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 Household Transmission and Clinical Features of SARS-CoV-2 Infections by Age in 2 US Communities

2021 ◽  
Author(s):  
Huong Q McLean ◽  
Carlos G Grijalva ◽  
Kayla E Hanson ◽  
Yuwei Zhu ◽  
Jessica E Deyoe ◽  
...  
Keyword(s):  
Age Differences ◽  
Secondary Infection ◽  
Infection Risk ◽  
Transmission Risk ◽  
Age Group ◽  
Primary Case ◽  
Household Contacts ◽  
Household Transmission ◽  
Age Related ◽  
Asymptomatic Infections

OBJECTIVES. Examine age differences in SARS-CoV-2 transmission risk from primary cases and infection risk among household contacts, and symptoms among those with SARS-CoV-2 infection. METHODS. People with SARS-CoV-2 infection in Nashville, Tennessee and central and western Wisconsin and their household contacts were followed daily for 14 days to ascertain symptoms and secondary transmission events. Households were enrolled between April 2020 and April 2021. Secondary infection risks (SIR) by age of the primary case and contacts were estimated using generalized estimating equations. RESULTS. The 226 primary cases were followed by 197 (49%) secondary SARS-CoV-2 infections among 404 household contacts. Age group-specific SIR among contacts ranged from 35% to 53%, with no differences by age. SIR was lower from primary cases aged 12-17 years than from primary cases 18-49 years (risk ratio [RR] 0.42; 95% confidence interval [CI] 0.19-0.92). SIR was 56% and 45%, respectively, among primary case-contact pairs in the same versus different age group (RR 1.54; 95% CI 1.03-2.31). SIR was highest among primary case-contacts pairs aged ≥65 years (77%) and 5-11 years (70%). Among secondary SARS-CoV-2 infections, 19% were asymptomatic; there was no difference in the frequency of asymptomatic infections by age group. CONCLUSIONS. Both children and adults can transmit and are susceptible to SARS-CoV-2 infection. SIR did not vary by age, but further research is needed to understand age-related differences in probability of transmission from primary cases by age.

scholarly journals Coronavirus Occurrence and Transmission Over 8 Years in the HIVE Cohort of Households in Michigan

2020 ◽  
Vol 222 (1) ◽  
pp. 9-16 ◽  
Author(s):  
Arnold S Monto ◽  
Peter M DeJonge ◽  
Amy P Callear ◽  
Latifa A Bazzi ◽  
Skylar B Capriola ◽  
...  
Keyword(s):  
Influenza A ◽  
Respiratory Infections ◽  
Secondary Infection ◽  
Age Groups ◽  
Infection Risk ◽  
Infection Frequency ◽  
Transmission Potential ◽  
Time Period ◽  
Serial Interval ◽  
Human Coronaviruses

Abstract Background As part of the Household Influenza Vaccine Evaluation (HIVE) study, acute respiratory infections (ARI) have been identified in children and adults from 2010 to 2018. Methods Annually, 890 to 1441 individuals were followed and contacted weekly to report ARIs. Specimens collected during illness were tested for human coronaviruses (HCoV) types OC43, 229E, HKU1, and NL63. Results In total, 993 HCoV infections were identified during the 8 years, with OC43 most commonly seen and 229E the least. HCoVs were detected in a limited time period, between December and April/May and peaked in January/February. Highest infection frequency was in children <5 years (18 per 100 person-years), with little variation in older age groups (range, 7 to 11 per 100 person-years). Overall, 9% of adult cases and 20% of cases in children were associated with medical consultation. Of the 993 infections, 260 were acquired from an infected household contact. The serial interval between index and household-acquired cases ranged from 3.2 to 3.6 days and the secondary infection risk ranged from 7.2% to 12.6% by type. Conclusions Coronaviruses are sharply seasonal. They appear, based on serial interval and secondary infection risk, to have similar transmission potential to influenza A(H3N2) in the same population.

scholarly journals Infection fatality rate of SARS-CoV-2 infection in a German community with a super-spreading event

