Mortality among the early cases of COVID-19 and its association with key comorbidities in a large state in South India

Background: The mortality associated with the pandemic COVID-19 is a subject of intense scrutiny as COVID-19 can cause severe disease leading to hospitalization in ICU and potentially death, especially in the elderly with comorbidities. A statistical analysis is carried out to study the impact of age, gender and comorbidities on deaths among early one lakh infected population of Karnataka, a large state in south India.Methods: Daily case fatality rate and adjusted case fatality rate (CFR) (adjusted to median death time) are estimated. The impacts of age, gender and comorbidities on mortality outcomes of COVID patients are studied.Results: The daily CFR on 27th July for Karnataka is estimated from the dataset to be 1.93%. However, the adjusted CFR based on the median number of days from diagnosis to death was found to be 2.15% (95% confidence interval 2%-2.3%) on that day. The deaths among male patients outnumber those in females. As far as age of the patients is concerned, more than 50% of the deaths occurred in the age group 50-60 and 60-70 years. Majority of deaths reported in the state were associated with at least one of the comorbidity. Diabetes mellitus and hypertension were the most significant comorbidities.Conclusions: The daily adjusted CFR for the study region is found to be lower than the CFR of the whole nation. Also the age, gender and comorbidities were found to be associated with the deaths as opposed to the infection alone. It was also deduced that, patients with a history of diabetes or hypertension or ischemic heart disease or a combination of any of these were most likely to experience severe outcomes of the infection.

Download Full-text

The Impact of COVID-19 on Radiation Oncology and Cancer Care: A Perspective from the Cancer Belt Region of India

Asian Journal of Oncology ◽

10.1055/s-0040-1713960 ◽

2020 ◽

Vol 6 (02) ◽

pp. 47-52

Author(s):

Sapna Marcus ◽

Rohit Mahajan

Keyword(s):

Cancer Patients ◽

Radiation Oncology ◽

Case Fatality Rate ◽

Case Fatality ◽

Multimodality Treatment ◽

Respiratory Illness ◽

Risk Groups ◽

The Elderly ◽

Fatality Rate ◽

The Impact

AbstractA pandemic coronavirus, termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causes a respiratory illness called coronavirus disease 2019 (COVID-19) that is often severe or life threatening. Considering the low immunity status of cancer patients due to multimodality treatment, they seem to be more prone to COVID-19. Given the rapidity with which the novel coronavirus (SARS-CoV-2) is spreading, we can expect an increased burden of cancer patients diagnosed with COVID-19 at oncology treatment clinics and a need to address the issues associated. As of the date of this writing, United States has been witnessing an increase in confirmed cases, not far behind are the large outbreaks of European countries. Patients with cancer may have compromised immunity due to their disease or its ongoing treatment, and early reports suggest cancer is a risk factor for severe COVID-19. Since the outbreak in Wuhan, Chinese researchers have published on their experience with COVID-19 and have highlighted high-risk groups, including the elderly and patients with comorbidities, including cancer. In one of the largest series reported from Wuhan, elderly patients were at a higher risk for disease severity with an 8.0% case fatality rate in those aged between 70 and 79 years, and 14.8% in those aged 80 years and older. The case fatality rate for cancer patients in that cohort was notably higher than noncancer patients at 5.6 versus 2.1% in the whole sample. This review focuses on the pandemic-driven strategies that need to be adopted to overcome the radiation oncology clinics burden, especially in this region of India popularly termed as the cancer belt. Although colleagues around the world have dealt with enormous service pressures in the face of natural disaster or infection previously, the global scale and challenge of COVID-19 are unprecedented. Our aim is to highlight the quintessential point that even within these circumstances the morbidity and mortality associated with cancer should not be taken lightly. Departmental protocols should be regularly upgraded to provide smooth and efficient functioning of the department.

Download Full-text

COVID-19, Australia: Epidemiology Report 17: Fortnightly reporting period ending 24 May 2020

Communicable Diseases Intelligence ◽

10.33321/cdi.2020.44.51 ◽

2020 ◽

Vol 44 ◽

Cited By ~ 1

Author(s):

Keyword(s):

