scholarly journals Delay-Adjusted Age-Specific COVID-19 Case Fatality Rates in a High Testing Setting: South Korea, February 2020 to February 2021

2021 ◽  
Vol 18 (10) ◽  
pp. 5053
Author(s):  
Eunha Shim
Keyword(s):  
Older Adults ◽  
South Korea ◽  
Incidence Rate ◽  
Disease Onset ◽  
Case Fatality ◽  
Credible Interval ◽  
High Death Rate ◽  
High Death ◽  
Case Fatality Risk ◽  
Survival Interval

In South Korea, a country with a high coronavirus disease 19 (COVID-19) testing rate, a total of 87,324 COVID-19 cases, including 1562 deaths, have been recorded as of 23 February 2021. This study assessed the delay-adjusted COVID-19 case fatality risk (CFR), including data from the second and third waves. A statistical method was applied to the data from 20 February 2021 through 23 February 2021 to minimize bias in the crude CFR, accounting for the survival interval as the lag time between disease onset and death. The resulting overall delay-adjusted CFR was 1.97% (95% credible interval: 1.94–2.00%). The delay-adjusted CFR was highest among adults aged ≥80 years and 70–79 years (22.88% and 7.09%, respectively). The cumulative incidence rate was highest among individuals aged ≥80 years and 60–69 years. The cumulative mortality rate was highest among individuals aged ≥80 years and 70–79 years (47 and 12 per million, respectively). In South Korea, older adults are being disproportionately affected by COVID-19 with a high death rate, although the incidence rate among younger individuals is relatively high. Interventions to prevent COVID-19 should target older adults to minimize the number of deaths.

scholarly journals COVID-19 in South Korea: epidemiological and spatiotemporal patterns of the spread and the role of aggressive diagnostic tests in the early phase

2020 ◽  
Vol 49 (4) ◽  
pp. 1106-1116 ◽  
Author(s):  
Whanhee Lee ◽  
Seung-Sik Hwang ◽  
Insung Song ◽  
Chaerin Park ◽  
Honghyok Kim ◽  
...  
Keyword(s):  
South Korea ◽  
Diagnostic Testing ◽  
Early Period ◽  
Case Fatality ◽  
Credible Interval ◽  
Mitigation Strategies ◽  
Logistic Growth ◽  
Start Date ◽  
Time To Peak ◽  
Novel Coronavirus

Abstract Background South Korea experienced the novel coronavirus disease (COVID-19) outbreak in the early period; thus data from this country could provide significant implications for global mitigation strategies. This study reports how COVID-19 has spread in South Korea and examines the effects of rapid widespread diagnostic testing on the spread of the disease in the early epidemic phase. Methods We collected daily data on the number of confirmed cases, tests and deaths due to COVID-19 from 20 January to 13 April 2020. We estimated the spread pattern with a logistic growth model, calculated the daily reproduction number (Rt) and examined the fatality pattern of COVID-19. Results From the start date of the epidemic in Korea (18 February 2020), the time to peak and plateau were 15.2 and 25 days, respectively. The initial Rt was 3.9 [95% credible interval (CI) 3.7 to 4.2] and declined to <1 after 2 weeks. The initial epidemic doubling time was 3.8 days (3.4 to 4.2 days). The aggressive testing in the early days of the epidemic was associated with reduction in transmission speed of COVID-19. In addition, as of 13 April, the case fatality rate of COVID-19 in Korea was 2.1%, suggesting a positive effect of the targeted treatment policy for severe patients and medical resources. Conclusions Our findings provide important information for establishing and revising action plans based on testing strategies and severe patient care systems, needed to address the unprecedented pandemic.

scholarly journals Estimating the Risk of COVID-19 Death during the Course of the Outbreak in Korea, February–May 2020

2020 ◽  
Vol 9 (6) ◽  
pp. 1641 ◽  
Author(s):  
Eunha Shim ◽  
Kenji Mizumoto ◽  
Wongyeong Choi ◽  
Gerardo Chowell
Keyword(s):  
Time Delay ◽  
Early Stage ◽  
Case Fatality ◽  
Credible Interval ◽  
Adjusted Risk ◽  
Risk Of Death ◽  
Early Implementation ◽  
Daily Series ◽  
Case Fatality Risk ◽  
Reporting Delay