2020 ◽  
Author(s):  
Hendrik Streeck ◽  
Bianca Schulte ◽  
Beate M. Kümmerer ◽  
Enrico Richter ◽  
Tobias Höller ◽  
...  
Keyword(s):  
Infection Rate ◽  
Secondary Infection ◽  
Severe Disease ◽  
Case Fatality ◽  
Infection Risk ◽  
Population Characteristics ◽  
Fatality Rate ◽  
Transient Wave ◽  
The World ◽  
Study Participants

AbstractThe world faces an unprecedented SARS-CoV2 pandemic where many critical factors still remain unknown. The case fatality rates (CFR) reported in the context of the SARS-CoV-2 pandemic substantially differ between countries. For SARS-CoV-2 infection with its broad clinical spectrum from asymptomatic to severe disease courses, the infection fatality rate (IFR) is the more reliable parameter to predict the consequences of the pandemic. Here we combined virus RT-PCR testing and assessment for SARS-CoV2 antibodies to determine the total number of individuals with SARS-CoV-2 infections in a given population.MethodsA sero-epidemiological GCP- and GEP-compliant study was performed in a small German town which was exposed to a super-spreading event (carnival festivities) followed by strict social distancing measures causing a transient wave of infections. Questionnaire-based information and biomaterials were collected from a random, household-based study population within a seven-day period, six weeks after the outbreak. The number of present and past infections was determined by integrating results from anti-SARS-CoV-2 IgG analyses in blood, PCR testing for viral RNA in pharyngeal swabs and reported previous positive PCR tests.ResultsOf the 919 individuals with evaluable infection status (out of 1,007; 405 households) 15.5% (95% CI: [12.3%; 19.0%]) were infected. This is 5-fold higher than the number of officially reported cases for this community (3.1%). Infection was associated with characteristic symptoms such as loss of smell and taste. 22.2% of all infected individuals were asymptomatic. With the seven SARS-CoV-2-associated reported deaths the estimated IFR was 0.36% [0.29%; 0.45%]. Age and sex were not found to be associated with the infection rate. Participation in carnival festivities increased both the infection rate (21.3% vs. 9.5%, p<0.001) and the number of symptoms in the infected (estimated relative mean increase 1.6, p=0.007). The risk of a person being infected was not found to be associated with the number of study participants in the household this person lived in. The secondary infection risk for study participants living in the same household increased from 15.5% to 43.6%, to 35.5% and to 18.3% for households with two, three or four people respectively (p<0.001).ConclusionsWhile the number of infections in this high prevalence community is not representative for other parts of the world, the IFR calculated on the basis of the infection rate in this community can be utilized to estimate the percentage of infected based on the number of reported fatalities in other places with similar population characteristics. Whether the specific circumstances of a super-spreading event not only have an impact on the infection rate and number of symptoms but also on the IFR requires further investigation. The unexpectedly low secondary infection risk among persons living in the same household has important implications for measures installed to contain the SARS-CoV-2 virus pandemic.

scholarly journals Deaths From Plasmodium knowlesi Malaria: Case Series and Systematic Review

2019 ◽  
Vol 69 (10) ◽  
pp. 1703-1711 ◽  
Author(s):  
Giri S Rajahram ◽  
Daniel J Cooper ◽  
Timothy William ◽  
Matthew J Grigg ◽  
Nicholas M Anstey ◽  
...  
Keyword(s):  
Systematic Review ◽  
Odds Ratio ◽  
Plasmodium Knowlesi ◽  
Case Series ◽  
Case Fatality ◽  
Mandatory Reporting ◽  
Incidence Data ◽  
Cardiovascular Comorbidities ◽  
Department Of Health ◽  
Appropriate Therapy