United States ◽

Case Fatality Rate ◽

Severe Disease ◽

Diagnostic Testing ◽

Case Fatality ◽

The United States ◽

Median Number ◽

International Travel ◽

Fatality Rate ◽

Overseas Travel

Confirmed cases in Australia notified up to 24 May 2020: notifications = 7,135; deaths = 102. The incidence of COVID-19 has markedly reduced since a peak in mid-March. There have been no cases reported in SA, the NT or the ACT in the last four weeks. The numbers of new cases reported from other jurisdictions continue to be very low. Testing rates have been higher across all jurisdictions, with Victoria reporting an 85% testing rate increase and NSW a 40% increase over this period. The positivity rate nationally continues to remain very low at less than 0.1% over the reporting period. Continued high rates of testing are necessary to detect and mitigate the spread of COVID-19 in the community. Over the past fortnight, 45% of cases acquired their infection overseas. Of cases considered to be locally acquired over this period, most were associated with contacts of confirmed cases or were associated with known outbreaks. The highest rate of COVID-19 continues to be among people aged 65–79 years. Three-quarters of all cases in this age group have been associated with overseas travel, including several outbreaks linked to cruise ships. The lowest rate of disease is in children under 18, a pattern reflected in international reports. A small proportion of cases overall have experienced severe disease, requiring hospitalisation or intensive care with some fatalities. The crude case fatality rate amongst Australian cases is 1.4%. People who are older and have one or more comorbidities are more likely to experience severe disease. A combination of early case identification, physical distancing, public health measures and a reduction in international travel have likely been effective in slowing the spread of the disease in Australia. In addition, the median number of days between symptom onset and diagnostic testing has improved considerably from 7 days in the early phase of the outbreak to 1 day in the latest phase of the epidemic. Internationally, as at 24 May 2020, there have been recent increases in the number of daily cases reported globally. The largest numbers of both cases and deaths have been reported in the United States. Of the confirmed cases reported globally, the case fatality rate is approximately 6.5%. Countries in South America are starting to see rapid acceleration, while the United States is seeing a very slow decline in its daily new case numbers. In the South East Asia region, India and Bangladesh are seeing accelerating epidemics, compounded by the recovery from Cyclone Amphan. Increasing numbers of cases are also being reported in Africa, although the numbers are much smaller. In the Pacific there are very few daily new cases reported.

Download Full-text

Impact of hydroxychloroquin/azithromycin protocol on COVID-19 case-fatality rate reduction in Algeria. (Preprint)

10.2196/preprints.20886 ◽

2020 ◽

Author(s):

Ahmed Youssef Kada

Keyword(s):

Case Fatality Rate ◽

Doubling Time ◽

Case Fatality ◽

World Health ◽

Fatality Rate ◽

Therapeutic Protocol ◽

First Case ◽

The World ◽

The Impact ◽

At Home

BACKGROUND Covid-19 is an emerging infectious disease like viral zoonosis caused by new coronavirus SARS CoV 2. On December 31, 2019, Wuhan Municipal Health Commission in Hubei province (China) reported cases of pneumonia, the origin of which is a new coronavirus. Rapidly extendable around the world, the World Health Organization (WHO) declares it pandemic on March 11, 2020. This pandemic reaches Algeria on February 25, 2020, date on which the Algerian minister of health, announced the first case of Covid-19, a foreign citizen. From March 1, a cluster is formed in Blida and becomes the epicentre of the coronavirus epidemic in Algeria, its total quarantine is established on March 24, 2020, it will be smoothly alleviated on April 24. A therapeutic protocol based on hydroxychloroquine and azithromycin was put in place on March 23, for complicated cases, it was extended to all the cases confirmed on April 06. OBJECTIVE This study aimed to demonstrate the effectiveness of hydroxychloroquin/azithromycin protocol in Algeria, in particular after its extension to all patients diagnosed COVID-19 positive on RT-PCR test. We were able to illustrate this fact graphically, but not to prove it statistically because the design of our study, indeed in the 7 days which followed generalization of therapeutic protocol, case fatality rate decrease and doubling time increase, thus confirming the impact of wide and early prescription of hydroxychloroquin/azithromycin protocol. METHODS We have analyzed the data collected from press releases and follow-ups published daily by the Ministry of Health, we have studied the possible correlations of these data with certain events or decisions having a possible impact on their development, such as confinement at home and its reduction, the prescription of hydroxychloroquine/azithromycin combination for serious patients and its extension to all positive COVID subjects. Results are presented in graphics, the data collection was closed on 31/05/2020. RESULTS Covid-19 pandemic spreads from February 25, 2020, when a foreign citizen is tested positive, on March 1 a cluster is formed in the city of Blida where sixteen members of the same family are infected during a wedding party. Wilaya of Blida becomes the epicentre of coronavirus epidemic in Algeria and lockdown measures taken, while the number of national cases diagnosed begins to increases In any event, the association of early containment measures combined with a generalized initial treatment for all positive cases, whatever their degree of severity, will have contributed to a reduction in the fatality rate of COVID 19 and a slowing down of its doubling time. CONCLUSIONS In Algeria, the rapid combination of rigorous containment measure at home and early generalized treatment with hydroxychloroquin have demonstrated their effectiveness in terms of morbidity and mortality, the classic measures of social distancing and hygiene will make it possible to perpetuate these results by reducing viral transmission, the only unknown, the reopening procedure which can only be started after being surrounded by precautions aimed at ensuring the understanding of the population. CLINICALTRIAL Algeria, Covid-19, pandemic, hydroxychloroquin, azithromycin, case fatality rate

Download Full-text

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

Scientific Reports ◽

10.1038/s41598-021-89617-2 ◽

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.