Background: In Korea, a total of 10,840 confirmed cases of COVID-19 including 256 deaths have been recorded as of May 9, 2020. The time-delay adjusted case fatality risk (CFR) of COVID-19 in Korea is yet to be estimated. Methods: We obtained the daily series of confirmed cases and deaths in Korea reported prior to May 9, 2020. Using statistical methods, we estimated the time-delay adjusted risk for death from COVID-19 in Daegu, Gyeongsangbuk-do, other regions in Korea, as well as the entire country. Results: Our model-based crude CFR fitted the observed data well throughout the course of the epidemic except for the very early stage in Gyeongsangbuk-do; this was partially due to the reporting delay. Our estimates of the risk of death in Gyeongsangbuk-do reached 25.9% (95% Credible Interval (CrI): 19.6%–33.6%), 20.8% (95% CrI: 18.1%–24.0%) in Daegu, and 1.7% (95% CrI: 1.1%–2.5%) in other regions, whereas the national estimate was 10.2% (95% CrI: 9.0%–11.5%). Conclusions: The latest estimates of CFR of COVID-19 in Korea are considerably high, even with the early implementation of public health interventions including widespread testing, social distancing, and delayed school openings. Geographic differences in the CFR are likely influenced by clusters tied to hospitals and nursing homes.

scholarly journals Estimation of undetected COVID-19 infections in India

2020 ◽  
Author(s):  
Siuli Mukhopadhyay ◽  
Debraj Chakraborty
Keyword(s):  
Death Rate ◽  
Case Fatality Rate ◽  
Indian Population ◽  
Case Fatality ◽  
Infection Model ◽  
Fatality Rate ◽  
Single Digit ◽  
High Death Rate ◽  
True Number ◽  
High Death

Background and ObjectivesWhile the number of detected COVID-19 infections are widely available, an understanding of the extent of undetected COVID-19 cases is urgently needed for an effective tackling of the pandemic and as a guide to lifting the lockdown. The aim of this work is to estimate and predict the true number of COVID-19 (detected and undetected) infections in India for short to medium forecast horizons. In particular, using publicly available COVID-19 infection data up to 28th April 2020, we forecast the true number of infections in India till the end of lockdown (3rd May) and five days beyond (8th May).MethodsThe high death rate observed in most COVID-19 hit countries is suspected to be a function of the undetected infections existing in the population. An estimate of the age weighted infection fatality rate (IFR) of the disease of 0.41%, specifically calculated by taking into account the age structure of Indian population, is already available in the literature. In addition, the recorded case fatality rate (CFR= 1%) of Kerala, the first state in India to successfully flatten the curve by consistently reporting single digit new infections from 12-20 April, is used as a second estimate of the IFR. These estimates are used to formulate a relationship between deaths recorded and the true number of infections and recoveries. The estimated undetected and detected cases time series based on these two IFR estimates are then used to fit a discrete time multivariate infection model to predict the total infections at the end of the formal lockdown period.ResultsOver three consecutive fortnight periods during the lockdown, it was noted that the rise in detected infections has decreased by 8.2 times. For an IFR of 0.41%, the rise in undetected infections decreased 2.5 times, while for the higher IFR value of 1%, undetected cases decreased by 2.4 times. The predicted number of total infections in India on 3rd May for both IFRs varied from 2.8 - 6.8 lakhs.Interpretation and ConclusionsThe behaviour of the undetected cases over time effectively illustrates the effects of lockdown and increased testing. From our estimates, it is found that the lockdown has brought down the undetected to detected cases ratio, and has consequently dampened the increase in the number of total cases. However, even though the rate of rise in total infections has fallen, the lifting of the lockdown should be done keeping in mind that 2.3 to 6.4 lakhs undetected cases will already exist in the population by 3rd May.

scholarly journals Finding the real COVID-19 case-fatality rates for SAARC countries

2020 ◽  
Author(s):  
Md. Rafil Tazir Shah ◽  
Tanvir Ahammed ◽  
Aniqua Anjum ◽  
Anisa Ahmed Chowdhury ◽  
Afroza Jannat Suchana
Keyword(s):  
Sri Lanka ◽  
South Asian ◽  
Case Fatality Rate ◽  
Regional Cooperation ◽  
Disease Onset ◽  
Case Fatality ◽  
Fatality Rate ◽  
Outcome Bias ◽  
Reporting Rates ◽  
Survival Interval

