scholarly journals Correlation between immunity from BCG and the morbidity and mortality of COVID-19

2020 ◽  
Author(s):  
Dakshitha Wickramasinghe ◽  
Nilanka Wickramasinghe ◽  
Sohan Anjana Kamburugamuwa ◽  
Carukshi Arambepola ◽  
Dharmabandhu N Samarasekera
Keyword(s):  
Linear Regression Analysis ◽  
Univariate Analysis ◽  
Case Fatality ◽  
Income Level ◽  
Morbidity And Mortality ◽  
Vaccination Policy ◽  
Specific Data ◽  
Bcg Vaccination ◽  
Country Level ◽  
Country Specific

Abstract Background To investigate the association between parameters indicating immunity from BCG at country level (presence of BCG vaccination policy, BCG coverage, age-specific incidence of tuberculosis(TB)) and the morbidity and mortality of COVID-19. Methods Country-specific data for COVID-19 cases and deaths, demographic details, BCG coverage and policy, age-specific TB incidence and income level were obtained. The crude COVID-19 cases and deaths per 100,000 population were calculated and assessed against the parameters indicating immunity from BCG using linear regression analysis. Results Univariate analysis identified higher income level of a country to be significantly associated with COVID-19 cases (p<0.0001) and deaths (p<0.0001) but not with its case fatality rate. The association between COVID-19 and TB was strongest for TB incidence in patients >65-years (Cases(rs=-0.785,p=0.0001)) and deaths (rs=-0.647,p=0.0001).Multivariate analysis identified the higher income level of a country and not having a universal BCG vaccination policy to affect the COVID-19 cases. The deaths were inversely affected by the presence of BCG vaccination policy and coverage; and positively by the TB incidence in patients >65-years. Conclusion Significant inverse correlations observed between cases and deaths of COVID-19 and BCG related parameters highlights immunity from BCG as a likely explanation for the variation in COVID-19 across countries.

scholarly journals Correlation between immunity from BCG and the morbidity and mortality of COVID-19

2020 ◽  
Author(s):  
Dakshitha Wickramasinghe ◽  
Nilanka Wickramasinghe ◽  
Sohan Anjana Kamburugamuwa ◽  
Carukshi Arambepola ◽  
Dharmabandhu N Samarasekera
Keyword(s):  
Linear Regression Analysis ◽  
Univariate Analysis ◽  
Case Fatality ◽  
Income Level ◽  
Morbidity And Mortality ◽  
Vaccination Policy ◽  
Specific Data ◽  
Bcg Vaccination ◽  
Country Level ◽  
Country Specific

Abstract Purpose To investigate the association between parameters indicating immunity from BCG at country level (presence of BCG vaccination policy, BCG coverage, age-specific incidence of tuberculosis (TB)) and the morbidity and mortality of COVID-19. Methods Country-specific data for COVID-19 cases and deaths, demographic details, BCG coverage and policy, age-specific TB incidence and income level were obtained. The crude COVID-19 cases and deaths per 100,000 population were calculated and assessed against the parameters indicating the immunity from BCG using linear regression analysis. Results Univariate analysis identified higher income level of a country to be significantly associated with COVID-19 cases (p<0.0001) and deaths (p<0.0001) but not with its case fatality rate. The association between COVID-19 and TB was strongest for TB incidence in patients >65-years (Cases(r s =-0.785,p=0.0001)) and deaths (r s =-0.647,p=0.0001). Multivariate analysis identified the higher income level of a country and not having a universal BCG vaccination policy to affect the COVID-19 cases. The deaths were affected negatively by the presence of BCG vaccination policy and coverage; and positively by the TB incidence in patients >65-years. Conclusion Significant negative correlations observed between cases and deaths of COVID-19 and parameters indicating immunity from BCG highlight a likely explanation for the variation in COVID-19 across countries.

scholarly journals Correlation between immunity from BCG and the morbidity and mortality of COVID-19