Download Full-text

Managing older adults’ fear of coronavirus disease: A new role for social work practice

Qualitative Social Work ◽

10.1177/1473325020973295 ◽

2020 ◽

pp. 147332502097329

Author(s):

Hamed Mortazavi

Keyword(s):

Older Adults ◽

Case Fatality Rate ◽

Severe Disease ◽

Case Fatality ◽

Social Work Practice ◽

World Health ◽

National Committee ◽

Fatality Rate ◽

Number Of Patients ◽

Incidence And Mortality

As the number of patients infected with the 2019 novel coronavirus disease (nCOVID-19) increases, the number of deaths has also been increasing. According to World Health Organization (WHO), as of 4 October 2020, 34,804,348 cases had tested positive for nCOVID-19 globally, which among them, 1,030,738 confirmed deaths had occurred, equivalent to a case-fatality rate of 2.96%. However, in comparison with global statistics, the incidence and mortality of the nCOVID-19 infection are higher in Iran. As reported by the National Committee on COVID-19 Epidemiology of Ministry of Health of Iran, the total number of patients with confirmed COVID-19 infection has reached 468,119, of which 26,746 have died, equivalent to a case-fatality rate of 5.71%. Currently, there is solid evidence that older adults are at a higher risk of severe disease following infection from COVID-19.

Download Full-text

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

Sustainability ◽

10.3390/su12135228 ◽

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.

Download Full-text

Pediatric Stroke Rates Over 17 Years: Report From a Population-Based Study

Journal of Child Neurology ◽

10.1177/0883073818767039 ◽

2018 ◽

Vol 33 (7) ◽

pp. 463-467 ◽

Cited By ~ 10

Author(s):

Laura L. Lehman ◽

Jane C. Khoury ◽

J. Michael Taylor ◽

Samrat Yeramaneni ◽

Heidi Sucharew ◽

...

Keyword(s):

Case Fatality Rate ◽

Case Fatality ◽

Population Based ◽

Pediatric Stroke ◽

Stroke Rate ◽

Fatality Rate ◽

Population Based Study ◽

Study Region ◽

Stroke Study ◽

Stroke Type

We previously published rates of pediatric stroke using our population-based Greater Cincinnati Northern Kentucky Stroke Study (GCNK) for periods July 1993–June 1994 and 1999. We report population-based rates from 2 additional study periods: 2005 and 2010. We identified all pediatric strokes for residents of the GCNK region that occurred in July 1, 1993–June 30, 1994, and calendar years 1999, 2005, and 2010. Stroke cases were ascertained by screening discharge ICD-9 codes, and verified by a physician. Pediatric stroke was defined as stroke in those <20 years of age. Stroke rates by study period, overall, by age and by race, were calculated. Eleven children died within 30 days, yielding an all-cause case fatality rate of 15.7% (95% confidence interval 1.1%, 26.4%) with 3 (27.3%) ischemic, 6 (54.5%) hemorrhagic, and 2 (18.2%) unknown stroke type. The pediatric stroke rate of 4.4 per 100 000 in the GCNK study region has not changed over 17 years.

Download Full-text

Key to successful treatment of COVID-19: accurate identification of severe risks and early intervention of disease progression

10.1101/2020.04.06.20054890 ◽

2020 ◽

Cited By ~ 7

Author(s):

Meizhu Chen ◽

Changli Tu ◽

Cuiyan Tan ◽

Xiaobin Zheng ◽

Xiaohua Wang ◽

...

Keyword(s):

