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 Epidemiology study of SARS-CoV-2 pandemic in India, the first and second wave

2021 ◽  
Author(s):  
Dwaipayan Chaudhuri ◽  
Joyeeta Datta ◽  
Satyabrata Majumder ◽  
Kalyan Giri
Keyword(s):  
Statistical Analysis ◽  
Epidemic Model ◽  
Age Distribution ◽  
Age Groups ◽  
Salient Feature ◽  
Age Group ◽  
Sir Epidemic Model ◽  
Sir Epidemic ◽  
And Gender ◽  
Second Wave

Background and objectives: SARS-CoV-2 has wrecked the world for the past 17 months. India has been hit by the second wave of the virus which has been characterized by new symptoms. This study focuses on the pattern of infection over the last 13 months utilizing epidemic model to predict course of the pandemic. Material and methods: The data was collected from covid19india.org to perform analysis based on age and gender distribution. Statistical analysis was performed to determine the relation between confirmed and recovered cases while SIR epidemic model was used to determine the course of the pandemic in the country and the changes that have occurred from the first to the second wave. Results and discussions: Results show infectivity rate to be higher in ages 20-50 while mortality is higher in 50-80 age group while 60-70% of the infected population are males. Each of the 9 states have their own salient feature curves of infection. It was seen that the confirmed and recovered cases are more correlated at present than previous wave. The curves for both waves show a polynomial distribution while the reproduction number data shows an almost U-shaped curve indicating decrease of infection spread in the middle phase when the first wave was on a decline before picking up again owing to the second wave. Interpretations and conclusion: The gender and age distribution shows that although lower age group is more infected, mortality is high for higher age groups, on the other hand males are more prone to the infection. The statistical analysis shows the nature of spread of the disease, the data of which is quantified by the SIR model based study.

"Epidemiology of Diphtheria in Yemen, 2017-2018: Surveillance Data Analysis" (Preprint)

2021 ◽  
Author(s):  
Mohammed Alamad ◽  
Yousef S. Khader, Khader
Keyword(s):  
Surveillance System ◽  
Case Fatality Rate ◽  
Age Groups ◽  
Case Fatality ◽  
Warning System ◽  
Daily Basis ◽  
Vaccination Status ◽  
Age Group ◽  
Fatality Rate ◽  
Probable Case

BACKGROUND As a consequence of war and collapse of health system in Yemen, diphtheria fatal epidemic occurred at the end of 2017 OBJECTIVE This study aims to describe epidemiology of diphtheria in Yemen, determine its incidence and case fatality rate METHODS Data of patients with diphtheria was obtained from the Diphtheria program in a form of line list which were collected on daily basis by electronic Diseases Early Warning System (eDEWS). Probable case was defined as any person suffered from laryngitis or pharyngitis or tonsillitis and adherent membrane of the tonsils, pharynx and/or nose. Confirmed case was defined as probable case that is laboratory-confirmed or linked epidemiologically to laboratory-confirmed case RESULTS A total of 2,243 cases were reported during the period between July 2017 and August 2018. About 49% of cases were males and 51% of cases were females. About 44% of cases were 5 -15 years old. Respiratory tract infection was the predominant symptoms (91%) followed by psedumembrane (81%). Based on the vaccination status, the percentage of partial vaccinated patients, vaccinated, unvaccinated, and unknown were 7%, 31%, 48% and 14%, respectively. The overall incidence of diphtheria was 8 per 100,000 of population. The highest incidence was among age group <15 years (11 per 100,000) and the lowest incidence was among age group of ≥ 15 years (5 per 100,000). The overall case fatality rate (CFR) among all age groups was 5%, being higher (10%) in the age group < 5 years. . Five of difficult to access governorates had double CFR (22%) which were Raymah, Abyan , Sa'ada, Lahj, Al Jawf. CONCLUSIONS : Diphtheria in Yemen in 2017-2018 affected a significant number of people. The majority of patients were partially or not vaccinated. Children ≤ 15 years were more affected with higher fatality among children < five years. Five of difficult to access governorates had double CFR of WHO estimate. To control diphthereia epidemic in Yemn, it is recommended to increase vaccination coverage through campaigns and boosters, increase public health awareness toward diphtheria and strengthen the surveillance system for early detection and immediate response and provide antitoxin for management of severe cases.

