Age-Dependent Serotype-Associated Case-Fatality Rate in Invasive Pneumococcal Disease in the Autonomous Community of Madrid between 2007 and 2020

The aim of this study was to investigate the serotype-associated fatality rate in cases of invasive pneumococcal disease (IPD) in the Spanish region of Madrid between 2007 and 2020. Serotyping was performed by Pneumotest Latex and the Quellung reaction using commercial antisera. Case-fatality rate was estimated as the ratio between the number of deaths at hospital discharge and the number of cases attributable to each serotype. To evaluate the association measures, the odds ratios with a 95% confidence interval were calculated. Twenty five pneumococcal serotypes were associated to mortality and comprised 87.8% of the total number of isolates characterized. Serotypes 8, 3, 19A, 1, 7F, 22F, 12F, and 11A were the most prevalent (≥3% each). Serotypes 31, 11A, and 19F were significantly associated to high case-fatality rates (>20% each). The lower significantly associated case-fatality rate (<10% each) was found in serotypes 5, 1, 12B, 7F, 12F, 8, 33, and 10A. The serotypes with higher mortality levels (≥0.04 per 100,000 population) were 11A (fatality 24.0%), 3 (fatality 18.7%), 19A (fatality 12.5%), and 8 (fatality 7.2%). Serotype 3 was worrisome because it is associated with important fatality levels combined with very high incidence and mortality rates. Serotype 11A also showed a high fatality with marked incidence and mortality levels. Some few frequent serotypes as 31, 19F, and 15A despite its high fatality had low levels of mortality. By contrast other serotypes as 8 showing low fatality had high mortality ranges because it shows a wide extended distribution. Finally, common serotypes, such as 1 and 5, presented small mortality length, due to their low case-fatality rates.

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Decreasing case fatality rate following invasive pneumococcal disease, North East England, 2006–2016

Epidemiology and Infection ◽

10.1017/s0950268819000657 ◽

2019 ◽

Vol 147 ◽

Cited By ~ 2

Author(s):

C. Houseman ◽

K. E. Chapman ◽

P. Manley ◽

R. Gorton ◽

D. Wilson ◽

...

Keyword(s):

Invasive Pneumococcal Disease ◽

Case Fatality Rate ◽

Pneumococcal Disease ◽

Demographic Data ◽

Case Fatality ◽

Risk Groups ◽

Significant Decline ◽

Fatality Rate ◽

North East ◽

Increased Risk

AbstractDeclining mortality following invasive pneumococcal disease (IPD) has been observed concurrent with a reduced incidence due to effective pneumococcal conjugate vaccines. However, with IPD now increasing due to serotype replacement, we undertook a statistical analysis to estimate the trend in all-cause 30-day case fatality rate (CFR) in the North East of England (NEE) following IPD. Clinical, microbiological and demographic data were obtained for all laboratory-confirmed IPD cases (April 2006–March 2016) and the adjusted association between CFR and epidemiological year estimated using logistic regression. Of the 2510 episodes of IPD included in the analysis, 486 died within 30 days of IPD (CFR 19%). Increasing age, male sex, a diagnosis of septicaemia, being in ⩾1 clinical risk groups, alcohol abuse and individual serotypes were independently associated with increased CFR. A significant decline in CFR over time was observed following adjustment for these significant predictors (adjusted odds ratio 0.93, 95% confidence interval 0.89–0.98; P = 0.003). A small but significant decline in 30-day all-cause CFR following IPD has been observed in the NEE. Nonetheless, certain population groups remain at increased risk of dying following IPD. Despite the introduction of effective vaccines, further strategies to reduce the ongoing burden of mortality from IPD are needed.

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Invasive pneumococcal disease in hospitalised children from Lima, Peru before and after introduction of the 7-valent conjugated vaccine

Epidemiology and Infection ◽

10.1017/s0950268819000037 ◽

2019 ◽

Vol 147 ◽

Cited By ~ 1

Author(s):

A. Luna-Muschi ◽

F. Castillo-Tokumori ◽

M. P. Deza ◽

E. H. Mercado ◽

M. Egoavil ◽

...

Keyword(s):

Invasive Pneumococcal Disease ◽

Case Fatality Rate ◽

Pneumococcal Disease ◽

Case Fatality ◽

Fatality Rate ◽

Erythromycin Resistance ◽

National Immunisation ◽

National Immunisation Program ◽

Before And After ◽

Sterile Site

AbstractThe objective of this study was to determine the serotype distribution and antibiotic resistance of invasive pneumococcal disease (IPD) strains in children from Lima, Peru, before and after the introduction of the 7-valent pneumococcal conjugate vaccine (PCV7), which was introduced in the national immunisation program on 2009. We conducted a prospective, multicentre, passive surveillance IPD study during 2006–2008 and 2009–2011, before and right after the introduction of PCV7 in Peru. The study was performed in 11 hospitals and five private laboratories in Lima, Peru, in patients <18 years old, with sterile site cultures yielding Streptococcus pneumoniae. In total 159 S. pneumoniae isolates were recovered. There was a decrease in the incidence of IPD in children <2 years old after the introduction of PCV7 (18.4/100 000 vs. 5.1/100 000, P = 0.004). Meningitis cases decreased significantly in the second period (P = 0.036) as well as the overall case fatality rate (P = 0.025), including a decreased case fatality rate of pneumonia (16.3% to 0%, P = 0.04). PCV7 serotypes showed a downward trend. Vaccine-preventable serotypes caused 78.9% of IPD cases, mainly 14, 6B, 5, 19F and 23F. A non-significant increase in erythromycin resistance was reported. Our findings suggest that the introduction of PCV7 led to a significant decrease of IPD in children under 2 years old and in the overall case fatality rate.

