scholarly journals An Evidence Base for School Health Policy during the COVID-19 Pandemic

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Saif Badran ◽  
Omran Musa ◽  
Somaya Al-maadeed ◽  
Egon Toft ◽  
Suhail Doi
Keyword(s):  
Dose Response ◽  
Case Fatality Rate ◽  
School Health ◽  
Meta Analysis ◽  
Case Fatality ◽  
Evidence Base ◽  
Mortality Data ◽  
Response Analysis ◽  
Fatality Rate ◽  
Epidemiological Characteristics

Objective: Children represent a small fraction of confirmed COVID-19 cases, with a low case fatality rate (CFR). In this paper, we lay out an evidence-based policy for reopening schools. Methods: We gathered age-specific COVID-19 case counts and identified mortality data for 14 countries. Dose-response meta-analysis was used to examine the relationship of the incremental case fatality rate (CFR) to age. In addition, an evidence-to-decision framework (EtD) was used to correlate the dose-response data with other epidemiological characteristics of COVID-19 in childhood. Results: In the dose-response analysis, we found that there was an almost negligible fatality below age 18. CFR rose little between ages 5 to 50 years. The confidence intervals were narrow, suggesting relative homogeneity across countries. Further data suggested decreased childhood transmission from respiratory droplets and a low viral load among children. Conclusions: Opening up schools and kindergartens is unlikely to impact COVID-19 case or mortality rates in both the child and adult populations. We outline a robust plan for schools that recommends that general principles not be micromanaged, with authority left to schools and monitored by public health authorities.

scholarly journals Meta-analysis and metaregression of risk factors associated with mortality in hip fracture patients during the COVID-19 pandemic

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Firas J. Raheman ◽  
Djamila M. Rojoa ◽  
Jvalant Nayan Parekh ◽  
Reshid Berber ◽  
Robert Ashford
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Case Fatality Rate ◽  
Excess Mortality ◽  
Meta Analysis ◽  
Case Fatality ◽  
Pooled Analysis ◽  
Fatality Rate ◽  
Increased Risk ◽  
The Impact

AbstractIncidence of hip fractures has remained unchanged during the pandemic with overlapping vulnerabilities observed in patients with hip fractures and those infected with COVID-19. We aimed to investigate the independent impact of COVID-19 infection on the mortality of these patients. Healthcare databases were systematically searched over 2-weeks from 1st–14th November 2020 to identify eligible studies assessing the impact of COVID-19 on hip fracture patients. Meta-analysis of proportion was performed to obtain pooled values of prevalence, incidence and case fatality rate of hip fracture patients with COVID-19 infection. 30-day mortality, excess mortality and all-cause mortality were analysed using a mixed-effects model. 22 studies reporting 4015 patients were identified out of which 2651 (66%) were assessed during the pandemic. An excess mortality of 10% was seen for hip fractures treated during the pandemic (OR 2.00, p = 0.007), in comparison to the pre-pandemic controls (5%). Estimated mortality of COVID-19 positive hip fracture patients was four-fold (RR 4.59, p < 0.0001) and 30-day mortality was 38.0% (HR 4.73, p < 0.0001). The case fatality rate for COVID-19 positive patients was 34.74%. Between-study heterogeneity for the pooled analysis was minimal (I2 = 0.00) whereas, random effects metaregression identified subgroup heterogeneity for male gender (p < 0.001), diabetes (p = 0.002), dementia (p = 0.001) and extracapsular fractures (p = 0.01) increased risk of mortality in COVID-19 positive patients.

scholarly journals Crimean-Congo hemorrhagic fever-induced liver injury: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Sawai Singh Rathore ◽  
Ade Harrison Manju ◽  
Qingqing Wen ◽  
Manush Sondhi ◽  
Reshma Pydi ◽  
...  
Keyword(s):  
Liver Injury ◽  
Case Fatality Rate ◽  
Meta Analysis ◽  
Case Series ◽  
Case Fatality ◽  
Hemorrhagic Fever ◽  
Fatality Rate ◽  
High Case Fatality Rate ◽  
Crimean Congo Hemorrhagic Fever ◽  
Pooled Prevalence