scholarly journals The increase in the risk of severity and fatality rate of covid-19 in southern Brazil after the emergence of the Variant of Concern (VOC) SARS-CoV-2 P.1 was greater among young adults without pre-existing risk conditions

2021 ◽  
Author(s):  
André Ricardo Ribas Freitas ◽  
Daniele Rocha Queiróz Lemos ◽  
Otto Albuquerque Beckedorff ◽  
Luciano Pamplona de Góes Cavalcanti ◽  
Andre M Siqueira ◽  
...  
Keyword(s):  
Age Groups ◽  
Case Fatality ◽  
The State ◽  
Epidemiological Surveillance ◽  
Fatality Rate ◽  
Risk Of Death ◽  
New Variant ◽  
Before And After ◽  
Almost All ◽  
Second Wave

ABSTRACTBackgroundThe SARS-CoV-2 P.1 variant has been considered as “variant of concern (VOC)” since the end of 2020 when it was firstly identified in the Brazilian state of Amazonas and from there spread to other regions of Brazil. This variant was associated with an increase in transmissibility and worsening of the epidemiological situation in the places where it was detected. The aim of this study was to analyze the severity profile of covid-19 cases in the Rio Grande do Sul state, southern region of Brazil, before and after the emergence of the P.1 variant, considering also the context of the hospitals overload and the collapse of health services.MethodsWe analyzed data from the Influenza Epidemiological Surveillance Information System, SIVEP-Gripe (Sistema de Informação de Vigilância Epidemiológica da Gripe) and compare two epidemiological periods: the “first wave” comprised by cases occurred during November and December 2020 (EW 45 to 53) and the “second wave” with cases occurred in February 2021 (EW 5 to 8), considering that in this month there was a predominance of the new variant P.1. We calculated the proportion of severe forms among the total cases of covid-19, the case fatality rates (CFR) and hospital case fatality rate (hCFR) over both waves time set using the date of onset of symptoms as a reference. We analyzed separately the patients without pre-existing conditions of risk, by age and sex. For comparison between periods, we calculated the Risk Ratio (RR) with their respective 95% confidence intervals and the p-values.FindingsWe observed that in the second wave there were an increase in the proportion of severe cases and covid-19 deaths among younger age groups and patients without pre-existing conditions of risk. The proportion of people under the age of 60 among the cases that evolved to death raised from 18% (670 deaths) in November and December (1st wave) to 28% (1370 deaths) in February (2nd wave). A higher proportion of patients without pre-existing risk conditions was also observed among those who evolved to death due to covid-19 in the second wave (22%, 1,077 deaths) than in the first one (13%, 489 deaths). The CFR for covid-19 increased overall and in different age groups, in both sexes. The increase occurred in a greatest intensity in the population between 20 and 59 years old and among patients without pre-existing risk conditions. Female 20 to 39 years old, with no pre-existing risk conditions, were at risk of death 5.65 times higher in February (95%CI = 2.9 - 11.03; p <0.0001) and in the age group of 40 and 59 years old, this risk was 7.7 times higher (95%CI = 5.01-11.83; p <0.0001) comparing with November-December.InterpretationOur findings showed an increase in the proportion of young people and people without previous illnesses among severe cases and deaths in the state of RS after the identification of the local transmission of variant P.1 in the state. There was also an increase in the proportion of severe cases and in the CFR, in almost all subgroups analyzed, this increase was heterogeneous in different age groups and sex. As far as we know, these are the first evidences that the P.1 variant can disproportionately increase the risk of severity and deaths among population without pre-existing diseases, suggesting related changes in pathogenicity and virulence profiles. New studies still need to be done to confirm and deepen these findings.

scholarly journals Towards Understanding the COVID-19 Case Fatality Rate

2021 ◽  
Author(s):  
Donghui Yan ◽  
Aiyou Chen ◽  
Buqing Yang
Keyword(s):  
Public Health ◽  
Case Fatality Rate ◽  
Exploratory Data Analysis ◽  
Age Groups ◽  
Case Fatality ◽  
Age Effect ◽  
Fatality Rate ◽  
Apparent Discrepancy ◽  
Exploratory Data ◽  
Second Wave

