret this interaction relationship. The overall standardized 30-day mortality rate was 8.5 deaths/100,000 person-years. Sherbrooke had a significantly lower 30-day mortality rate compared to Finland. Patients that were either ≥70-years-old or male both experienced significantly higher mortality rates than those < 70-years-old or female. Conclusions In our study populations, region, age, and sex were significantly associated with both 30-day case fatality risk and mortality rate. Additionally, 3GC resistance and location of onset were significantly associated with 30-day case fatality risk. Escherichia coli BSIs caused a considerable burden of disease from 30-day mortality. When analyzing population-based mortality data, it is important to explore mortality through two lenses, mortality rate and case fatality risk.

scholarly journals Estimating the Case Fatality Risk of COVID-19 using Cases from Outside China

2020 ◽  
Author(s):  
Nick Wilson ◽  
Amanda Kvalsvig ◽  
Lucy Telfar Barnard ◽  
Michael G Baker
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Meta Analysis ◽  
Case Fatality ◽  
Large Uncertainty ◽  
Icu Patients ◽  
Fatality Risk ◽  
Case Fatality Risk ◽  
Respiratory Conditions

AbstractThere is large uncertainty around the case fatality risk (CFR) for COVID-19 in China. Therefore, we considered symptomatic cases outside of China (countries/settings with 20+ cases) and the proportion who are in intensive care units (4.0%, 14/349 on 13 February 2020). Given what is known about CFRs for ICU patients with severe respiratory conditions from a meta-analysis, we estimated a CFR of 1.37% (95%CI: 0.57% to 3.22%) for COVID- 19 cases outside of China.

scholarly journals A Comparison of Case Fatality Risk of COVID-19 between Singapore and Japan

2020 ◽  
Vol 9 (10) ◽  
pp. 3326
Author(s):  
Taishi Kayano ◽  
Hiroshi Nishiura
Keyword(s):  
Age Distribution ◽  
Case Fatality ◽  
Standardized Mortality Ratio ◽  
Fatality Risk ◽  
Illness Onset ◽  
High Virulence ◽  
Mortality Ratio ◽  
The Many ◽  
Case Fatality Risk ◽  
Protection Against Infection

The crude case fatality risk (CFR) for coronavirus disease (COVID-19) in Singapore is remarkably small. We aimed to estimate the unbiased CFR by age for Singapore and Japan and compare these estimates by calculating the standardized mortality ratio (SMR). Age-specific CFRs for COVID-19 were estimated in real time, adjusting for the delay from illness onset to death. The SMR in Japan was estimated by using the age distribution of the Singapore population. Among cases aged 60–69 years and 70–79 years, the age-specific CFRs in Singapore were estimated as 1.84% (95% confidence interval: 0.46–4.72%) and 5.57% (1.41–13.97%), respectively, and those in Japan as 5.52% (4.55–6.62%) and 15.49% (13.81–17.27%), respectively. The SMR of COVID-19 in Japan, when compared with Singapore as the baseline, was estimated to be 1.46 (1.09–2.96). The overall CFR for Singapore is lower than that for Japan. It is possible that the circulating variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Singapore causes a milder clinical course of COVID-19 infection compared with other strains. If infection with a low-virulence SARS-CoV-2 variant provides protection against infection by high-virulence strains, the existence of such a strain is encouraging news for the many countries struggling to suppress this virus.

scholarly journals Case Fatality Risk of the First Pandemic Wave of Coronavirus Disease 2019 (COVID-19) in China

2020 ◽  
Author(s):  
Xiaowei Deng ◽  
Juan Yang ◽  
Wei Wang ◽  
Xiling Wang ◽  
Jiaxin Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Influenza Pandemic ◽  
Mainland China ◽  
Case Fatality ◽  
Likelihood Estimation ◽  
H1n1 Influenza ◽  
Right Censoring ◽  
Time To Event ◽  
Fatality Risk ◽  
Case Fatality Risk

Abstract Background To assess the case fatality risk (CFR) of COVID-19 in mainland China, stratified by region and clinical category, and estimate key time-to-event intervals. Methods We collected individual information and aggregated data on COVID-19 cases from publicly available official sources from 29 December 2019 to 17 April 2020. We accounted for right-censoring to estimate the CFR and explored the risk factors for mortality. We fitted Weibull, gamma, and log-normal distributions to time-to-event data using maximum-likelihood estimation. Results We analyzed 82 719 laboratory-confirmed cases reported in mainland China, including 4632 deaths and 77 029 discharges. The estimated CFR was 5.65% (95% confidence interval [CI], 5.50–5.81%) nationally, with the highest estimate in Wuhan (7.71%) and lowest in provinces outside Hubei (0.86%). The fatality risk among critical patients was 3.6 times that of all patients and 0.8–10.3-fold higher than that of mild-to-severe patients. Older age (odds ratio [OR], 1.14 per year; 95% CI, 1.11–1.16) and being male (OR, 1.83; 95% CI, 1.10–3.04) were risk factors for mortality. The times from symptom onset to first healthcare consultation, to laboratory confirmation, and to hospitalization were consistently longer for deceased patients than for those who recovered. Conclusions Our CFR estimates based on laboratory-confirmed cases ascertained in mainland China suggest that COVID-19 is more severe than the 2009 H1N1 influenza pandemic in hospitalized patients, particularly in Wuhan. Our study provides a comprehensive picture of the severity of the first wave of the pandemic in China. Our estimates can help inform models and the global response to COVID-19.

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 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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