2020 ◽  
Author(s):  
Dakshitha Wickramasinghe ◽  
Nilanka Wickramasinghe ◽  
Sohan Anjana Kamburugamuwa ◽  
Carukshi Arambepola ◽  
Dharmabandhu N Samarasekera
Keyword(s):  
Linear Regression Analysis ◽  
Univariate Analysis ◽  
Case Fatality ◽  
Income Level ◽  
Morbidity And Mortality ◽  
Vaccination Policy ◽  
Specific Data ◽  
Bcg Vaccination ◽  
Country Level ◽  
Country Specific

Abstract Background To investigate the association between parameters indicating immunity from BCG at country level (presence of BCG vaccination policy, BCG coverage, age-specific incidence of tuberculosis(TB)) and the morbidity and mortality of COVID-19. Methods Country-specific data for COVID-19 cases and deaths, demographic details, BCG coverage and policy, age-specific TB incidence and income level were obtained. The crude COVID-19 cases and deaths per 100,000 population were calculated and assessed against the parameters indicating immunity from BCG using linear regression analysis. Results Univariate analysis identified higher income level of a country to be significantly associated with COVID-19 cases (p<0.0001) and deaths (p<0.0001) but not with its case fatality rate. The association between COVID-19 and TB was strongest for TB incidence in patients >65-years (Cases(rs=-0.785,p=0.0001)) and deaths (rs=-0.647,p=0.0001).Multivariate analysis identified the higher income level of a country and not having a universal BCG vaccination policy to affect the COVID-19 cases. The deaths were inversely affected by the presence of BCG vaccination policy and coverage; and positively by the TB incidence in patients >65-years. Conclusion Significant inverse correlations observed between cases and deaths of COVID-19 and BCG related parameters highlights immunity from BCG as a likely explanation for the variation in COVID-19 across countries.

scholarly journals BCG protects against COVID-19? A word of caution

2020 ◽  
Author(s):  
Reka Szigeti ◽  
Domos Kellermayer ◽  
Richard Kellermayer
Keyword(s):  
Case Fatality ◽  
Morbidity And Mortality ◽  
Vaccination Policy ◽  
Protective Measures ◽  
Scientific Rigor ◽  
Bcg Vaccination ◽  
Public Media ◽  
Arbitrary Selection ◽  
Viral Outbreak

AbstractThe COVID-19 pandemic, caused by type 2 Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2), puts all of us to the test. Epidemiologic observations could critically aid the development of protective measures to combat this devastating viral outbreak. A recent publication, linked nation based universal Bacillus Calmette-Guerin (BCG) vaccination to potential protection against morbidity and mortality from SARS-CoV-2, and received much attention in public media, even before its peer review. We wished to validate the findings by examining the association between daily rates of COVID-19 case fatality (i.e. Death Per Case) /Days of the endemic [dpc/d]) and the presence of universal BCG vaccination before 1980, or the year of the establishment of universal vaccination. There was no significant association in either analysis. In this work we emphasize caution amidst the publication surge on COVID-19, and highlight the political/economical-, arbitrary selection-, and fear/anxiety related biases, which may obscure scientific rigor. It is underscored that physical (social) distancing (i.e. quarantine) and use of personal protective equipment (PPE) are the only epidemiologic measures (Iceland being a great example, where universal BCG vaccination policy was never in place), which consistently associate with successful counteraction of morbidity and mortality during the pandemic.

scholarly journals An ecological study to evaluate the association of Bacillus Calmette-Guerin (BCG) vaccination on cases of SARS-CoV2 infection and mortality from COVID-19

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243707
Author(s):  
Lucy Chimoyi ◽  
Kavindhran Velen ◽  
Gavin J. Churchyard ◽  
Robert Wallis ◽  
James J. Lewis ◽  
...  
Keyword(s):  
Linear Regression ◽  
Regression Models ◽  
Morbidity And Mortality ◽  
World Health ◽  
Linear Regression Models ◽  
Vaccination Policy ◽  
Geographical Differences ◽  
Bcg Vaccination ◽  
Country Level ◽  
Log Linear