AbstractAn important parameter for COVID-19 is the case fatality rate (CFR). It has been applied to wide applications, including the measure of the severity of the infection, the estimation of the number of infected cases, risk assessment etc. However, there remains a lack of understanding on several aspects of CFR, including population factors that are important to CFR, the apparent discrepancy of CFRs in different countries, and how the age effect comes into play. We analyze the CFRs at two different time snapshots, July 6 and Dec 28, with one during the first wave and the other a second wave of the COVID-19 pandemic. We consider two important population covariates, age and GDP as a proxy for the quality and abundance of public health. Extensive exploratory data analysis leads to some interesting findings. First, there is a clear exponential age effect among different age groups, and, more importantly, the exponential index is almost invariant across countries and time in the pandemic. Second, the roles played by the age and GDP are a little surprising: during the first wave, age is a more significant factor than GDP, while their roles have switched during the second wave of the pandemic, which may be partially explained by the delay in time for the quality and abundance of public health and medical research to factor in.

scholarly journals Erratum: COVID-19, Australia: Epidemiology Report 14. Reporting week ending 23:59 AEST 3 May 2020

2020 ◽  
Vol 44 ◽  
Author(s):  
Keyword(s):  
Data Processing ◽  
Case Fatality Rate ◽  
Age Groups ◽  
Case Fatality ◽  
Age Group ◽  
Fatality Rate

An error in data processing resulted in the tabulation of incorrect CFR values, for age groups of 50–59 and above, in Table 5 (Crude Case Fatality Rate of all cases and hospitalised cases, by age group) as originally published in the COVID-19 (Australia) epidemiology report 14 (https://doi.org/10.33321/cdi.2020.44.42). The table below provides the corrected values.

scholarly journals Disease Profile and Death Pattern among the Children Admitted in Rajshahi Medical College Hospital

2021 ◽  
Vol 34 (1) ◽  
pp. 55-62
Author(s):  
Be Nazir Ahmmad ◽  
Fazlur Rahman ◽  
Naznin Parvin ◽  
Md Shamsul Alam ◽  
Shitangshu Banerjee ◽  
...  
Keyword(s):  
Health Care ◽  
Case Fatality Rate ◽  
Age Groups ◽  
Case Fatality ◽  
Medical College Hospital ◽  
Watery Diarrhea ◽  
Fatality Rate ◽  
College Hospital ◽  
Under Five ◽  
Medical College

Background: Rajshahi medical college hospital is a tertiary care teaching and referral center in the North-West part of Bangladesh. To assess the epidemiological trend in hospital admission, including morbidity and mortality pattern of illness in the pediatric population, it needs to develop effective health care planning, appropriate resource allocation, and integration of existing health care service facilities. Objective: To evaluate the diseases and deaths of children admitted in the department of pediatrics, Rajshahi medical college hospital, Rajshahi. Materials and methods: This is a retrospective study. The collected case records of all patients admitted in the department of pediatrics from 1st January 2017 to 31st December 2019 (3 years) were analyzed.  Result: A total of 62000 children were admitted during the mentioned study period. All the patients were distributed into three age groups infant, under five, and more than five, contributing 22%, 27.5%, and 19%, respectively. Acute watery diarrhea (21%), hereditary hemolytic anemia (18%), bronchopneumonia (10.4%), acute gastritis (9.4%), and acute bronchiolitis and wheezy child (7.17%) were the top five diseases in each of the three years of admission. Among the total admitted patients, 1003 (1.61%) patients died. Infant, under five, and more than five age groups constitute 61.3%, 28.1%, and 15.1%, respectively. Encephalitis and fulminant hepatic failure found the top two diseases causing death with a case fatality rate was 61% and 43%, respectively. The next highest case fatality rate was found in acute leukemia (15%). Other common causes of death include meningitis, cerebral palsy with complications (7.5%), bronchopneumonia with complications (3.8%). Conclusion: An admission-related comprehensive evaluation of this study will help to understand the diseases and death patterns of a hospital, leading to the development of more effective planning and case management strategies. TAJ 2021; 34: No-1: 55-62

scholarly journals Evolution of case fatality rates in the second wave of coronavirus in England: effects of false positives, a Variant of Concern and vaccination.

