scholarly journals Age-specific rate of severe and critical SARS-CoV-2 infections estimated with multi-country seroprevalence studies

2021 ◽  
Author(s):  
Daniel Herrera-Esposito ◽  
Gustavo de los Campos
Keyword(s):  
Risk Evaluation ◽  
Close Agreement ◽  
Hospital Admissions ◽  
Severe Disease ◽  
Individual Risk ◽  
Mortality Data ◽  
Specific Rate ◽  
Epidemic Modeling ◽  
Public Data ◽  
Order Of Magnitude

Knowing the age-specific rates at which individuals infected with SARS-CoV-2 develop severe and critical disease is essential for designing public policy, for epidemic modeling, and for individual risk evaluation. In this study, we present the first estimates of these rates using multi-country serology studies, together with public data on hospital admissions and mortality. Our results show that the risk of severe and critical disease increases exponentially with age, but much less steeply than the risk of fatal illness. Importantly, the estimated rate of severe disease outcome in adolescents is an order of magnitude larger than the reported rate of vaccine side-effects; thus, showing how these estimates are relevant for health policy. Finally, we validate our results by showing that they are in close agreement with the estimates obtained from an indirect method that uses reported infection fatality rates estimates and hospital mortality data.

NUMERICAL COEFFICIENT FOR ENDOMETRIAL CANCER INDIVIDUAL RISK EVALUATION IN POSTMENOPAUSAL WOMEN

2017 ◽  
Vol 63 (3) ◽  
pp. 461-465
Author(s):  
Lev Bershteyn ◽  
Dmitriy Vasilev ◽  
Tatyana Poroshina ◽  
Igor Berlev
Keyword(s):  
Breast Cancer ◽  
Endometrial Cancer ◽  
Risk Evaluation ◽  
Tumor Response ◽  
Molecular Genetic ◽  
Response To Treatment ◽  
Individual Risk ◽  
The Past ◽  
Genetic Landscape ◽  
Numerical Coefficient

Increased frequency of endometrial cancer (EC) since the beginning of this century exceeds that of breast cancer and to a large extent can be attributed to dynamics of parameters, which characterize hormonal and metabolic status of ill women and molecular genetic landscape of transforming endometrium. During the past few years there are suggested several options for a personalized assessment of the risk of EC. The aim of this article is to propose and justify own version of this score with the idea of its further not only retrospective but also prospective testing both in relation to the risk of developing endometrial cancer as well as an additional marker helping to predict tumor response to treatment.

scholarly journals Collateral impact of COVID-19: why should children continue to suffer?

2021 ◽  
Author(s):  
Prasad Nagakumar ◽  
Ceri-Louise Chadwick ◽  
Andrew Bush ◽  
Atul Gupta
Keyword(s):  
Young People ◽  
Large Scale ◽  
Hospital Admissions ◽  
Severe Disease ◽  
Children And Young People ◽  
Collateral Effects ◽  
Rsv Infection ◽  
Syncytial Virus ◽  
Set Up ◽  
The Uk

AbstractThe COVID-19 pandemic caused by SARS-COV-2 virus fortunately resulted in few children suffering from severe disease. However, the collateral effects on the COVID-19 pandemic appear to have had significant detrimental effects on children affected and young people. There are also some positive impacts in the form of reduced prevalence of viral bronchiolitis. The new strain of SARS-COV-2 identified recently in the UK appears to have increased transmissibility to children. However, there are no large vaccine trials set up in children to evaluate safety and efficacy. In this short communication, we review the collateral effects of COVID-19 pandemic in children and young people. We highlight the need for urgent strategies to mitigate the risks to children due to the COVID-19 pandemic. What is Known:• Children and young people account for <2% of all COVID-19 hospital admissions• The collateral impact of COVID-19 pandemic on children and young people is devastating• Significant reduction in influenza and respiratory syncytial virus (RSV) infection in the southern hemisphere What is New:• The public health measures to reduce COVID-19 infection may have also resulted in near elimination of influenza and RSV infections across the globe• A COVID-19 vaccine has been licensed for adults. However, large scale vaccine studies are yet to be initiated although there is emerging evidence of the new SARS-COV-2 strain spreading more rapidly though young people.• Children and young people continue to bear the collateral effects of COVID-19 pandemic

scholarly journals Integrating public risk perception into formal natural hazard risk assessment