Background: Crimean-Congo hemorrhagic fever (CCHF) is a fatal acute tick-borne viral infection and a substantial emerging global public health threat. This illness has a high case fatality rate of up to 40%. The liver is one of the important target organs of the CCHF virus. Objective: The aim of this meta-analysis to evaluate the correlation between CCHF  and liver injury and draw more generalized inferences about the abnormal serum markers of liver injury such as alanine aminotransferase (ALT), aspartate aminotransferase (AST) in CCHF patients. Methods: A literature search was accomplished for published eligible articles with MEDLINE/PubMed and Embase databases. All eligible observational studies and case series were included from around the world. The inclusion criteria were articles describing liver injury biomarkers AST and ALT amongst patients diagnosed with CCHF. Results: Data from 18 studies, consisting of 1238 patients with CCHF  were included in this meta-analysis. The overall pooled prevalence of at least one raised liver injury biomarker was 77.95% (95% CI, I2 = 88.50%, p < 0.0001). Similarly, pooled prevalence of elevated AST and ALT was 85.92% (95% CI, I2 = 85.27%,  p < 0.0001) and 64.30% (95% CI, I2 = 88.32%,  p < 0.0001) respectively.  Both Egger and Begg-Mazumdar’s tests detected no apparent publication bias in all three meta-analyses(p > 0.05).  Conclusion: These elevated liver injury biomarkers have been identified as significant prognostic factors. Hence, Physicians must recognize and continuously monitor these biomarkers, since these aid early stratification of prognosis and the prevention of severe outcomes in infection with such a high case fatality rate.

scholarly journals COVID-19 Healthcare Planning: Predicting Mortality and the Role of the Herd Immunity Barrier in the General Population

2020 ◽  
Vol 12 (13) ◽  
pp. 5228
Author(s):  
Julio Emilio Marco-Franco ◽  
Natividad Guadalajara-Olmeda ◽  
Silvia González-de Julián ◽  
David Vivas-Consuelo
Keyword(s):  
General Population ◽  
Case Fatality Rate ◽  
Meta Analysis ◽  
Herd Immunity ◽  
Case Fatality ◽  
Fatality Rate ◽  
Daily Monitoring ◽  
Age Related ◽  
The Impact ◽  
Carlos Iii

Using a mathematical model for COVID-19 incorporating data on excess of mortality compared to the corresponding period of the previous year obtained from the daily monitoring of mortality in Spain (MoMo), the prediction of total number of casualties in Spain for the first outbreak has been computed. From this figure, and following a stepwise meta-analysis of available reports, the case fatality rate (CFR) and the infectious case fatality rate (IFR) for the outbreak have been estimated. As the impact of age on these rates is notable, it is proposed to include an age-related adjusted fatality ratio in future comparative analyses between studies, calculated by adjusting the results by risk ratio to a reference age band (e.g., 60–69). From the casualty figures, and the corresponding CFR and IFR ratios, the forecast of serologically positive cases in the general Spanish population has been estimated at approximately 1% (0.87–1.3%) of the samples. If the data are confirmed by the ongoing study of the Carlos III Institute, until a vaccine is found, the immunity acquired in the general population after the infectious outbreak is far from the 65–70% herd immunity required as a barrier for COVID-19.

scholarly journals Clinical Characteristics and Outcomes of COVID-19–Infected Cancer Patients: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Hua Zhang ◽  
Han Han ◽  
Tianhui He ◽  
Kristen E Labbe ◽  
Adrian V Hernandez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Case Fatality Rate ◽  
Meta Analysis ◽  
Univariate Analysis ◽  
Case Fatality ◽  
The United States ◽  
Fatality Rate ◽  
Patients With Cancer ◽  
Increased Risk