As the SARS-CoV2 pandemic has progressed, there have been marked geographical differences in the pace and extent of its spread. We evaluated the association of BCG vaccination on morbidity and mortality of SARS-CoV2, adjusted for country-specific responses to the epidemic, demographics and health. SARS-CoV2 cases and deaths as reported by 31 May 2020 in the World Health Organization situation reports were used. Countries with at least 28 days following the first 100 cases, and available information on BCG were included. We used log-linear regression models to explore associations of cases and deaths with the BCG vaccination policy in each country, adjusted for population size, gross domestic product, proportion aged over 65 years, stringency level measures, testing levels, smoking proportion, and the time difference from date of reporting the 100th case to 31 May 2020. We further looked at the association that might have been found if the analyses were done at earlier time points. The study included 97 countries with 73 having a policy of current BCG vaccination, 13 having previously had BCG vaccination, and 11 having never had BCG vaccination. In a log-linear regression model there was no effect of country-level BCG status on SARS-CoV2 cases or deaths. Univariable log-linear regression models showed a trend towards a weakening of the association over time. We found no statistical evidence for an association between BCG vaccination policy and either SARS-CoV2 morbidity or mortality. We urge countries to rather consider alternative tools with evidence supporting their effectiveness for controlling SARS-CoV2 morbidity and mortality.

scholarly journals COVID19-world: a shiny application to perform comprehensive country-specific data visualization for SARS-CoV-2 epidemic

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Cristian Tebé ◽  
Joan Valls ◽  
Pau Satorra ◽  
Aurelio Tobías
Keyword(s):  
Data Visualization ◽  
Web Application ◽  
Case Fatality ◽  
Epidemiological Surveillance ◽  
Fatality Rate ◽  
Specific Data ◽  
User Friendly ◽  
And Control ◽  
Shiny Application ◽  
Country Specific

Abstract Background Data analysis and visualization is an essential tool for exploring and communicating findings in medical research, especially in epidemiological surveillance. Results Data on COVID-19 diagnosed cases and mortality, from January 1st, 2020, onwards is collected automatically from the European Centre for Disease Prevention and Control (ECDC). We have developed a Shiny application for data visualization and analysis of several indicators to follow the SARS-CoV-2 epidemic using ECDC data. A country-specific tool for basic epidemiological surveillance, in an interactive and user-friendly manner. The available analyses cover time trends and projections, attack rate, population fatality rate, case fatality rate, and basic reproduction number. Conclusions The COVID19-World online web application systematically produces daily updated country-specific data visualization and analysis of the SARS-CoV-2 epidemic worldwide. The application may help for a better understanding of the SARS-CoV-2 epidemic worldwide.

scholarly journals Association of national Bacille Calmette-Guérin vaccination policy with COVID-19 epidemiology: an ecological study in 78 countries

2020 ◽  
Author(s):  
Norifumi Kuratani
Keyword(s):  
Protective Mechanism ◽  
Vaccination Policy ◽  
Bacille Calmette Guerin ◽  
Mixed Effect ◽  
Bcg Vaccination ◽  
Risk Of Death ◽  
Effect Model ◽  
Increase Rate ◽  
A Current ◽  
Country Specific

A possible association between national Bacille Calmette-Guérin (BCG) vaccination policy and lower COVID-19 incidence has been suggested in some preprint papers. Using publicly accessible databases, I explored associations of national BCG vaccination policy with COVID-19 epidemiology in 78 countries. Data collection was conducted from April 25 to May 5, 2020. I compared countries that have a current universal BCG vaccination policy (BCG countries), with countries that currently lack such a policy (non-BCG countries). The mixed effect model revealed national BCG policy decreases in the country-specific risk of death by COVID-19, correspond to odds ratio of 0.446 (95% confidence intervals 0.323 - 0.614, P =1×10-5). In BCG countries, the case increase rate was attenuated marginally by 25.4% (95% CI 3.0 to 42.7, P=0.029) as compared with those of the non-BCG countries. Although the protective mechanism of BCG vaccination against COVID-19 remains unknown, further laboratory and clinical research should be warranted.