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1309. Incidence and Epidemiology of Invasive Pneumococcal Disease due to Serotype 3 in South-Central Ontario

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.1501 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S743-S743

Author(s):

Allison McGeer ◽

Agron Plevneshi ◽

Kazi Hassan ◽

Wayne Gold ◽

Larissa Matukas ◽

...

Keyword(s):

Older Adults ◽

Invasive Pneumococcal Disease ◽

Case Fatality Rate ◽

Pneumococcal Disease ◽

Case Fatality ◽

Population Based ◽

Fatality Rate ◽

South Central ◽

Study Laboratory ◽

Over Time

Abstract Background In our population, the most common serotype (ST) of S. pneumoniae causing invasive pneumococcal disease (IPD) is now ST 3. We undertook an analysis of population based surveillance for IPD to examine the incidence and epidemiology of ST 3 disease over the last 25 years. Methods The Toronto Invasive Bacterial Diseases Network has performed population-based surveillance for IPD in Toronto/Peel region (pop’n 4.5M) since 1995. All sterile site isolates of S. pneumoniae are reported to a central study laboratory, isolates are serotyped, and clinical and vaccination data are collected via patient and physician interview and chart review. Population data are obtained from Statistics Canada. Results From 1995-2020, 11032 episodes of IPD occurred; 10015 had STs available, and 10484 clinical data. Overall, ST 3 comprised 9.2% of cases (N=931). Compared to other patients with IPD, those with ST 3 IPD were older (median age 65 vs. 58.5, P< .001), more likely to have underlying lung (22.7% v 16.0%, P< .0001) and cardiac (21.7 v 18.4, P=.02) disease and less likely to be immunocompromised (IC) (23.1% v 29.0% P< .0001). ST3 episodes were more likely to be pneumonia (81% v 65%), less likely to be bacteremia without focus (7.6% v 18.9%), and more likely to require ICU admission (42.3% v 25.1%) and to die (27.1% v 16.6%). In multivariable analysis, patients with ST 3 disease remained more likely to die (OR 1.65; 95%CI1.3-2.0). Over time, the proportion of patients with ST 3 IPD who were nursing home (NH) residents (18/171 in 1995-2000 vs. 4/215 in 2016-2020, P=.0002), and who were IC (46/169 in 1995-2000 vs 39/204 in 2016-2020, P=.007) decreased significantly; in IPD due to other STs, the proportion who were NH residents declined, but the proportion IC increased significantly. The case fatality rate (CFR) declined significantly in IPD due to ST3 but not other STs (Figure 1). Changes in incidence are shown in Figure 2. Figure 2: Incidence of serotype 3 IPD over time, Toronto/Peel, 1995-2020 The incidence of ST3 IPD in children and adults under 65 did not change significantly from 1995/96 to 2019/20. In older adults, the annual incidence of disease declined from 4.98 per 100,000 per year in 1995-2000 to 3.53 per 100,000 per year in 2001-2010 (IRR 0.71, 95%CI 0.56-0.90), then to 2.23 per 100,000 per year in 2011-2020 (IRR compared to 2001-2010 0.63, 95%CI 0.50-0.79) FIgure 2: Case fatality rate of IPD due to serotype 3 and other serotypes over time, 1995-2020, Toronto-Peel The case fatality rate of IPD due to ST3 declined from 37.6% (56/149) in 1995-2000 to 50/235 (21.3%) in 2015-2020 (P<.0001). The CFR in other serotypes did not change. Conclusion The epidemiology of IPD due to ST3 has changed significantly over time and the CFR has declined. The incidence of ST3 disease in children and younger adults has not changed significantly, although the power to detect change is low in children. In older adults the incidence of ST3 disease declined significantly after PPV23 introduction in 1995/6 and again after PCV13 introduction for children. Disclosures All Authors: No reported disclosures

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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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“Association between air pollution in Lima and the high incidence of COVID-19: findings from a post hoc analysis.”

10.21203/rs.3.rs-39404/v2 ◽

2021 ◽

Author(s):

Bertha V. Vasquez-Apestegui ◽

Enrique Parras-Garrido ◽

Vilma Tapia ◽

Valeria M. Paz-Aparicio ◽

Jhojan P. Rojas ◽

...