Abstract Background Previous studies have indicated coronavirus disease 2019 (COVID-19) patients with cancer have a high fatality rate. Methods We conducted a systematic review of studies that reported fatalities in COVID-19 patients with cancer. A comprehensive meta-analysis that assessed the overall case fatality rate and associated risk factors was performed. Using individual patient data, univariate and multivariable logistic regression analyses were used to estimate odds ratios (OR) for each variable with outcomes. Results We included 15 studies with 3019 patients, of which 1628 were men; 41.0% were from the United Kingdom and Europe, followed by the United States and Canada (35.7%), and Asia (China, 23.3%). The overall case fatality rate of COVID-19 patients with cancer measured 22.4% (95% confidence interval [CI] = 17.3% to 28.0%). Univariate analysis revealed age (OR = 3.57, 95% CI = 1.80 to 7.06), male sex (OR = 2.10, 95% CI = 1.07 to 4.13), and comorbidity (OR = 2.00, 95% CI = 1.04 to 3.85) were associated with increased risk of severe events (defined as the individuals being admitted to the intensive care unit, or requiring invasive ventilation, or death). In multivariable analysis, only age greater than 65 years (OR = 3.16, 95% CI = 1.45 to 6.88) and being male (OR = 2.29, 95% CI = 1.07 to 4.87) were associated with increased risk of severe events. Conclusions Our analysis demonstrated that COVID-19 patients with cancer have a higher fatality rate compared with that of COVID-19 patients without cancer. Age and sex appear to be risk factors associated with a poorer prognosis.

scholarly journals Global epidemiology of septic shock: a protocol for a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e032289
Author(s):  
Frank Leonel Tianyi ◽  
Joel Noutakdie Tochie ◽  
Celestin Danwang ◽  
Aime Mbonda ◽  
Mazou N Temgoua ◽  
...  
Keyword(s):  
Systematic Review ◽  
Septic Shock ◽  
Case Fatality Rate ◽  
Hospital Admissions ◽  
Meta Analysis ◽  
Case Fatality ◽  
Primary Study ◽  
Fatality Rate ◽  
Cross Sectional ◽  
Global Epidemiology

BackgroundSeptic shock is a life-threatening infection frequently responsible for hospital admissions or may be acquired as nosocomial infection in hospitalized patients with resultant significant morbidity and mortality . There is a dearth of data on a résumé and meta-analysis on the global epidemiology of this potentially deadly condition. Therefore, we propose the first systematic review to synthesize existing data on the global incidence, prevalence and case fatality rate of septic shock worldwide.MethodsWe will include cross-sectional, case-control and cohort studies reporting on the incidence, and case fatality rate of septic shock. Electronic databases including PubMed, Embase, WHO Global Health Library and Web of Science will be searched for relevant records published between 1 January 2000 and 31 August 2019. Independents reviewers will perform study selection and data extraction, as well as assessment of methodological quality of included studies. Appropriate meta-analysis will then be used to pool studies judged to be clinically homogenous. Egger’s test and funnel plots will be used to detect publication bias. Findings will be reported and compared by human development level of countries.Ethics and disseminationBeing a review, ethical approval is not required as it was obtained in the primary study which will make up the review. This review is expected to provide relevant data to help in evaluating the burden of septic shock in the general population. The overall findings of this research will be published in a peer-reviewed journal.PROSPERO registration numberCRD42019129783.

scholarly journals Bacterial pathogens and resistance causing community acquired paediatric bloodstream infections in low- and middle-income countries: a systematic review and meta-analysis

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Nina Droz ◽  
Yingfen Hsia ◽  
Sally Ellis ◽  
Angela Dramowski ◽  
Mike Sharland ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Culture ◽  
Case Fatality Rate ◽  
Bacterial Pathogens ◽  
Meta Analysis ◽  
Case Fatality ◽  
Bloodstream Infections ◽  
Fatality Rate ◽  
Middle Income ◽  
Middle Income Countries