AbstractCrude case fatality rate (CFR) is the most accurate when the pandemic is over. Adjustments to the crude CFR measure can better explain the pandemic situation by improving the CFR estimation. However, no study has thoroughly investigated COVID-19 adjusted CFR of the South Asian Association for Regional Cooperation (SAARC) countries. In this study, we estimated both survival interval and underreporting adjusted CFR of COVID-19 for the SAARC countries and observed the CFR changes due to the imposition of fees on COVID-19 tests in Bangladesh. Using the daily records up to 9th October, we implemented a statistical method to remove both the bias in crude CFR, i.e., the delay between disease onset and outcome bias and due to asymptomatic or mild symptomatic cases, reporting rates lower than 50% (95% CI: 10%-50%) bias. According to our findings, Afghanistan had the highest CFR, followed by Pakistan, India, Bangladesh, Nepal, Maldives, and Sri Lanka. Our estimated crude CFR varied from 3.71% to 0.29%, survival interval adjusted CFR varied from 3.77% to 0.3% and further underreporting adjusted CFR varied from 1.1% to 0.08%. We have also found that crude CFR increased from 1.261% to 1.572% after imposing the COVID-19 test fees in Bangladesh. Therefore, the authorities of countries with higher CFR should be looking for strategic counsel from the countries with lower CFR to equip themselves with the necessary knowledge to combat the pandemic. Moreover, caution is needed to report the CFR.

scholarly journals Case fatality risk by age from COVID-19 in a high testing setting in Latin America: Chile, March-May, 2020

2020 ◽  
Author(s):  
Eduardo A. Undurraga ◽  
Gerardo Chowell ◽  
Kenji Mizumoto
Keyword(s):  
Latin America ◽  
Time Delay ◽  
Case Fatality Rate ◽  
Age Groups ◽  
Case Fatality ◽  
Epidemiological Data ◽  
Credible Interval ◽  
Fatality Rate ◽  
Demographic Groups ◽  
Case Fatality Risk

AbstractBackgroundEarly severity estimates of COVID-19 are critically needed to better assess the potential impact of the ongoing pandemic in different socio-demographic groups. Using real-time epidemiological data from Chile, the nation in Latin America with the highest testing rate for COVID-19, we derive delay-adjusted severity estimates by age group as of May 18th, 2020.MethodsWe employed statistical methods and daily series of age-stratified COVID-19 cases and deaths reported in Chile to estimate the delay-adjusted case fatality rate across six age groups.ResultsOur most recent estimates of the time-delay adjusted case fatality rate are 0.08% (95% Credible Interval CrI:0.04-0.13%) among persons aged 0-39, 0.61% (95%CrI:0.41-0.87%) for those aged 40-49, 1.06% (95%CrI:0.76-1.40%) for those aged 50-59, 3.79% (95%CrI:3.04-4.66%) for those aged 60-69, 12.22% (95%CrI:10.40-14.38%) for those aged 70-79, and 26.27% (95%CrI:22.95-2980%) for persons aged 80 and over. The overall time-delay adjusted case fatality rate is1.78% (95%CrI: 1.63-1.95%) across all age groups.ConclusionsSeverity estimates from COVID-19 in Chile indicate a disproportionate impact among seniors, especially among those aged ≥ 70 years. COVID-19 is imposing a high death toll in Latin America. Case fatality rates in Chile suggest the health system is not yet overwhelmed, but the epidemic is expanding fast.

Nationwide trends in the incidence of orbital lymphoma from 1999 to 2016 in South Korea

2020 ◽  
pp. bjophthalmol-2020-316796
Author(s):  
Su Kyung Jung ◽  
Jiwon Lim ◽  
Suk Woo Yang ◽  
Young-Joo Won
Keyword(s):  
South Korea ◽  
B Cell ◽  
Incidence Rate ◽  
Cell Lymphoma ◽  
Survival Rates ◽  
B Cell Lymphoma ◽  
Population Based ◽  
Incidence Rates ◽  
Annual Percent Change ◽  
Orbital Lymphoma