scholarly journals Time-adjusted Analysis Shows Weak Associations Between BCG Vaccination Policy and COVID-19 Disease Progression

2020 ◽  
Author(s):  
Katarína Bod’ová ◽  
Vladimír Boža ◽  
Broňa Brejová ◽  
Richard Kollár ◽  
Katarína Mikušová ◽  
...  
Keyword(s):  
Disease Progression ◽  
Case Fatality ◽  
Vaccination Status ◽  
Vaccination Policy ◽  
Weak Correlation ◽  
Bcg Vaccination ◽  
Adjusted Analysis ◽  
Adjusted Indicators

AbstractIn this study, we ascertain the associations between BCG vaccination policies and progression of COVID-19 through analysis of various time-adjusted indicators either directly extracted from the incidence and death reports, or estimated as parameters of disease progression models. We observe weak correlation between BCG vaccination status and indicators related to disease reproduction characteristics. We did not find any associations with case fatality rates (CFR), but the differences in CFR estimates are at present likely dominated by differences in testing and case reporting between countries.

scholarly journals Correlation between universal BCG vaccination policy and reduced morbidity and mortality for COVID-19: an epidemiological study

2020 ◽  
Author(s):  
Aaron Miller ◽  
Mac Josh Reandelar ◽  
Kimberly Fasciglione ◽  
Violeta Roumenova ◽  
Yan Li ◽  
...  
Keyword(s):  
Elderly Population ◽  
Respiratory Infections ◽  
Morbidity And Mortality ◽  
Childhood Vaccination ◽  
Cultural Norms ◽  
Vaccination Policy ◽  
Bcg Vaccination ◽  
National Differences ◽  
Late Start ◽  
The Impact

AbstractCOVID-19 has spread to most countries in the world. Puzzlingly, the impact of the disease is different in different countries. These differences are attributed to differences in cultural norms, mitigation efforts, and health infrastructure. Here we propose that national differences in COVID- 19 impact could be partially explained by the different national policies respect to Bacillus Calmette-Guérin (BCG) childhood vaccination. BCG vaccination has been reported to offer broad protection to respiratory infections. We compared large number of countries BCG vaccination policies with the morbidity and mortality for COVID-19. We found that countries without universal policies of BCG vaccination (Italy, Nederland, USA) have been more severely affected compared to countries with universal and long-standing BCG policies. Countries that have a late start of universal BCG policy (Iran, 1984) had high mortality, consistent with the idea that BCG protects the vaccinated elderly population. We also found that BCG vaccination also reduced the number of reported COVID-19 cases in a country. The combination of reduced morbidity and mortality makes BCG vaccination a potential new tool in the fight against COVID-19.

scholarly journals Connecting BCG Vaccination and COVID-19: Additional Data

2020 ◽  
Author(s):  
Devi Dayal ◽  
Saniya Gupta
Keyword(s):  
Disease Burden ◽  
Additional Data ◽  
Severe Disease ◽  
Case Fatality ◽  
Epidemiological Data ◽  
Vaccination Policy ◽  
Bcg Vaccination ◽  
Significant Difference ◽  
The Impact ◽  
High Disease Burden

AbstractThe reasons for a wide variation in severity of coronavirus disease 2019 (COVID-19) across the affected countries of the world are not known. Two recent studies have suggested a link between the BCG vaccination policy and the morbidity and mortality due to COVID-19. In the present study we compared the impact of COVID-19 in terms of case fatality rates (CFR) between countries with high disease burden and those with BCG revaccination policies presuming that revaccination practices would have provided added protection to the population against severe COVID-19. We found a significant difference in the CFR between the two groups of countries. Our data further supports the view that universal BCG vaccination has a protective effect on the course of COVID-19 probably preventing progression to severe disease and death. Clinical trials of BCG vaccine are urgently needed to establish its beneficial role in COVID-19 as suggested by the epidemiological data, especially in countries without a universal BCG vaccination policy.

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