Abstract Background Despite a high mortality rate in childhood, there is limited evidence on the causes and outcomes of paediatric bloodstream infections from low- and middle-income countries (LMICs). We conducted a systematic review and meta-analysis to characterize the bacterial causes of paediatric bloodstream infections in LMICs and their resistance profile. Methods We searched Pubmed and Embase databases between January 1st 1990 and October 30th 2019, combining MeSH and free-text terms for “sepsis” and “low-middle-income countries” in children. Two reviewers screened articles and performed data extraction to identify studies investigating children (1 month-18 years), with at least one blood culture. The main outcomes of interests were the rate of positive blood cultures, the distribution of bacterial pathogens, the resistance patterns and the case-fatality rate. The proportions obtained from each study were pooled using the Freeman-Tukey double arcsine transformation, and a random-effect meta-analysis model was used. Results We identified 2403 eligible studies, 17 were included in the final review including 52,915 children (11 in Africa and 6 in Asia). The overall percentage of positive blood culture was 19.1% [95% CI: 12.0–27.5%]; 15.5% [8.4–24.4%] in Africa and 28.0% [13.2–45.8%] in Asia. A total of 4836 bacterial isolates were included in the studies; 2974 were Gram-negative (63.9% [52.2–74.9]) and 1858 were Gram-positive (35.8% [24.9–47.5]). In Asia, Salmonella typhi (26.2%) was the most commonly isolated pathogen, followed by Staphylococcus aureus (7.7%) whereas in Africa, S. aureus (17.8%) and Streptococcus pneumoniae (16.8%) were predominant followed by Escherichia coli (10.7%). S. aureus was more likely resistant to methicillin in Africa (29.5% vs. 7.9%), whereas E. coli was more frequently resistant to third-generation cephalosporins (31.2% vs. 21.2%), amikacin (29.6% vs. 0%) and ciprofloxacin (36.7% vs. 0%) in Asia. The overall estimate for case-fatality rate among 8 studies was 12.7% [6.6–20.2%]. Underlying conditions, such as malnutrition or HIV infection were assessed as a factor associated with bacteraemia in 4 studies each. Conclusions We observed a marked variation in pathogen distribution and their resistance profiles between Asia and Africa. Very limited data is available on underlying risk factors for bacteraemia, patterns of treatment of multidrug-resistant infections and predictors of adverse outcomes.

scholarly journals Epidemiological characteristics of an outbreak of Coronavirus Disease 2019 in the Philippines

2020 ◽  
Author(s):  
Mark M. Alipio ◽  
Joseph Dave M. Pregoner
Keyword(s):  
Case Fatality Rate ◽  
Mainland China ◽  
Case Fatality ◽  
The Philippines ◽  
Fatality Rate ◽  
Metro Manila ◽  
Infectivity Rate ◽  
Precautionary Measures ◽  
Infection Control Guidelines ◽  
Epidemiological Characteristics

AbstractThe outbreak of Coronavirus disease 2019 (Covid-2019) is a source of great concern in the Philippines. In this paper, we described the epidemiological characteristics of the laboratory-confirmed patients with Covid-2019 in the Philippines as of April 3, 2020 and provided recommendations on how to limit the spread of the disease. Data from the DOH NCOV tracker and University of the Philippines’ Covid-2019 tracker were extracted, from its initiation (January 30, 2020) until the most recent situation report (April 3, 2020). The total number of cases and deaths were stratified by sex, age, and region of the Philippines. Descriptive statistics were used to analyze the demographic profile of the confirmed cases. Case fatality rate, in percent, was calculated by dividing the total number of deaths to the total number of confirmed cases. Results revealed that a total of 3,018 cases of Covid-2019 spread were confirmed across 17 regions in the Philippines. These cases occurred over the course of 73 days through person-to-person transmission, highlighting an extremely high infectivity rate. The 144 deaths accounted for, equate to 4.51 case fatality rate, seemingly lower compared to its predecessors, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), but higher compared to that of United States of America, Germany, mainland China, and neighboring Southeast Asian countries such as Malaysia, Singapore, Brunei, and Thailand. Of the 3,018 confirmed cases, majority were male, elderly, and diagnosed in Metro Manila region. Case fatality rates were higher in male and highest among elderly and Filipinos in the Ilocos region. With the surge on the number of cases, precautionary measures should remain a responsibility, and protocols for prevention need to be set. Adherence to infection control guidelines such as but not limited to frequently handwashing for at least 20 seconds, observing coughing etiquette, wearing of masks, and social distancing should be maintained in order to contain the disease.