2021 ◽  
Author(s):  
James A Ackland ◽  
Graeme J Ackland ◽  
David J Wallace
Keyword(s):  
False Positive ◽  
Age Groups ◽  
Case Fatality ◽  
Potential Effect ◽  
Time To Death ◽  
New Variant ◽  
Government Data ◽  
The Uk ◽  
Second Wave ◽  
Over Time

Objective: To track the statistical case fatality rate (CFR) in the second wave of the UK coronavirus outbreak, and to understand its variations over time. Design: Publicly available UK government data and clinical evidence on the time between first positive PCR test and death are used to determine the relationships between reported cases and deaths, according to age groups and across regions in England. Main Outcome Measures: Estimates of case fatality rates and their variations over time. Results: Throughout October and November 2020, deaths in England can be broadly understood in terms of CFRs which are approximately constant over time. The same CFRs prove a poor predictor of deaths when applied back to September, when prevalence of the virus was comparatively low, suggesting that the potential effect of false positive tests needs to be taken into account. Similarly, increasing CFRs are needed to match cases to deaths when projecting the model forwards into December. The growth of the S gene dropout VOC in December occurs too late to explain this increase in CFR alone, but at 33% increased mortality, it can explain the peak in deaths in January. On our analysis, if there were other factors responsible for the higher CFRs in December and January, 33% would be an upper bound for the higher mortality of the VOC. From the second half of January, the CFRs for older age groups show a marked decline. Since the fraction of the VOC has not decreased, this decline is likely to be the result of the rollout of vaccination. However, due to the rapidly decreasing nature of the raw cases data (likely due to a combination of vaccination and lockdown), any imprecisions in the time-to-death distribution are greatly exacerbated in this time period, rendering estimates of vaccination effect imprecise. Conclusions: The relationship between cases and deaths, even when controlling for age, is not static through the second wave of coronavirus in England. An apparently anomalous low case-fatality ratio in September can be accounted for by a modest 0.4% false-positive fraction. The large jump in CFR in December can be understood in terms of a more deadly new variant B1.1.7, while a decline in January correlates with vaccine roll-out, suggesting that vaccine reduce the severity of infection, as well as the risk.

Phylogenetic group and serotype of E. coli isolates are important risk factors affecting intensity of colibacillosis in broilers

2018 ◽  
Author(s):  
S. Kumar ◽  
R. Gupta ◽  
N. Jindal and Y.C. Bangar
Keyword(s):  
Case Fatality Rate ◽  
Age Groups ◽  
Case Fatality ◽  
Phylogenetic Group ◽  
Fatality Rate ◽  
Phylogenetic Groups ◽  
Factors Affecting ◽  
E Coli ◽  
Significant Difference ◽  
Class 1

The study was conducted on 106 E. coli isolates to determine the phylogenetic group, serotype and carriage of Class 1 integrons in isolates and ascertain their association along with other parameters with vital disease measures in broiler flocks affected with colibacillosis. Out of 32 isolates of which “O” antigen was characterized, serogroup O2 comprising of 12 (37.5%) isolates was most prevalent in the present study. Most of the isolates (85/106; 80.19%) belonged to phylogenetic group B2. Mean apparent morbidity, mortality and case fatality rate (CFR) were 3.77%, 2.32% and 61.49%, respectively. There was significant difference in number of outbreaks reported in different age groups (p less than 0.0001). Also, there was significant association between phylogenetic group and age of outbreak due to E. coli (p=0.024). Comparatively, no significant association was observed between age of outbreaks and serotypes (p=0.980). There was significant association between various disease measures and E. coli isolates affiliated to various phylogenetic groups and serotypes. All the measures (apparent morbidity, mortality and CFR) of disease were highest in outbreaks due to isolates of phylogenetic group B2 and serogroup O20. However, the measures were not significantly affected by the presence of integrons in the E. coli.

scholarly journals Invasive Haemophilus influenzae disease in adults

2000 ◽  
Vol 124 (3) ◽  
pp. 441-447 ◽  
Author(s):  
J. SARANGI ◽  
K. CARTWRIGHT ◽  
J. STUART ◽  
S. BROOKES ◽  
R. MORRIS ◽  
...  
Keyword(s):  
Haemophilus Influenzae ◽  
Clinical Presentation ◽  
Age Groups ◽  
Case Fatality ◽  
Underlying Disease ◽  
Reference Laboratory ◽  
Age Group ◽  
Childhood Immunization ◽  
Clinical Presentations ◽  
Vaccines For Children

