Pre-existing comorbidity, the highest risk factor for poor prognosis of COVID-19 among the Mexican population

The coronavirus disease 2019 (COVID-19) pandemic represents a challenge for public health and a high risk for patients with pre-existing comorbidity. As of July 20, 2020, the Case Fatality Rate (CFR) was 11.30% and the Mortality Rate (MR) was 31.28 deaths per 100,000 population. In Mexico, the prevalence of obesity, diabetes mellitus, and hypertension among the adult Mexican population is 30%, 9.2%, and 40%, respectively. The objective of this research was to identify the risk factors associated with eight comorbidities and their dependency on age for death caused by COVID-19. Method: This study used the dataset published on July 20, 2020, by the General Directorate of Epidemiology of the Ministry of Health of Mexico. From this dataset, we analysed 130,896 positive COVID-19 cases, where 35,483 (27.107%) patients had one comorbidity, and 95,413 (72.892%) patients had not medical comorbidity. Statistical analyses include the Case Fatality Rate (CFR), the estimation of the Odds Ratio (OR), and its 95% Confidence Interval (CI). Results: The highest CFR was 14.382% for COPD, 10.266% for CKD, 10.126% for diabetes, and 8.954% for hypertension. The obesity CFR was 3.535%. Moreover, we detected a higher risk for patients with COPD, diabetes, and CKD, resulting in OR of 4.443 (95% CI: 3.404-5.799), 3.283 (95% CI: 3.018-3.570), and 3.016 (95% CI: 2.248-4.047), respectively. Conclusion: This study corroborates that the highest risk for severe disease and death caused by COVID-19 among the Mexican population are pre-existing comorbidities. Findings show that COPD, CKD, diabetes, hypertension, and cardiovascular disease increase the risk of death for patients older than 54 years. The most vulnerable age group is older than 65 years.

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Risk factors for mortality in hospitalized patients with COVID-19 at the start of the pandemic in Belgium: a retrospective cohort study

BMC Infectious Diseases ◽

10.1186/s12879-020-05605-3 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Karlijn van Halem ◽

Robin Bruyndonckx ◽

Jeroen van der Hilst ◽

Janneke Cox ◽

Paulien Driesen ◽

...

Keyword(s):

Risk Factors ◽

Hospital Mortality ◽

Case Fatality Rate ◽

Clinical Characteristics ◽

Severe Disease ◽

Univariate Analysis ◽

Case Fatality ◽

Fatality Rate ◽

Risk Of Death ◽

Increased Risk

Abstract Background Belgium was among the first countries in Europe with confirmed coronavirus disease 2019 (COVID-19) cases. Since the first diagnosis on February 3rd, the epidemic has quickly evolved, with Belgium at the crossroads of Europe, being one of the hardest hit countries. Although risk factors for severe disease in COVID-19 patients have been described in Chinese and United States (US) cohorts, good quality studies reporting on clinical characteristics, risk factors and outcome of European COVID-19 patients are still scarce. Methods This study describes the clinical characteristics, complications and outcomes of 319 hospitalized COVID-19 patients, admitted to a tertiary care center at the start of the pandemic in Belgium, and aims to identify the main risk factors for in-hospital mortality in a European context using univariate and multivariate logistic regression analysis. Results Most patients were male (60%), the median age was 74 (IQR 61–83) and 20% of patients were admitted to the intensive care unit, of whom 63% needed invasive mechanical ventilation. The overall case fatality rate was 25%. The best predictors of in-hospital mortality in multivariate analysis were older age, and renal insufficiency, higher lactate dehydrogenase and thrombocytopenia. Patients admitted early in the epidemic had a higher mortality compared to patients admitted later in the epidemic. In univariate analysis, patients with obesity did have an overall increased risk of death, while overweight on the other hand showed a trend towards lower mortality. Conclusions Most patients hospitalized with COVID-19 during the first weeks of the epidemic in Belgium were admitted with severe disease and the overall case fatality rate was high. The identified risk factors for mortality are not easily amenable at short term, underscoring the lasting need of effective therapeutic and preventative measures.

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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.

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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.

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

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20204009 ◽

2020 ◽

Vol 7 (10) ◽

pp. 3882

Author(s):

Suhas Bhat ◽

Rohan Kolla ◽

Shashank D. Shindhe ◽

Surekha B. Munoli

Keyword(s):

Case Fatality Rate ◽

Severe Disease ◽

Case Fatality ◽

The Elderly ◽

Median Number ◽

Fatality Rate ◽

Study Region ◽

Large State ◽

Death Time ◽

The Impact

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.

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The Global Case-Fatality Rate of COVID-19 Has Been Declining Since May 2020

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.20-1496 ◽

2021 ◽

Author(s):

Mohammad Nayeem Hasan ◽

Najmul Haider ◽

Florian L. Stigler ◽

Rumi Ahmed Khan ◽

David McCoy ◽

...