2006 ◽  
Vol 6 (3) ◽  
pp. 471-483 ◽  
Author(s):  
Th. Plattner ◽  
T. Plapp ◽  
B. Hebel
Keyword(s):  
Risk Assessment ◽  
Risk Perception ◽  
Risk Evaluation ◽  
Formal Model ◽  
Relevant Literature ◽  
Historical Context ◽  
Individual Risk ◽  
Affecting Factors ◽  
Plausibility Check ◽  
Novel Approach

Abstract. An urgent need to take perception into account for risk assessment has been pointed out by relevant literature, its impact in terms of risk-related behaviour by individuals is obvious. This study represents an effort to overcome the broadly discussed question of whether risk perception is quantifiable or not by proposing a still simple but applicable methodology. A novel approach is elaborated to obtain a more accurate and comprehensive quantification of risk in comparison to present formal risk evaluation practice. A consideration of relevant factors enables a explicit quantification of individual risk perception and evaluation. The model approach integrates the effective individual risk reff and a weighted mean of relevant perception affecting factors PAF. The relevant PAF cover voluntariness of risk-taking, individual reducibility of risk, knowledge and experience, endangerment, subjective damage rating and subjective recurrence frequency perception. The approach assigns an individual weight to each PAF to represent its impact magnitude. The quantification of these weights is target-group-dependent (e.g. experts, laypersons) and may be effected by psychometric methods. The novel approach is subject to a plausibility check using data from an expert-workshop. A first model application is conducted by means of data of an empirical risk perception study in Western Germany to deduce PAF and weight quantification as well as to confirm and evaluate model applicbility and flexibility. Main fields of application will be a quantification of risk perception by individual persons in a formal and technical way e.g. for the purpose of risk communication issues in illustrating differing perspectives of experts and non-experts. For decision making processes this model will have to be applied with caution, since it is by definition not designed to quantify risk acceptance or risk evaluation. The approach may well explain how risk perception differs, but not why it differs. The formal model generates only "snap shots" and considers neither the socio-cultural nor the historical context of risk perception, since it is a highly individualistic and non-contextual approach.

scholarly journals The Patient Level Cost of Asthma in Adults in South Central Ontario

1998 ◽  
Vol 5 (6) ◽  
pp. 463-471 ◽  
Author(s):  
Wendy J Ungar ◽  
Peter C Coyte ◽  
Kenneth R Chapman ◽  
Linda MacKeigan ◽  
Keyword(s):  
Cost Of Illness ◽  
Hospital Admissions ◽  
Severe Disease ◽  
Indirect Costs ◽  
Provincial Government ◽  
Multiple Perspectives ◽  
Drug Plan ◽  
Medication Costs ◽  
South Central

OBJECTIVE: To assess the annual cost of asthma per adult patient from the perspectives of society, the Ontario Ministry of Health and the patient.DESIGN: Prospective cost of illness evaluation.SETTING: Ambulatory out-patients residing in southern central Ontario.POPULATION STUDIED: Nine hundred and forty patients with asthma over 15 years of age studied between May 1995 and April 1996.OUTCOME MEASURES: Direct costs, such as respiratory-related visits to general/family practitioners, respiratory specialists, emergency rooms, hospital admissions, laboratory tests, prescription medications, dispensing fees, devices and out-of-pocket expenses, were calculated. Indirect costs, such as absences from work or usual activities, and travel and waiting time, were studied.MAIN RESULTS: Unadjusted annual costs were $2,550 per patient. Hospitalizations and medications each accounted for 22% of the total cost and indirect costs 50% of the total costs. More severe disease, older age, smoking, drug plan availability and retirement were significant predictors of costs. Annual costs per patient varied from $1,255 (95% CI $1,061 to $1,485) in young nonsmokers with no drug plan and mild disease to $5,032 (95% CI $4,347 to $5,825) in older smokers with drug plans and severe disease. Clinically important reductions in the quality of life occurred with increasing severity.CONCLUSIONS: Interventions aimed at reducing productivity losses, admissions to hospital and medication costs may result in savings to society, the provincial government and the patient. The quality of policy and allocation decisions may be enhanced by cost of illness estimates that are comprehensive, precise and incorporate multiple perspectives.