Background/AimsLymphomas are the most frequent neoplasm of the orbit. However, the epidemiology of orbital lymphomas is not well reported. This study aimed to provide a population-based report on the epidemiology of orbital lymphomas and measure the trends in the incidence of orbital lymphoma cancer in South Korea.MethodsNationwide cancer incidence data from 1999 to 2016 were obtained from the Korea Central Cancer Registry. Age-standardised incidence rates and annual percent changes were calculated according to sex and histological types. The analysis according to the Surveillance, Epidemiology, and End Results summary stage classifications was performed from 2006 to 2016. Survival rates were estimated for cases diagnosed from 1999 to 2016.ResultsA total of 630 patients (median age: 54 years) with orbital lymphoma in the orbital soft tissue were included in this study. The age-standardised incidence rates increased from 0.03 to 0.08 per 100 000 individuals between 1999 and 2016, with an annual percent change of 6.61%. The most common histopathological type of orbital lymphoma was extra marginal zone B cell lymphoma, accounting for 82.2% of all orbital lymphomas during 1999–2016, followed by diffuse large B cell lymphoma (9.2%). Five-year, 10-year and 15-year overall survival (OS) of orbital lymphoma was 90.8%, 83.8% and 75.8%, respectively. OS showed a significant decrease as age increased and no significant differences between men and women.ConclusionThe incidence rate of orbital lymphoma is very low in South Korea. However, the incidence rate has increased over the past years. Orbital lymphomas have a worse prognosis as age increases.

scholarly journals Infectious disease outbreaks in the African region: overview of events reported to the World Health Organization in 2018

2019 ◽  
Vol 147 ◽  
Author(s):  
F. Mboussou ◽  
P. Ndumbi ◽  
R. Ngom ◽  
Z. Kassamali ◽  
O. Ogundiran ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Disease Onset ◽  
Disease Outbreaks ◽  
Case Fatality ◽  
World Health ◽  
African Region ◽  
Regional Office ◽  
Member States ◽  
Infectious Disease Outbreaks ◽  
The World

Abstract The WHO African region is characterised by the largest infectious disease burden in the world. We conducted a retrospective descriptive analysis using records of all infectious disease outbreaks formally reported to the WHO in 2018 by Member States of the African region. We analysed the spatio-temporal distribution, the notification delay as well as the morbidity and mortality associated with these outbreaks. In 2018, 96 new disease outbreaks were reported across 36 of the 47 Member States. The most commonly reported disease outbreak was cholera which accounted for 20.8% (n = 20) of all events, followed by measles (n = 11, 11.5%) and Yellow fever (n = 7, 7.3%). About a quarter of the outbreaks (n = 23) were reported following signals detected through media monitoring conducted at the WHO regional office for Africa. The median delay between the disease onset and WHO notification was 16 days (range: 0–184). A total of 107 167 people were directly affected including 1221 deaths (mean case fatality ratio (CFR): 1.14% (95% confidence interval (CI) 1.07%–1.20%)). The highest CFR was observed for diseases targeted for eradication or elimination: 3.45% (95% CI 0.89%–10.45%). The African region remains prone to outbreaks of infectious diseases. It is therefore critical that Member States improve their capacities to rapidly detect, report and respond to public health events.

scholarly journals 1717. Relationship between Neighborhood Census-tract Level Poverty and Respiratory Syncytial Virus (RSV)-associated Hospitalizations in U.S. adults, 2015-2017

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S842-S843
Author(s):  
Jenna Holmen ◽  
Art Reingold ◽  
Erica Bye ◽  
Lindsey Kim ◽  
Evan J Anderson ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Census Tract ◽  
Case Fatality ◽  
Demographic Characteristics ◽  
Emerging Infections ◽  
Poverty Level ◽  
Catchment Areas ◽  
Syncytial Virus ◽  
Four Levels ◽  
The U.S

