scholarly journals PROBABILITY OF HOSPITALIZATION AND DEATH AMONG COVID-19 PATIENTS WITH COMORBIDITY DURING OUTBREAKS OCCURRING IN MEXICO CITY

2021 ◽  
Author(s):  
José Sifuentes-Osornio ◽  
Ofelia Angulo-Guerrero ◽  
Guillermo De-Anda-Jáuregui ◽  
Juan L. Díaz-De-León-Santiago ◽  
Enrique Hernández-Lemus ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Mexico City ◽  
Considerable Increase ◽  
Age Groups ◽  
Hospitalized Patients ◽  
Fatality Rate ◽  
New Findings ◽  
Probability Of Death ◽  
Second Wave

ABSTRACTBackgroundWorldwide, it has been observed that there is a strong association between the severity of COVID-19 and with being over 40 years of age, having diabetes mellitus (DM), hypertension and/or obesity.ObjectiveTo compare the probability of death caused by COVID-19 in patients with comorbidities during three periods defined for this study as follows: first wave (March 23 to July 12, 2020), interwave period (July 13 to October 25, 2020), and the second wave (October 26, 2020, to March 29, 2021) using the different fatality rates observed in Mexico City.MethodsThe cohort studied included individuals over 20 years of age. During the first wave (symptomatic), the interwave period, and the second wave (symptomatic and asymptomatic), participants were diagnosed using nasopharyngeal swabs taken in kiosks. Symptomatic individuals with risk factors for serious disease or death were referred to hospital. SARS-CoV-2 infection was defined by real time polymerase chain reaction in all hospitalized patients. All data from hospitalized patients and outpatients were added to the SISVER database.ResultsThe total cohort size for this study was 2,260,156 persons (having a mean age of 43.1 years). Of these, 8.6% suffered from DM, 11.6% from hypertension, and 9.7% from obesity. Of the total of 2,260,156 persons, 666,694 tested positive (29.5%) to SARS CoV-2, (with a mean age of 45). During the first wave, 82,489 tested positive; in the interwave period, 112,115; and during the second wave, 472,090. That is, a considerable increase in the number of cases of infection was observed in all age groups between the first and second waves (an increase of +472% on the first wave).Of the infected persons, a total of 85,587 (12.8%) were hospitalized: 24,023 in the first wave (29.1% of those who tested positive in this period); 16,935 (15.1%) during the interwave period, and 44,629 (9.5%) in the second wave, which represents an increase of 85.77% on the first wave.Of the hospitalized patients, there were 42,979 deaths (50.2% of those hospitalized), in the first wave, 11,964 (49.8% of those hospitalized in this period), during the interwave period, 6,794 (40.1%), and in the second wave 24,221 (54.3%), an increase of +102.4% between the first wave and the second.While within the general population, the probability of a patient dying having both COVID-19 and one of the specified comorbidities (DM, obesity, or arterial hypertension) showed a systematic reduction across all age groups, the probability of death for a hospitalized patient with comorbidities increased across all age groups during the second wave. When comparing the fatality rate of hospitalized COVID-19 patients in the second wave with those of the first wave and the interwave period, a significant increase was observed across all age groups, even in individuals without comorbidities.ConclusionThe data from this study show a considerable increase in the number of detected cases of infection in all age groups between the first and second waves. In addition, 12.8% of those infected were hospitalized for severe COVID-19, representing an increase of +85.9% from the first wave to the second. A high mortality rate was observed among hospitalized patients (>50%), as was a higher probability of death in hospitalized COVID-19 patients with comorbidities for all age groups during the second wave, although there had been a slight decrease during the interwave period.SUMMARY BOXWhat is already known?Worldwide the resurging of COVID-19 cases in waves has been observed. In Mexico, like in the rest of the world, we have observed surges of SARS CoV-2 infections, COVID-19 hospitalizations and fatal outcomes followed by decreases leading to local minima. Pre-existing health conditions such as being older, having diabetes mellitus (DM), hypertension and/or obesity has been observed to be associated with an increase in the severity of COVID-19.What are the new findings?Between the first and second waves, considerable increases were observed in the number of detected cases of infection (+472%), in the number of hospitalized subjects (+85.9%), and the number of hospitalized subjects and deaths (+102.4%) in all age groups.When analysing only hospitalized individuals, with or without comorbidities, the Case Fatality Rate was high (50.2%), the probability of death increased considerably in all age groups between the first and second waves. This increase was more noticeable in those individuals with previously identified comorbidities (DM, hypertension, or obesity).An increased probability of death among individuals without comorbidities was observed between the first and second waves.What do the new findings imply?During the second wave, demand for hospitalization increased, magnifying the impact of age and comorbidities as risk factors. This situation highlights the importance of decreasing the prevalence of comorbidities among the population.