We reviewed retrospectively all invasive Haemophilus influenzae (Hi) infections in adults ascertained from reference laboratory records and notifications from five NHS regions over the 5 years from 1 October 1990, a period encompassing the introduction of routine Hib childhood immunization (October 1992). A total of 446 cases were identified, a rate of 0·73 infections per 105 adults per annum. Though numbers of Hib infections in adults fell after the introduction of Hib vaccines for children (P = 0·035), and there was no increase in infections caused by other capsulated Hi serotypes, total numbers of invasive Hi infections increased due to a large rise in infections caused by non-capsulated Hi (ncHi) strains (P = 0·0067). There was an unexpectedly low rate of infections in those aged 75 years or more (P < 0·0001). The commonest clinical presentations were pneumonia with bacteraemia (227/350, 65%) and bacteraemia alone (62/350, 18%) and the highest rates of disease were in the 65–74 years age group (P < 0·0001). Clinical presentation was not influenced by the capsulation status of the invading Hi strain. 103/350 cases (29%) died within 1 month, and 207/350 (59%) within 6 months of their Hi infection. Case fatality rates were high in all age groups. Pre-existing diseases were noted in 220/350 cases and were associated with a higher case fatality rate (82% vs. 21%, P < 0·0001). After the introduction of Hib immunization in children, invasive Hib infections in unimmunized adults also declined, but the overall rate of invasive Hi disease in adults increased, with most infections now caused by non-capsulated strains. Physicians and microbiologists should be aware of the changing epidemiology, the high associated mortality and high risk of underlying disease. Invasive haemophilus infections in adults should be investigated and treated aggressively.

scholarly journals Effectiveness of potential antiviral treatments in COVID-19 transmission control: a modelling study

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Sheng-Nan Lin ◽  
Jia Rui ◽  
Qiu-Ping Chen ◽  
Bin Zhao ◽  
Shan-Shan Yu ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Antiviral Treatment ◽  
Age Groups ◽  
Reduction Rate ◽  
Real Life ◽  
Older Age ◽  
Cumulative Number ◽  
Age Group ◽  
Fatality Rate ◽  
Transmission Control

Abstract Background Novel coronavirus disease 2019 (COVID-19) causes an immense disease burden. Although public health countermeasures effectively controlled the epidemic in China, non-pharmaceutical interventions can neither be maintained indefinitely nor conveniently implemented globally. Vaccination is mainly used to prevent COVID-19, and most current antiviral treatment evaluations focus on clinical efficacy. Therefore, we conducted population-based simulations to assess antiviral treatment effectiveness among different age groups based on its clinical efficacy. Methods We collected COVID-19 data of Wuhan City from published literature and established a database (from 2 December 2019 to 16 March 2020). We developed an age-specific model to evaluate the effectiveness of antiviral treatment in patients with COVID-19. Efficacy was divided into three types: (1) viral activity reduction, reflected as transmission rate decrease [reduction was set as v (0–0.8) to simulate hypothetical antiviral treatments]; (2) reduction in the duration time from symptom onset to patient recovery/removal, reflected as a 1/γ decrease (reduction was set as 1–3 days to simulate hypothetical or real-life antiviral treatments, and the time of asymptomatic was reduced by the same proportion); (3) fatality rate reduction in severely ill patients (fc) [reduction (z) was set as 0.3 to simulate real-life antiviral treatments]. The population was divided into four age groups (groups 1, 2, 3 and 4), which included those aged ≤ 14; 15–44; 45–64; and ≥ 65 years, respectively. Evaluation indices were based on outbreak duration, cumulative number of cases, total attack rate (TAR), peak date, number of peak cases, and case fatality rate (f). Results Comparing the simulation results of combination and single medication therapy s, all four age groups showed better results with combination medication. When 1/γ = 2 and v = 0.4, age group 2 had the highest TAR reduction rate (98.48%, 56.01–0.85%). When 1/γ = 2, z = 0.3, and v = 0.1, age group 1 had the highest reduction rate of f (83.08%, 0.71–0.12%). Conclusions Antiviral treatments are more effective in COVID-19 transmission control than in mortality reduction. Overall, antiviral treatments were more effective in younger age groups, while older age groups showed higher COVID-19 prevalence and mortality. Therefore, physicians should pay more attention to prevention of viral spread and patients deaths when providing antiviral treatments to patients of older age groups.

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