Abstract Background Plasmodium knowlesi causes severe and fatal malaria, and incidence in Southeast Asia is increasing. Factors associated with death are not clearly defined. Methods All malaria deaths in Sabah, Malaysia, from 2015 to 2017 were identified from mandatory reporting to the Sabah Department of Health. Case notes were reviewed, and a systematic review of these and all previously reported fatal P. knowlesi cases was conducted. Case fatality rates (CFRs) during 2010–2017 were calculated using incidence data from the Sabah Department of Health. Results Six malaria deaths occurred in Sabah during 2015–2017, all from P. knowlesi. Median age was 40 (range, 23–58) years; 4 cases (67%) were male. Three (50%) had significant cardiovascular comorbidities and 1 was pregnant. Delays in administering appropriate therapy contributed to 3 (50%) deaths. An additional 26 fatal cases were included in the systematic review. Among all 32 cases, 18 (56%) were male; median age was 56 (range, 23–84) years. Cardiovascular-metabolic disease, microscopic misdiagnosis, and delay in commencing intravenous treatment were identified in 11 of 32 (34%), 26 of 29 (90%), and 11 of 31 (36%) cases, respectively. The overall CFR during 2010–2017 was 2.5/1000: 6.0/1000 for women and 1.7/1000 for men (P = .01). Independent risk factors for death included female sex (odds ratio, 2.6; P = .04), and age ≥45 years (odds ratio, 4.7; P < .01). Conclusions Earlier presentation, more rapid diagnosis, and administration of intravenous artesunate may avoid fatal outcomes, particularly in females, older adults, and patients with cardiovascular comorbidities.

scholarly journals Understanding potential implications for non-trophic parasite transmission based on vertebrate behavior at mesocarnivore carcass sites

2021 ◽  
Author(s):  
Moisés Gonzálvez ◽  
Carlos Martínez-Carrasco ◽  
Marcos Moleón
Keyword(s):  
Red Fox ◽  
Close Contact ◽  
Infection Risk ◽  
Camera Traps ◽  
Emerging Pathogens ◽  
Domestic Species ◽  
Time Period ◽  
Wild Canids ◽  
Rubbing Behavior ◽  
Trophically Transmitted Parasites

AbstractHigh infection risk is often associated with aggregations of animals around attractive resources. Here, we explore the behavior of potential hosts of non-trophically transmitted parasites at mesocarnivore carcass sites. We used videos recorded by camera traps at 56 red fox (Vulpes vulpes) carcasses and 10 carcasses of other wild carnivore species in three areas of southeastern Spain. Scavenging species, especially wild canids, mustelids and viverrids, showed more frequent rubbing behavior at carcass sites than non-scavenging and domestic species, suggesting that they could be exposed to a higher potential infection risk. The red fox was the species that most frequently contacted carcasses and marked and rubbed carcass sites. Foxes contacted heterospecific carcasses more frequently and earlier than conspecific ones and, when close contact occurred, it was more likely to be observed at heterospecific carcasses. This suggests that foxes avoid contact with the type of carcass and time period that have the greatest risk as a source of parasites. Overall, non-trophic behaviors of higher infection risk were mainly associated with visitor-carcass contact and visitor contact with feces and urine, rather than direct contact between visitors. Moreover, contact events between scavengers and carnivore carcasses were far more frequent than consumption events, which suggests that scavenger behavior is more constrained by the risk of acquiring meat-borne parasites than non-trophically transmitted parasites. This study contributes to filling key gaps in understanding the role of carrion in the landscape of disgust, which may be especially relevant in the current global context of emerging and re-emerging pathogens. Graphical abstract

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 Clinical course and severity outcome indicators among COVID 19 hospitalized patients in relation to comorbidities distribution Mexican cohort

2020 ◽  
Author(s):  
Genny Carrillo ◽  
Nina Mendez Dominguez ◽  
Kassandra D Santos Zaldivar ◽  
Andrea Rochel Perez ◽  
Mario Azuela Morales ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Respiratory Diseases ◽  
Risk Estimation ◽  
Clinical Manifestations ◽  
Case Fatality ◽  
Hospitalized Patients ◽  
Hospital Death ◽  
Outcome Indicators