Abstract Background In the U.S., RSV is increasingly recognized as a cause of hospitalization for adults with respiratory illness. In adults > 50 years of age, it accounts for up to 12% of medically-attended acute respiratory illnesses and has a case fatality proportion of ~ 6–8%. Poverty can have important influences on health on both the individual level as well as the community level. Few studies have evaluated the relationship of RSV and poverty level, and no identified studies have evaluated this relationship among adults. We evaluated the incidence of RSV-associated hospitalizations in adults across multiple sites in the U.S. by census-tract (CT) level poverty. Methods Medical record data abstraction was conducted for all adults with a laboratory-confirmed RSV infection admitted to a hospital within the Centers for Disease Control and Prevention’s Emerging Infections Program catchment areas within California, Georgia, Maryland, Minnesota, New York, and Tennessee during the 2015–2017 RSV seasons (October-April). Patient addresses were geocoded to their corresponding CT. CTs were divided into four levels of poverty, as selected in prior publications, based on American Community Survey data of percentage of people living below the poverty level: 0–4.9%, 5–9.9%, 10-19.9%, and ³20%. Incidence rates were calculated by dividing the number of RSV cases in each CT poverty-level (numerator) by the number of adults living in each CT poverty level (denominator), as determined from the 2010 US census, and standardized for age. Results There were 1713 RSV case-patients with demographic characteristics (Table 1). The incidence of RSV-associated hospitalizations of adults increased with increasing CT level poverty (Figure 1 and Table 2). The risk of RSV-associated hospitalization was 2.58 times higher in census tracts with the highest (20%) versus the lowest (< 5%) percentages of individuals living below the poverty level. Table 1: Demographic characteristics of adults with an RSV-associated hospitalization, 2015-2017. Figure 1. Age-adjusted incidence rate of RSV-associated hospitalizations of adults by census-tract poverty level, 2015-2017 Table 2. Incidence rate ratios for RSV-associated hospitalizations of adults by census-tract poverty level, 2015-2017. Conclusion The incidence rate of RSV-associated hospitalization in adults appears to have a positive association with increasing CT level of poverty; however, this trend reached significance only among cases living in CTs with higher percentages of poverty (≥ 10%). Disclosures Evan J. Anderson, MD, Sanofi Pasteur (Scientific Research Study Investigator)

scholarly journals Mortality in Escherichia coli bloodstream infections: a multinational population-based cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Melissa C. MacKinnon ◽  
Scott A. McEwen ◽  
David L. Pearl ◽  
Outi Lyytikäinen ◽  
Gunnar Jacobsson ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Mortality Rate ◽  
Case Fatality ◽  
Population Based ◽  
Day Case ◽  
Fatality Risk ◽  
E Coli ◽  
Factors Associated ◽  
Case Fatality Risk ◽  
Age And Sex

Abstract Background Escherichia coli is the most common cause of bloodstream infections (BSIs) and mortality is an important aspect of burden of disease. Using a multinational population-based cohort of E. coli BSIs, our objectives were to evaluate 30-day case fatality risk and mortality rate, and determine factors associated with each. Methods During 2014–2018, we identified 30-day deaths from all incident E. coli BSIs from surveillance nationally in Finland, and regionally in Sweden (Skaraborg) and Canada (Calgary, Sherbrooke, western interior). We used a multivariable logistic regression model to estimate factors associated with 30-day case fatality risk. The explanatory variables considered for inclusion were year (2014–2018), region (five areas), age (< 70-years-old, ≥70-years-old), sex (female, male), third-generation cephalosporin (3GC) resistance (susceptible, resistant), and location of onset (community-onset, hospital-onset). The European Union 28-country 2018 population was used to directly age and sex standardize mortality rates. We used a multivariable Poisson model to estimate factors associated with mortality rate, and year, region, age and sex were considered for inclusion. Results From 38.7 million person-years of surveillance, we identified 2961 30-day deaths in 30,923 incident E. coli BSIs. The overall 30-day case fatality risk was 9.6% (2961/30923). Calgary, Skaraborg, and western interior had significantly increased odds of 30-day mortality compared to Finland. Hospital-onset and 3GC-resistant E. coli BSIs had significantly increased odds of mortality compared to community-onset and 3GC-susceptible. The significant association between age and odds of mortality varied with sex, and contrasts were used to interpret this interaction relationship. The overall standardized 30-day mortality rate was 8.5 deaths/100,000 person-years. Sherbrooke had a significantly lower 30-day mortality rate compared to Finland. Patients that were either ≥70-years-old or male both experienced significantly higher mortality rates than those < 70-years-old or female. Conclusions In our study populations, region, age, and sex were significantly associated with both 30-day case fatality risk and mortality rate. Additionally, 3GC resistance and location of onset were significantly associated with 30-day case fatality risk. Escherichia coli BSIs caused a considerable burden of disease from 30-day mortality. When analyzing population-based mortality data, it is important to explore mortality through two lenses, mortality rate and case fatality risk.

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