scholarly journals Role of BAP 65 (Blood Urea Nitrogen, Altered Mental Status, Pulse, Age 65 Years) Scoring System in Risk Stratification of Patients with Acute Exacerbation of Chronic Obstructive Lung Disease in Tertiary Care Hospital

2019 ◽  
Vol 2 (2) ◽  
pp. 5-10
Author(s):  
Ashish Thapa
Keyword(s):  
Mechanical Ventilation ◽  
Acute Exacerbation ◽  
Severe Disease ◽  
Tertiary Care ◽  
Chronic Obstructive Lung Disease ◽  
Institutional Review Boards ◽  
Mortality Data ◽  
Chronic Obstructive ◽  
P Value ◽  
Care Hospital

Introduction: Exacerbations are important events in the management of COPD because they negatively impact health status, rates of hospitalization and readmission, and disease progression. COPD AE is one of the commonest case presenting to the TUTH Emergency, average being 5 patients a day. The aim of the study was to co-relate the BAP 65 score, mortality and mechanical ventilation in patients with acute exacerbation of COPD. Methods: It was an observational study, 648 patients from emergency of TUTH were screened for the study from Magh 2073 to Asar 2074 after getting approval from the institutional review boards, among them 114 were included after applying inclusion and exclusion criteria and BAP 65 score was calculated. The patients were followed till discharge, mechanical ventilation or mortality. Data entry was done in MS EXCEL and statistical analysis was done using SPSS version 24. Results: Total of 114 patients enrolled for the study from the emergency of TUTH. There were total 16 mortality and 12 patients were mechanically ventilated. Most of the mortality and mechanical ventilation were from severe group ie BAP class IV and V. We used Pearson Chi-squared test to compare between BAP 65 class and Mortality, and found that mortality rate increased with increasing BAP 65 class with a p value of < 0.0001. The need of Mechanical Ventilation increased as well, as the BAP 65 Class increased, less than 1% of the patients with BAP class I needed MV, the cause being Type II Respiratory Failure, while around 50% of the patients with BAP class V needed MV. Conclusions: BAP 65 score is an effective and simple tool to classify the patients presenting with AECOPD, it correlated well with both the need of mechanical ventilation and mortality. Higher the score higher the chances of severe disease.

scholarly journals P488 The COVID19 pandemic impact on Inflammatory Bowel Disease Patients Management in a Romanian Tertiary Gastroenterology Centre

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S474-S475
Author(s):  
R Costache ◽  
R Iacob ◽  
R Vadan ◽  
T Stroie ◽  
L Gheorghe ◽  
...  
Keyword(s):  
Patient Management ◽  
Biological Therapy ◽  
Hospital Admissions ◽  
Severe Disease ◽  
Time Frame ◽  
Biological Agent ◽  
Significant Shift ◽  
Newly Diagnosed ◽  
Aminosalicylic Acid ◽  
Significant Difference