Introduction: COVID-19 affected worldwide, causing to date, around 500,000 deaths. In Mexico, by April 29, the general case fatality was 6.52%, with 11.1% confirmed case mortality and hospital recovery rate around 72%. Once hospitalized, the odds for recovery and hospital death rates depend mainly on the patients' comorbidities and age. In Mexico, triage guidelines use algorithms and risk estimation tools for severity assessment and decision-making. The study's objective is to analyze the underlying conditions of patients hospitalized for COVID-19 in Mexico concerning four severity outcomes. Materials and Methods: Retrospective cohort based on registries of all laboratory-confirmed patients with the COVID-19 infection that required hospitalization in Mexico. Independent variables were comorbidities and clinical manifestations. Dependent variables were four possible severity outcomes: (a) pneumonia, (b) mechanical ventilation (c) intensive care unit, and (d) death; all of them were coded as binary Results: We included 69,334 hospitalizations of laboratory-confirmed and hospitalized patients to June 30, 2020. Patients were 55.29 years, and 62.61% were male. Hospital mortality among patients aged<15 was 9.11%, 51.99% of those aged >65 died. Male gender and increasing age predicted every severity outcome. Diabetes and hypertension predicted every severity outcome significantly. Obesity did not predict mortality, but CKD, respiratory diseases, cardiopathies were significant predictors. Conclusion: Obesity increased the risk for pneumonia, mechanical ventilation, and intensive care admittance, but it was not a predictor of in-hospital death. Patients with respiratory diseases were less prone to develop pneumonia, to receive mechanical ventilation and intensive care unit assistance, but they were at higher risk of in-hospital death.

A decade of socioeconomic inequality in type 2 diabetes area-level prevalence: an unshakeable status quo?

2022 ◽  
pp. 140349482110623
Author(s):  
Ina Tapager ◽  
Anne Mette Bender ◽  
Ingelise Andersen
Keyword(s):  
Type 2 Diabetes ◽  
Socioeconomic Inequality ◽  
Socioeconomic Disadvantage ◽  
Socioeconomic Gradient ◽  
Time Period ◽  
Public Data ◽  
Welfare Systems ◽  
Index Of Inequality ◽  
Socioeconomic Composition

Aims: It is well known that there is a socioeconomic gradient in the prevalence of many chronic diseases, including type 2 diabetes (T2DM). We present a simple assessment of the macro-level association between area socioeconomic disadvantage and the area-level prevalence of T2DM in Danish municipalities and the development in this relationship over the last decade. Methods: We used readily available public data on the socioeconomic composition of municipalities and T2DM prevalence to illustrate this association and report the absolute and relative summary measures of socioeconomic inequality over the time period 2008–2018. Results: The results show a persistent relationship between municipality socioeconomic disadvantage and T2DM prevalence across all analyses, with a modelled gap in T2DM prevalence between the most and least disadvantaged municipalities, the slope index of inequality, of 1.23 [0.97;1.49] in 2018. Conclusions: These results may be used to indicate areas with specific needs, to encourage systematic monitoring of socioeconomic gradients in health, and to provide a descriptive backdrop for a discussion of how to tackle these socioeconomic and geographic inequalities, which seem to persist even in the context of the comprehensive welfare systems in Scandinavia.

Exploring Fieldwork Effects in a Mobile CATI Survey

2017 ◽  
Vol 59 (1) ◽  
pp. 57-76
Author(s):  
Paula Vicente
Keyword(s):  
Mobile Phone ◽  
Future Research ◽  
Computer Assisted ◽  
Contact Rates ◽  
Time Period ◽  
Sample Composition ◽  
Interview Survey ◽  
Day Of The Week ◽  
Time Periods ◽  
Cati Survey

This study explores the effects of call attempts and time periods on call outcomes and sample composition. A mobile computer-assisted telephone interview survey was conducted to collect data from adult mobile phone users about use and attitudes towards mobile phones; paradata regarding call dispositions, time and day of the week of calls and number of call attempts was also available. The first call contact rate was approximately 27% and varied significantly across time periods; the rate fell to below 20% for the second call. Weekend time periods yielded higher contact rates than weekday time periods. The interview rate on the first call was 12% and decreased steadily in subsequent calls. Mobile phone numbers that yielded call rejection, voicemail or were busy on the first call were very difficult to convert into interview on the second call. The number of call attempts and time period of the calls affect sample composition, namely in relation to respondents' age, educational level and area of residence. Future research and practical implications of the findings for mobile CATI surveys are discussed.

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