scholarly journals Case fatality rate in COVID-19: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Chanaka Kahathuduwa ◽  
Chathurika Dhanasekara ◽  
Shao-Hua Chin
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Critical Illness ◽  
Publication Bias ◽  
Case Fatality Rate ◽  
Meta Analysis ◽  
Case Fatality ◽  
Severe Illness ◽  
Fatality Rate ◽  
Meta Regression

AbstractBackgroundEstimating the prevalence of severe or critical illness and case fatality of COVID-19 outbreak in December, 2019 remains a challenge due to biases associated with surveillance, data synthesis and reporting. We aimed to address this limitation in a systematic review and meta-analysis and to examine the clinical, biochemical and radiological risk factors in a meta-regression.MethodsPRISMA guidelines were followed. PubMed, Scopus and Web of Science were searched using pre-specified keywords on March 07, 2020. Peer-reviewed empirical studies examining rates of severe illness, critical illness and case fatality among COVID-19 patients were examined. Numerators and denominators to compute the prevalence rates and risk factors were extracted. Random-effects meta-analyses were performed. Results were corrected for publication bias. Meta-regression analyses examined the moderator effects of potential risk factors.ResultsThe meta-analysis included 29 studies representing 2,090 individuals. Pooled rates of severe illness, critical illness and case fatality among COVID-19 patients were 15%, 5% and 0.8% respectively. Adjusting for potential underreporting and publication bias, increased these estimates to 26%, 16% and 7.4% respectively. Increasing age and elevated LDH consistently predicted severe / critical disease and case fatality. Hypertension; fever and dyspnea at presentation; and elevated CRP predicted increased severity.ConclusionsRisk factors that emerged in our analyses predicting severity and case fatality should inform clinicians to define endophenotypes possessing a greater risk. Estimated case fatality rate of 7.4% after correcting for publication bias underscores the importance of strict adherence to preventive measures, case detection, surveillance and reporting.

scholarly journals Estimation of the basic reproduction number, average incubation time, asymptomatic infection rate, and case fatality rate for COVID-19: Meta-analysis and sensitivity analysis

2020 ◽  
Author(s):  
Wenqing He ◽  
Grace Y. Yi ◽  
Yayuan Zhu
Keyword(s):  
Confidence Interval ◽  
Basic Reproduction Number ◽  
Incubation Time ◽  
Case Fatality Rate ◽  
Reproduction Number ◽  
Meta Analysis ◽  
Case Fatality ◽  
Asymptomatic Infection ◽  
Fatality Rate ◽  
The Basic Reproduction Number

AbstractThe coronavirus disease 2019 (COVID-19) has been found to be caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, comprehensive knowledge of COVID-19 remains incomplete and many important features are still unknown. This manuscripts conduct a meta-analysis and a sensitivity study to answer the questions: What is the basic reproduction number? How long is the incubation time of the disease on average? What portion of infections are asymptomatic? And ultimately, what is the case fatality rate? Our studies estimate the basic reproduction number to be 3.15 with the 95% interval (2.41, 3.90), the average incubation time to be 5.08 days with the 95% confidence interval (4.77, 5.39) (in day), the asymptomatic infection rate to be 46% with the 95% confidence interval (18.48%, 73.60%), and the case fatality rate to be 2.72% with 95% confidence interval (1.29%, 4.16%) where asymptomatic infections are accounted for.

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