scholarly journals Estimating effective infection fatality rates during the course of the COVID-19 pandemic in Germany

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christian Staerk ◽  
Tobias Wistuba ◽  
Andreas Mayr
Keyword(s):  
Age Distribution ◽  
Age Groups ◽  
Case Fatality ◽  
Time Dependent ◽  
Temporary Increase ◽  
International Studies ◽  
Age Group ◽  
Fatality Rate ◽  
Substantial Fraction ◽  
Second Wave

Abstract Background The infection fatality rate (IFR) of the Coronavirus Disease 2019 (COVID-19) is one of the most discussed figures in the context of this pandemic. In contrast to the case fatality rate (CFR), the IFR depends on the total number of infected individuals – not just on the number of confirmed cases. In order to estimate the IFR, several seroprevalence studies have been or are currently conducted. Methods Using German COVID-19 surveillance data and age-group specific IFR estimates from multiple international studies, this work investigates time-dependent variations in effective IFR over the course of the pandemic. Three different methods for estimating (effective) IFRs are presented: (a) population-averaged IFRs based on the assumption that the infection risk is independent of age and time, (b) effective IFRs based on the assumption that the age distribution of confirmed cases approximately reflects the age distribution of infected individuals, and (c) effective IFRs accounting for age- and time-dependent dark figures of infections. Results Effective IFRs in Germany are estimated to vary over time, as the age distributions of confirmed cases and estimated infections are changing during the course of the pandemic. In particular during the first and second waves of infections in spring and autumn/winter 2020, there has been a pronounced shift in the age distribution of confirmed cases towards older age groups, resulting in larger effective IFR estimates. The temporary increase in effective IFR during the first wave is estimated to be smaller but still remains when adjusting for age- and time-dependent dark figures. A comparison of effective IFRs with observed CFRs indicates that a substantial fraction of the time-dependent variability in observed mortality can be explained by changes in the age distribution of infections. Furthermore, a vanishing gap between effective IFRs and observed CFRs is apparent after the first infection wave, while an increasing gap can be observed during the second wave. Conclusions The development of estimated effective IFR and observed CFR reflects the changing age distribution of infections over the course of the COVID-19 pandemic in Germany. Further research is warranted to obtain timely age-stratified IFR estimates, particularly in light of new variants of the virus.

scholarly journals Trend and factors associated with Tuberculosis-Diabetes Mellitus comorbidity in a Northeastern Brazilian municipality

2021 ◽  
Vol 74 (3) ◽  
Author(s):  
Giana Gislanne da Silva de Sousa ◽  
Lívia Maia Pascoal ◽  
Ana Cristina Pereira de Jesus Costa ◽  
Floriacy Stabnow Santos ◽  
Leonardo Hunaldo dos Santos ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Customer Service ◽  
Poisson Regression ◽  
Associated Factors ◽  
Age Groups ◽  
Clinical Form ◽  
Factors Associated ◽  
Increasing Trend ◽  
Series Study

ABSTRACT Objectives: to identify the trend and factors associated with Tuberculosis-Diabetes Mellitus comorbidity in Imperatriz, Maranhão. Methods: epidemiological temporal-series study, conducted in a Northeastern Brazilian municipality. The population consisted of Tuberculosis cases with Diabetes Mellitus-associated aggravation notified in the Notifiable Diseases Information System (SINAN) between 2009 and 2018. We determined the prevalence and trend of comorbidity using Prais-Winsten regressions and to identify associated factors employed Poisson regression. Results: prevalence ranged from 3.23% in 2014 to 19.51% in 2018, with a mean of 11.5% for the period, showing an increasing trend. Age groups 30 to 59 years and ≥ 60 years, education < 8 years, and clinical form of pulmonary Tuberculosis were risk factors for comorbidity. Conclusions: The increasing trend of comorbidity and its associated factors alert us to the need to improve customer service at all levels of health care.