Mechanical Ventilation ◽

Early Intervention ◽

Disease Progression ◽

Case Fatality Rate ◽

Severe Disease ◽

Invasive Mechanical Ventilation ◽

Case Fatality ◽

List Type ◽

Fatality Rate ◽

Medical Burden

AbstractBackgroundCOVID-19 is a new and highly contagious respiratory disease that has caused global spread, high case fatality rate in severe patients, and a huge medical burden due to invasive mechanical ventilation. The current diagnosis and treatment guidelines are still need to be improved, and more excellent clinical experience is needed to provide reference.MethodsWe analyzed and summarized clinical data of 97 confirmed COVID-19 adult patients (including 26 severe cases) admitted to the Fifth Affiliated Hospital of Sun Yat-sen University from January 17, 2020 to March 10, 2020, included laboratory examination results, imaging findings, treatment effect, prognosis, etc, in order to put forward prediction index of severe COVID-19 patients, principles of early intervention and methylprednisolone usages in COVID-19 patients.ResultsHypoxemia, hyperlactic acid, hypoproteinemia, and hypokalemia were prevalent in COVID-19 patients. The significant low lymphocyte count, hypoproteinemia, hypokalemia, the persistent or worsen high CRP, high D-dimer, and high BNP, and the occurrence of hemoptysis and novel coronavirus (SARS-CoV-2) viremia were important indicators for early diagnosis and prediction of severe disease progression.Characteristic images of lung CT had a clear change in COVID-19, Ground-glass opacity (GGO) and high-density linear combinations may indicate different pathological changes. Rapid lobular progression of GGO suggests the possibility of severe disease.Basic principles of early intervention treatment of COVID-19: on the premise of no effective antiviral drugs, treatment is based on supportive and symptomatic therapy (albumin supplementation, supplement of potassium, supplement blood plasma, etc.) in order to maintain the stability of the intracellular environment and adequately reactivate body immunity to clean up SARS-CoV-2.According to severity, oxygenation index, body weight, age, underlying diseases, appropriate amount methylprednisolone application on severe/critical COVID-19 patients on demand, improved blood oxygen and reduced the utilization rate of invasive mechanical ventilation, case fatality rate and medical burden significantly. The most common indications for invasive mechanical ventilation should be strictly control in critical COVID-19 patients.ConclusionsAccurate and timely identification of clinical features in severe risks, and early and appropriate intervention can block disease progression. 2. Appropriate dose of methylprednisolone can effectively avoid invasive mechanical ventilation and reduce case fatality rate in critical COVID-19 patients.

Download Full-text

SEIHCRD Model for COVID-19 spread scenarios, disease predictions and estimates the basic reproduction number, case fatality rate, hospital, and ICU beds requirement

10.1101/2020.07.24.20161752 ◽

2020 ◽

Author(s):

Avaneesh Singh ◽

Manish Kumar Bajpai

Keyword(s):

Basic Reproduction Number ◽

Case Fatality Rate ◽

Reproduction Number ◽

Case Fatality ◽

The United States ◽

Fatality Rate ◽

Hospital Beds ◽

The Impact ◽

Over Time ◽

The Basic Reproduction Number

We have proposed a new mathematical method, SEIHCRD-Model that is an extension of the SEIR-Model adding hospitalized and critical twocompartments. SEIHCRD model has seven compartments: susceptible (S), exposed (E), infected (I), hospitalized (H), critical (C), recovered (R), and deceased or death (D), collectively termed SEIHCRD. We have studied COVID- 19 cases of six countries, where the impact of this disease in the highest are Brazil, India, Italy, Spain, the United Kingdom, and the United States. SEIHCRD model is estimating COVID-19 spread and forecasting under uncertainties, constrained by various observed data in the present manuscript. We have first collected the data for a specific period, then fit the model for death cases, got the values of some parameters from it, and then estimate the basic reproduction number over time, which is nearly equal to real data, infection rate, and recovery rate of COVID-19. We also compute the case fatality rate over time of COVID-19 most affected countries. SEIHCRD model computes two types of Case fatality rate one is CFR daily and the second one is total CFR. We analyze the spread and endpoint of COVID-19 based on these estimates. SEIHCRD model is time-dependent hence we estimate the date and magnitude of peaks of corresponding to the number of exposed cases, infected cases, hospitalized cases, critical cases, and the number of deceased cases of COVID-19 over time. SEIHCRD model has incorporated the social distancing parameter, different age groups analysis, number of ICU beds, number of hospital beds, and estimation of how much hospital beds and ICU beds are required in near future.

Download Full-text

Study of the Immune Response in the Elderly: Is It Necessary to Develop a Vaccine against Neisseria meningitidis for the Aged?

Journal of Aging Research ◽

10.1155/2019/9287121 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8

Author(s):

Gabriela Trzewikoswki de Lima ◽

Elizabeth De Gaspari

Keyword(s):

Immune Response ◽

Neisseria Meningitidis ◽

Case Fatality Rate ◽

Case Fatality ◽

The Elderly ◽

Fatality Rate ◽

System Function ◽

Immune System Function ◽

Need To Evaluate ◽

New Vaccines

Literature reports the association between aging and decline in the immune system function. The elderly have a higher risk of developing infectious diseases and are often less responsive to vaccines that are effective in the young. The case fatality rate of invasive meningococcal disease is higher in the elderly; therefore, vaccination for this population should be evaluated. Although new vaccines have been developed against Neisseria meningitidis, there is still a need to evaluate a vaccine for those older than 60 years, as the currently licensed vaccines are not indicated for this population.

Download Full-text