Keyword(s):

Time Series ◽

Case Fatality Rate ◽

Moving Average ◽

Case Fatality ◽

Mortality Data ◽

Fatality Rate ◽

Peak Period ◽

Prevalence Of Obesity ◽

Simple Exponential Smoothing ◽

Rate Ratios

The objective of this study was to evaluate the trend of reported case fatality rate (rCFR) of COVID-19 over time, using globally reported COVID-19 cases and mortality data. We collected daily COVID-19 diagnoses and mortality data from the WHO’s daily situation reports dated January 1 to December 31, 2020. We performed three time-series models [simple exponential smoothing, auto-regressive integrated moving average, and automatic forecasting time-series (Prophet)] to identify the global trend of rCFR for COVID-19. We used beta regression models to investigate the association between the rCFR and potential predictors of each country and reported incidence rate ratios (IRRs) of each variable. The weekly global cumulative COVID-19 rCFR reached a peak at 7.23% during the 17th week (April 22–28, 2020). We found a positive and increasing trend for global daily rCFR values of COVID-19 until the 17th week (pre-peak period) and then a strong declining trend up until the 53rd week (post-peak period) toward 2.2% (December 29–31, 2020). In pre-peak of rCFR, the percentage of people aged 65 and above and the prevalence of obesity were significantly associated with the COVID-19 rCFR. The declining trend of global COVID-19 rCFR was not merely because of increased COVID-19 testing, because COVID-19 tests per 1,000 population had poor predictive value. Decreasing rCFR could be explained by an increased rate of infection in younger people or by the improvement of health care management, shielding from infection, and/or repurposing of several drugs that had shown a beneficial effect on reducing fatality because of COVID-19.

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Mortality of tetanus at the Lagos University Teaching Hospital, Nigeria

Tropical Doctor ◽

10.1258/0049475054620806 ◽

2005 ◽

Vol 35 (3) ◽

pp. 178-181 ◽

Cited By ~ 14

Author(s):

F I Ojini ◽

M A Danesi

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Teaching Hospital ◽

Case Fatality Rate ◽

Case Fatality ◽

Developed Countries ◽

University Teaching ◽

Age Group ◽

Fatality Rate ◽

Medical Wards

Records of 349 tetanus patients, aged 10 years and above, admitted to the Lagos University Teaching Hospital, Nigeria, between 1990 and 1999 were reviewed. The male:female ratio was 1.98:1, and the ages were between 10 and 88 years, with a mean age of 29.8 years. The overall case fatality rate (CFR) of tetanus was 36.96% (33.19% for men and 44.44% for women). The CFR is similar to that previously reported in the hospital, but higher than that reported from Europe and North America. The lowest CFR was in the 10-19-year age group, and there was a trend towards increasing CFR with increasing age. Tetanus patients in the intensive care unit (ICU) had a significantly higher CFR than those in the medical wards. Unlike in developed countries, where management of tetanus in ICU has resulted in a decrease in CFR, the CFR of tetanus at the Lagos University Teaching Hospital has not significantly reduced over the years.

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Morbidity, mortality and spatial distribution of meningococcal disease, 1974–2007

Epidemiology and Infection ◽

10.1017/s0950268809002428 ◽

2009 ◽

Vol 137 (11) ◽

pp. 1631-1640 ◽

Cited By ~ 17

Author(s):

M. HOWITZ ◽

L. LAMBERTSEN ◽

J. B. SIMONSEN ◽

J. J. CHRISTENSEN ◽

K. MØLBAK

Keyword(s):

Risk Factors ◽

Spatial Distribution ◽

Meningococcal Disease ◽

Case Fatality Rate ◽

Case Fatality ◽

Incidence Rates ◽

Fatality Rate ◽

Risk Of Death ◽

Increased Risk ◽

High Age

SUMMARYTo identify determinants for mortality and sequelae and to analyse the spatial distribution of meningococcal disease, we linked four national Danish registries. In the period 1974–2007, 5924 cases of meningococcal disease were registered. Our analysis confirms known risk factors for a fatal meningococcal disease outcome, i.e. septicaemia and high age (>50 years). The overall case-fatality rate was 7·6%; two phenotypes were found to be associated with increased risk of death; C:2a:P1.2,5 and B:15:P1.7,16. B:15:P1.7,16 was also associated with excess risk of perceptive hearing loss. The incidence rates of meningococcal disease were comparable between densely and less densely populated areas, but patients living further from a hospital were at significantly higher risk of dying from the infection. To improve control of meningococcal disease, it is important to understand the epidemiology and pathogenicity of virulent ‘successful clones’, such as C:2a:P1.2,5 and B:15:P1.7,16, and, eventually, to develop vaccines against serogroup B.

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Risk factors for mortality in patients over 70 years old with COVID-19 in Wuhan at the early break: retrospective case series

BMC Infectious Diseases ◽

10.1186/s12879-021-06450-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xu Zhu ◽

Wenzheng Yuan ◽

Junwei Shao ◽

Kesheng Huang ◽

Qingbo Wang ◽

...