scholarly journals Hospital mortality in hematogenous vertebral osteomyelitis

2021 ◽  
Vol 18 (3) ◽  
pp. 86-93
Author(s):  
A. Yu. Bazarov ◽  
K. S. Sergeyev ◽  
A. O. Faryon ◽  
R. V. Paskov ◽  
I. A. Lebedev
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Hospital Mortality ◽  
Medical Records ◽  
Vertebral Osteomyelitis ◽  
Hospital Death ◽  
Factors Affecting ◽  
Comorbidity Index ◽  
Probability Of Death ◽  
Type C

Objective. To analyze lethal outcomes in patients with hematogenous vertebral osteomyelitis.Material and Methods. Study design: retrospective analysis of medical records. A total of 209 medical records of inpatients who underwent treatment for hematogenous vertebral osteomyelitis in 2006–2017 were analyzed. Out of them 68 patients (32.5 %) were treated conservatively, and 141 (67.5 %) – surgically. The risk factors for lethal outcomes were studied for various methods of treatment, and a statistical analysis was performed.Results. Hospital mortality (n = 9) was 4.3 %. In patients who died in hospital, average time for diagnosis making was 4 times less (p = 0.092). The main factors affecting mortality were diabetes mellitus (p = 0.033), type C lesion according to the Pola classification (p = 0.014) and age over 70 years (p = 0.006). To assess the relationship between hospital mortality and the revealed differences between the groups, a regression analysis was performed, which showed that factors associated with mortality were Pola type C.4 lesions (OR 9.73; 95 % CI 1.75–54.20), diabetes mellitus (OR 5.86; 95 % CI 1.14–30.15) and age over 70 years (OR 12.58; 95 % CI 2.50–63.34). The combination of these factors increased the likelihood of hospital mortality (p = 0.001). Sensitivity (77.8 %) and specificity (84.2 %) were calculated using the ROC curve. In the group with mortality, the comorbidity index (CCI) was significantly higher (≥4) than in the group without mortality (p = 0.002). With a CCI of 4 or more, the probability of hospital death increases significantly (OR 10.23; 95 % CI 2.06–50.82), p = 0.005. Long-term mortality was 4.3 % (n = 9), in 77.8 % of cases the cause was acute cardiovascular pathology, and no recurrence of vertebral osteomyelitis was detected.Conclusion. Hospital mortality was 4.3 %, and there was no mortality among patients treated conservatively. The main risk factors were diabetes mellitus, type C lesion according to Pola and age over 70 years. There was a significant mutual burdening of these factors (p = 0.001). With CCI ≥4, the probability of death is higher (p = 0.005).

Identifying risk factors for HIV-positive test results in walk-in and hospitalized patients in a Mexico City HIV clinic: a descriptive study

2019 ◽  
Vol 30 (6) ◽  
pp. 569-576
Author(s):  
Ester Gutiérrez-Velilla ◽  
Francisco J Quezada-Juárez ◽  
Ivonne N Pérez-Sánchez ◽  
Maria C Iglesias ◽  
Gustavo Reyes-Terán ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hiv Testing ◽  
Mexico City ◽  
Hiv Risk ◽  
Hospitalized Patients ◽  
Hiv Positive ◽  
City Hospital ◽  
Cross Sectional ◽  
Hiv Test ◽  
Hiv Risk Factors

The objective of this study was to analyze risk factors for HIV-positive tests in walk-in users and in hospitalized patients in a Mexico City hospital. We undertook a cross-sectional study based on routine HIV testing and counseling service data in adults undergoing an HIV test from January 2015 to July 2017. Multivariate analysis was performed to determine risk factors for walk-in and hospitalized patients. The results showed that 2040 people tested during the period; hospitalized patients were more likely to test HIV-positive than walk-in users (18 versus 15%; p < 0.05). HIV risk factors for hospitalized patients included being men who have sex with men (MSM) (adjusted odds ratio [aOR] 7.2, 95% CI 2.0–26.5), divorced (aOR 4.4, 95% CI 1.3–14.4), having 3–5 lifetime sexual partners (aOR 2.7, 95% CI 1.0–7.4), and being in the emergency room (aOR 3.6, 95% CI 1.1–11.3), intensive care (aOR 27.2, 95% CI 3.4–217.2), or clinical pneumology wards (aOR 33.4, 95% CI 9.7–115.2). In the walk-in group, HIV risk factors included being male (aOR 2.8, 95% CI 1.3–5.9), being MSM (aOR 4.3, 95% CI 2.0–9.5), having sex while using drugs (aOR 2.3, 95% CI 1.3–4.0), being referred by a physician for testing (aOR 3.2, 95% CI 1.6–6.3), and perceiving oneself at risk (aOR 3.8, 95% CI 2.3–6.3). Differential risk factors found among hospitalized patients and walk-in testers can be helpful in designing better HIV testing strategies to increase early diagnosis and linkage to care.