Abstract Background The IBD patients management has been challenging during the ongoing COVID-19 pandemic, due to lockdowns, limitation of access to medical facilities and new recommendations regarding patient management. The implications of the COVID-19 pandemic on IBD patient’s management were assessed in our Tertiary Gastroenterology Centre in Bucharest, Romania. Methods Using the hospital’s medical system, records of IBD patients admitted between 15th of March and 15th of August 2020 have been retrospectively reviewed and compared to a control cohort of consecutive IBD patients admitted to our unit during the corresponding period of 2019, registering the epidemiological features, patient management and the incidence of COVID-19 infection. Results 410 individual IBD cases were managed in our unit in 2020 compared to 532 in 2019, with a significant shift towards one-day hospitalization: 1059 admissions (9% ward hospitalizations, 91% one-day hospitalizations) compared to 1327 cases in the corresponding period of 2019 (17.8% ward hospitalizations, 82.2% one day hospitalizations). There was no statistically significant difference between the distribution of patient’s gender, IBD phenotype or newly diagnosed IBD cases between the two periods. A significantly lower proportion of admitted patients received 5-aminosalicylic acid (29% vs. 41.2%, p=0.0001), whereas a substantially higher number pf patients were prescribed biological therapy in 2020 in comparison to the corresponding 2019-time frame (79.5% vs 57.9%, p&lt;0.0001). The distribution of the biological agent used was significantly different, mainly due to the increase of vedolizumab prescription in 2020 (p&lt;0.0001). Among the newly diagnosed cases 50.0% had a severe disease requiring a biological agent (vs 30.2% in 2019, p&gt;0.05). Moreover, from our previously diagnosed patients, 7.1% needed the initiation of biological therapy due to disease flare-up (vs. 4.3% in 2019, p=0.003). During the study period in 2020, seven IBD patients (1.7%) were diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-Cov2) infection, all of them with mild symptoms without impact on the IBD course. Conclusion The COVID-19 pandemic led to reorganizing medical care, restricting the hospital admissions in favour of severe IBD cases, favouring telemedicine for mild disease and optimization of treatment for moderate to severe IBD with an increased use of biologicals aimed to maximize the risk/benefit ratio. Incidence of SARS-Cov2 infection during the first wave of COVID-19 infection in our study group was 1.7% and did not adversely impact the IBD disease course.

scholarly journals Estimation of age-stratified contact rates during the COVID-19 pandemic using a novel inference algorithm

2022 ◽  
Author(s):  
Christopher M Pooley ◽  
Andrea B Doeschl-Wilson ◽  
Glenn Marion
Keyword(s):  
Hospital Admissions ◽  
Epidemiological Data ◽  
Joint Analysis ◽  
Model Parameters ◽  
Inference Algorithm ◽  
Public Response ◽  
Contact Rates ◽  
Reproduction Numbers ◽  
Public Data ◽  
Approximate Bayesian

Well parameterised epidemiological models including accurate representation of contacts, are fundamental to controlling epidemics. However, age-stratified contacts are typically estimated from pre-pandemic/peace-time surveys, even though interventions and public response likely alter contacts. Here we fit age-stratified models, including re-estimation of relative contact rates between age-classes, to public data describing the 2020-21 COVID-19 outbreak in England. This data includes age-stratified population size, cases, deaths, hospital admissions, and results from the Coronavirus Infection Survey (almost 9000 observations in all). Fitting stochastic compartmental models to such detailed data is extremely challenging, especially considering the large number of model parameters being estimated (over 150). An efficient new inference algorithm ABC-MBP combining existing Approximate Bayesian Computation (ABC) methodology with model-based proposals (MBP) is applied. Modified contact rates are inferred alongside time-varying reproduction numbers that quantify changes in overall transmission due to pandemic response, and age-stratified proportions of asymptomatic cases, hospitalisation rates and deaths. These inferences are robust to a range of assumptions including the values of parameters that cannot be estimated from available data. ABC-MBP is shown to enable reliable joint analysis of complex epidemiological data yielding consistent parametrisation of dynamic transmission models that can inform data-driven public health policy and interventions.

scholarly journals Estimating individual risks of COVID-19-associated hospitalization and death using publicly available data

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243026
Author(s):  
Rajiv Bhatia ◽  
Jeffrey Klausner
Keyword(s):  
Risk Estimation ◽  
Secondary Infection ◽  
Case Fatality ◽  
Infection Risk ◽  
Individual Risk ◽  
Incidence Data ◽  
Household Transmission ◽  
Contact Rates ◽  
Time Period ◽  
Public Data