Keyword(s):

Risk Factors ◽

Elderly Patients ◽

Blood Urea Nitrogen ◽

Clinical Data ◽

Case Fatality Rate ◽

Case Fatality ◽

Fatality Rate ◽

Urea Nitrogen ◽

High Case Fatality Rate ◽

Risk Of Death

Abstract Background Elderly patients with COVID-19 were shown to have a high case-fatality rate. We aimed to explore the risk factors associated with death in patients over 70 years old (yr). Methods In this retrospective study, we enrolled consecutively hospitalized patients over 70 yr with COVID-19 between January 20 and February 15, 2020 in Renmin Hospital of Wuhan University. Epidemiological, demographic, and clinical data were collected. Clinical subtypes, including mild, moderate, severe, and critical types, were used to evaluate the severity of disease. Patients were classified into two groups: survivor and non-survivor groups. Clinical data were compared between the two groups. Univariable and multivariable Cox regression methods were used to explore the risk factors. Results A total of 147 patients were enrolled. The case-fatality rate was 28.6%. Multivariable Cox proportional hazard regression showed that clinical subtypes, including the severe type (HR = 2.983, 95% CI: 1.231–7.226, P = 0.016) and the critical type (HR = 3.267, 95%CI: 1.009–10.576, P = 0.048), were associated with increasing risk of death when compared with the general type. Blood urea nitrogen greater than 9.5 mmol/L (HR = 2.805, 95% CI: 1.141–6.892, P = 0.025) on admission was an independent risk factor for death among laboratory findings. Conclusion The patients over 70 yr with COVID-19 had a high case-fatality rate. The risk factors, including clinical subtypes and blood urea nitrogen greater than 9.5 mmol/L, could help physicians to identify elderly patients with poor clinical outcomes at an early stage.

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Age-specific infection and death rates for human A(H5N1) avian influenza in Egypt

Eurosurveillance ◽

10.2807/ese.14.18.19198-en ◽

2009 ◽

Vol 14 (18) ◽

Cited By ~ 19

Author(s):

J P Dudley

Keyword(s):

Influenza A ◽

Case Fatality Rate ◽

Case Fatality ◽

Age Group ◽

Fatality Rate ◽

Death Rates ◽

H5n1 Avian Influenza ◽

Human H5n1 ◽

Sex Biases ◽

Age And Sex

The age-specific infection and death profiles among confirmed human cases of influenza A(H5N1) infection in Egypt differ markedly from those recorded in other countries. The case fatality rate among human H5N1 cases in Egypt is 34%, versus an average of 66% in other countries. In Egypt, children younger than 10 years comprise 48% of reported cases, nearly twice the global average of approximately 25%, and no H5N1 fatalities have been confirmed among individuals in this age group as of 23 April 2009. Females outnumber males among confirmed H5N1 cases by a factor of nearly 2:1, and 90% of reported fatalities in Egypt have been females. The evident age and sex biases in morbidity and mortality among H5N1 cases in Egypt are phenomena that warrant further investigation and analysis.

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COVID-19, Australia: Epidemiology Report 20. Fortnightly reporting period ending 5 July 2020

Communicable Diseases Intelligence ◽

10.33321/cdi.2020.44.63 ◽

2020 ◽

Vol 44 ◽

Cited By ~ 3

Author(s):

Keyword(s):

Intensive Care ◽

Vulnerable Populations ◽

Small Proportion ◽

Surveillance System ◽

Case Fatality Rate ◽

Severe Disease ◽

Case Fatality ◽

Fatality Rate ◽

Notifiable Diseases ◽

The Past

Notified cases of COVID-19 and associated deaths reported to the National Notifiable Diseases Surveillance System (NNDSS) to 5 July 2020. Cumulative confirmed cases in Australia notified up to 5 July 2020: notifications = 8,566, deaths = 106. Over the past fortnightly reporting period (22 June to 5 July), 897 cases were notified, with 4 deaths. The national incidence of COVID-19 remained low, with very few cases reported by most jurisdictions in this reporting period. The majority of the current cases reported over this fortnight are from Victoria, with an increasing number and proportion of cases reported as being locally acquired. Total case numbers have increased with an average of 54 cases reported on any one day, more than twice the average number reported in the previous reporting period. The number and proportion of deaths associated with COVID-19 remains low and it appears that vulnerable populations have not been disproportionately affected by COVID-19 overall. Testing rates continue to be high across all jurisdictions, with the nationwide positivity rate remaining very low at less than 0.3%. In this reporting period, the number of cases reported nationally has increased from 214 (8 June to 21 June) to 897 (22 June to 5 July). Of the cases notified in this reporting period, 87% (781 cases) were notified from Victoria and 89% of these cases were acquired locally. Of the remaining 116 cases reported from other jurisdictions only 6% were locally acquired. The increase in Victoria is attributable to multiple epidemiologically linked outbreaks across a range of settings and locations. A small proportion of cases have experienced severe disease, requiring hospitalisation or intensive care, with some fatalities. The crude case fatality rate amongst Australian cases is 1.2%. People who are older and have one or more comorbidities are more likely to experience severe disease.

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