Frequency of risk factors in patients of acute coronary syndrome due to coronary ectasia

2020 ◽  
Vol 28 (6) ◽  
pp. 312-315
Author(s):  
Noor Dastgir ◽  
Arslan Masood ◽  
Ahmed Muqeet ◽  
Gul Zaman Khan Niazi
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Age Groups ◽  
Coronary Risk Factors ◽  
Coronary Risk ◽  
Coronary Syndrome ◽  
Coronary Ectasia ◽  
Few Data

Background Coronary artery ectasia is a relatively common entity characterized by inappropriate dilatation of the coronary vasculature. In some cases of acute coronary syndrome without obstructive coronary lesions, coronary ectasia is the sole cause. The exact mechanism of its development is unknown but evidence suggests a combination of genetic predisposition, common risk factors for coronary artery disease, and abnormal vessel wall metabolism. As there are few data regarding the pattern of coronary risk factors in patients with coronary ectasia, the objective of the study was to determine the frequency and distribution of coronary risk factors in patients with acute coronary syndrome solely due to coronary ectasia. Methods The study included 155 patients over a period of 6 months, with coronary angiographic evidence of coronary ectasia as the sole cause of acute coronary syndrome. There were 79 (51%) men and 76 (49%) women with a mean age 51.92 ± 7.83 years; 73 (47.10%) were aged 20–50 years and 82 (52.90%) were 51–80 years of age. The frequencies of coronary risk factors were stratified according to sex and the two age groups. Results Seventy-one patients (45.80%) had diabetes mellitus, 83 (53.54%) had hypertension, 55 (35.48%) were smokers, 46 (29.68%) had dyslipidemia, and 47 (30.3%) were obese. Conclusion Hypertension is the leading coronary risk factors in patients with acute coronary syndrome solely due to coronary ectasia, followed by diabetes mellitus and smoking.

scholarly journals Prevalence of Stroke Risk Factors and Their Distribution Based on Stroke Subtypes in Gorgan: A Retrospective Hospital-Based Study—2015-2016

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Mahdi Habibi-koolaee ◽  
Leila Shahmoradi ◽  
Sharareh R. Niakan Kalhori ◽  
Hossein Ghannadan ◽  
Erfan Younesi
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Ischemic Stroke ◽  
Stroke Risk ◽  
Healthcare Providers ◽  
Age Groups ◽  
University Hospital ◽  
Stroke Registry ◽  
Stroke Risk Factors ◽  
Stroke Subtypes

Background. Stroke is a leading cause of death and disability worldwide. According to the Iranian Ministry of Medical Health and Education, out of 100,000 stroke incidents in the country, 25,000 lead to death. Thus, identifying risk factors of stroke can help healthcare providers to establish prevention strategies. This study was conducted to investigate the prevalence of stroke risk factors and their distribution based on stroke subtypes in Sayad Shirazi Hospital, Gorgan, Northeastern Iran. Material and Methods. A retrospective hospital-based study was conducted at Sayad Shirazi Hospital in Gorgan, the only referral university hospital for stroke patients in Gorgan city. All medical records with a diagnosis of stroke were identified based on the International Classification of Diseases, Revision 10, from August 23, 2015, to August 22, 2016. A valid and reliable data gathering form was used to capture data about demographics, diagnostics, lifestyle, risk factors, and medical history. Results. Out of 375 cases, two-thirds were marked with ischemic stroke with mean ages (standard deviation) of 66.4 (14.2) for men and 64.6 (14.2) for women. The relationship between stroke subtypes and age groups (P=0.008) and hospital outcome (P=0.0001) was significant. Multiple regression analysis showed that hypertension (Exp. (B) =1.755, P=0.037), diabetes mellitus (Exp. (B) =0.532, P=0.021), and dyslipidemia (Exp. (B) =2.325, P=0.004) significantly increased the risk of ischemic stroke. Conclusion. Overall, hypertension, diabetes mellitus, and dyslipidemia were the major risk factors of stroke in Gorgan. Establishment of stroke registry (population- or hospital-based) for the province is recommended.