We describe a method to estimate individual risks of hospitalization and death attributable to non-household and household transmission of SARS-CoV-2 using available public data on confirmed-case incidence data along with estimates of the clinical fraction, timing of transmission, isolation adherence, secondary infection risks, contact rates, and case-hospitalization and case-fatality ratios. Using the method, we estimate that risks for a 90-day period at the median daily summertime U.S. county confirmed COVID-19 case incidence of 10.8 per 100,000 and pre-pandemic contact rates range from 0.4 to 8.9 per 100,000 for the four deciles of age between 20 and 60 years. The corresponding 90-day period risk of hospitalization ranges from 13.7 to 69.2 per 100,000. Assuming a non-household secondary infection risk of 4% and pre-pandemic contact rates, the share of transmissions attributable to household settings ranges from 73% to 78%. These estimates are sensitive to the parameter assumptions; nevertheless, they are comparable to the COVID-19 hospitalization and fatality rates observed over the time period. We conclude that individual risk of hospitalization and death from SARS-CoV-2 infection is calculable from publicly available data sources. Access to publicly reported infection incidence data by setting and other exposure characteristics along with setting specific estimates of secondary infection risk would allow for more precise individual risk estimation.

scholarly journals Analysis of Covid-19 Hospital Admissions in Ivano-Frankivsk, Ukraine

2021 ◽  
Vol 28 (4) ◽  
pp. E202141
Author(s):  
Oryna Detsyk ◽  
Natalia Fedorkiv ◽  
Olha Burak ◽  
Roksolana Kaluzhna
Keyword(s):  
Hospital Admissions ◽  
Local Level ◽  
National Level ◽  
Mortality Data ◽  
City Hospital ◽  
Substantial Impact ◽  
Admission Data ◽  
Elderly Males ◽  
Primary Determinant ◽  
Time Frames

The Covid-19 pandemic has a substantial impact on socioeconomic, political, demographic, and other aspects of life. Effective healthcare is, however, a primary determinant of successful fighting against Covid-19. The analysis of local healthcare indicators serves as a source for estimating pandemic magnitude and the adaptation of healthcare at a national level. In this study, the rates of Covid-19 hospital admissions to the Ivano-Frankivsk City Hospital, Ukraine, from April 2020 to May 2021 were analysed. All cases were grouped by age, sex, and the type of admission; data were analyzed monthly and seasonally. The peaks of hospital admissions were observed in November 2020 and March 2021; however, the highest mortality rates were seen from August to November 2020. The analysis of age- and sex-disaggregated Covid-19 mortality data showed the predominance of elderly males (61.9%, 66.6 ± 3.9 years) over females (38.1%, 71.8 ± 2.3 years). The ratio of hospital admissions was unstable: the percentage of emergency, GP-referred and self-referred admissions was similar from April to May 2020; however, GP-referred admissions prevailed, and the number of self-referral patients decreased twice between March and May 2021. In conclusions, the trends in hospital admissions were similar to those reported in other studies. However, the differences in time frames and socio-demographic characteristics were observed that highlights the importance of considering regional, social and geographic aspects of the population when improving the capacity of healthcare system and establishing effective preventive measures against the pandemic at the local level.

scholarly journals COVID-19 as a syndemic: from inequalities to biological embodiment

2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
Paolo Vineis
Keyword(s):  
Socioeconomic Position ◽  
Severe Disease ◽  
Individual Risk ◽  
Population Groups ◽  
Socioeconomic Determinants ◽  
Health And Wellbeing ◽  
Indirect Impact

Abstract Different determinants play a role in the health and wellbeing of people, population groups, communities, and the society as a whole. During the COVID-19 epidemic (and beyond) the direct and indirect impact of such determinants has become yet more evident. Individual proximal factors such as age, ethnicity, socioeconomic position, underlying comorbidities have concurred to increase individual risk of acquiring the infection as well as of developing severe disease complications, including death. The concept of COVID-19 as a syndemic has been proposed on this ground, whereby socioeconomic determinants of disease have catalyzed health worse outcomes.

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