scholarly journals Rasprostranennost' ozhireniya,kardiometabolicheskikh faktorov riska,metabolicheskogo sindroma i sakharnogo diabetasredi zhenshchin razlichnykh vozrastnykh gruppMoskovskogo regiona

2009 ◽  
Vol 6 (4) ◽  
pp. 28-33
Author(s):  
S A Butrova ◽  
M A Berkovskaya ◽  
F Kh Dzgoeva ◽  
K A Komshilova
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Metabolic Syndrome ◽  
Cardiometabolic Risk ◽  
Age Groups ◽  
Visceral Obesity ◽  
Cardiometabolic Risk Factors ◽  
Group A ◽  
Group B ◽  
Parameters Measurement

The object of the study was to assess the frequency of visceral obesity, cardiometabolic risk factors, metabolic syndrome and diabetes mellitus in women of different ages. Materials and methods: 562 women from 20 to 65 years old were included and divided into 3 groups: 273 women < 45 years old (group A), 160 women of 45 - 55 years old (group B) and 129 - > 55 years old (group C). The examination included antropometric parameters, measurement of blood pressure, blood samples collection in order to investigate concentrations of glucose and lipids. Results: the frequency of visceral obesity was 52,0%, and metabolic syndrome - 18,1%. These frequencies increased in parallel with age. Higher insidence of arterial hypertension, hypercholesterolemia, hypertrigliceridemia and impaired fasting plasma gucose level were also observed with age. Diabetes mellitus was revealed in 1,2% of women. It`s frequency was 0,6% in group B and 4,7% in group C; in women younger than 45 years old no cases of diabetes mellitus were observed. Conclusion: significant increase of frequencies of visceral obesity, cardiometabolic risk factors, metabolic syndrome and diabetes mellitus in women older than 45, and especially - older than 55 years old stresses the necessity of an intense medical care for women of these age groups, and implementation of measures for prevention of cardiovascular diseases and diabetes mellitus.

scholarly journals Changes and evolution among SARS-COV-2 hospitalised patients in terms of severity, mortality and virus genome in a Spanish cohort

2021 ◽  
Author(s):  
Rocío Aznar-Gimeno ◽  
J. Ramón Paño-Pardo ◽  
Luis M. Esteban ◽  
Gorka Labata-Lezaun ◽  
M. José Esquillor-R ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Cohort ◽  
Mortality Rates ◽  
Virus Genome ◽  
Hospitalized Patients ◽  
Icu Admission ◽  
Hospitalised Patients ◽  
Survival Differences ◽  
Second Wave ◽  
Spanish Cohort

Abstract A comparison between pandemic waves could help to understand the evolution of this disease. The objective of this work was to study the evolution of COVID-19 hospitalized patients on different pandemic waves in terms of severity and mortality. We performed an observational retrospective cohort study of hospitalized patients (5,220) with SARS-CoV-2 infection from February to September in Aragon, Spain. In a comparative way, we analyzed ICU admission and 30-day mortality, clinical characteristics and risk factors, of first and second waves. SARS-CoV-2 virus genome were analyzed in 236 samples. Patients in the first wave (n=2,547) were older (74 y, IQR: 60-86 vs. 70 y, IQR: 53-85; p<0.001) and showed worse clinical and analytical parameters related to severe COVID-19 than in the second wave (n=2,673). The probability of ICU admission at 30 days was 16% and 10% in the first and second wave, respectively (p<0.001). The cumulative 30-day mortality rates were 38% in the first wave and 32% in the second one (p=0.007). Survival differences were observed among patients aged 60 to 80 years. There was variability among death risk factors and virus genome between waves. Therefore, the two COVID-19 pandemic waves analyzed were different, in terms of disease severity and mortality.

Sign in / Sign up

Export Citation Format

Share Document