Keyword(s):

Air Pollution ◽

Case Fatality Rate ◽

Virus Disease ◽

Case Fatality ◽

Fatality Rate ◽

Food Markets ◽

Early Implementation ◽

High Incidence ◽

Post Hoc

Abstract Background Corona virus disease (COVID-19) originated in China in December 2019. Thereafter, a global logarithmic expansion of the cases has occurred. Some countries have a higher rate of infections despite of early implementation of quarantine. Air pollution could be related to the high susceptibility to SARS-CoV-2 and the associated case-fatality rates (deaths/cases*100). Lima, Peru has the second highest incidence of COVID-19 in Latin America, and it is also one of the cities with highest levels of air pollution in the Region. Methods This study investigated the association of the levels of PM2.5 exposure in the previous years (2010–2016) in 24 districts of Lima with the positive-cases, deaths and case-fatality rates of COVID-19. Multiple Linear regression was used to evaluate this association controlled by age, sex, population density and number of food markets per district. The study period was from March 6 to June 12, 2020. Results There were in Lima 128,700 SARS-CoV-2 positive cases, and 2,382 deaths due to COVID-19. The case-fatality rate was 1.93%. Previous exposure to PM2.5 (years 2010—2016) was associated with number of Covid-19 positive-cases (β = 0.07; 95% CI: 0.034–0.107) and deaths (β = 0.0014; 95% CI: 0.0006–0.0.0023), but not with case-fatality rate. Conclusions the higher rates of COVID-19 in Metropolitan Lima is attributable, among others, to the increased PM2.5 exposure in the previous years after adjusting for age, sex and number of food markets. Reduction of air pollution since a long-term perspective, and social distancing are needed to prevent spreads of virus outbreak.

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Association Between Air Pollution in Lima and the High Incidence of COVID-19: Findings from a Post Hoc Analysis

10.21203/rs.3.rs-39404/v1 ◽

2020 ◽

Cited By ~ 4

Author(s):

Vanessa Vasquez-Apestegui ◽

Enrique Parras-Garrido ◽

Vilma Tapia ◽

Valeria M. Paz-Aparicio ◽

Jhojan P. Rojas ◽

...

Keyword(s):

Air Pollution ◽

Case Fatality Rate ◽

Virus Disease ◽

National Level ◽

Case Fatality ◽

Fatality Rate ◽

Food Markets ◽

Early Implementation ◽

Incidence And Mortality ◽

Post Hoc

Abstract Background Corona virus disease (COVID-19) originated in China in December 2019. Thereafter, a global logarithmic expansion of the cases has occurred. Some countries have a higher rate of infections despite of early implementation of quarantine. Air pollution could be related to the high susceptibility to SARS-CoV-2 and the associated case-fatality rates (deaths/cases*100). Lima, Peru has the second highest incidence of COVID-19 in Latin America and it is also one of the cities with highest levels of air pollution in the Region. Methods This study investigated the association of the levels of PM2.5 exposure in the previous years (2010–2016) in 24 districts of Lima with the cases, deaths and case-fatality rates of COVID-19. Results Until June 12, 2020, there were 6,308 deaths and 220,749 SARS-CoV-2 positive cases in Peru. In Lima, the total number of COVID-19 deaths in all metropolitan areas was 2,382. The case-fatality rate at the national level was 2.58% and 1.93% in Lima. Higher PM2.5 levels are associated with higher number of cases and deaths of COVID-19. The case-fatality rate (Deaths/cases*100) did not increase with the increase in PM2.5 levels. A higher number of food markets was associated with higher incidence and mortality of COVID-19 (p < 0.01 for both); these associations persisted when cases (r = 0.49; p < 0.01) and deaths (r = 0.58; p < 0.01) were adjusted by the population density. The association of PM2.5 with cases of COVID-19 was maintained after controlling analysis by age, sex and number of food markers. Conclusions the higher rates of COVID-19 in Metropolitan Lima is attributable, among others, to the increased PM2.5 exposure in the previous years after adjusting for age, sex and number of food markets. Reduction of air pollution since a long term perspective, and social distancing are needed to prevent spreads of virus outbreak.

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Protective role of intravesical BCG in COVID-19 severity

BMC Urology ◽

10.1186/s12894-021-00823-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Héctor Gallegos ◽

Pablo A. Rojas ◽

Francisca Sepúlveda ◽

Álvaro Zúñiga ◽

Ignacio F. San Francisco

Keyword(s):

Cumulative Incidence ◽

Case Fatality Rate ◽

Case Fatality ◽

National Registry ◽

Categorical Variables ◽

Control Group ◽

Fatality Rate ◽

Incidence And Mortality ◽

Intravesical Bcg

Abstract Objectives To establish the role of BCG instillations in the incidence and mortality of COVID-19. Patients and methods NMIBC patients in instillations with BCG (induction or maintenance) during 2019/2020 were included, establishing a COVID-19 group (with a diagnosis according to the national registry) and a control group (NO-COVID). The cumulative incidence (cases/total patients) and the case fatality rate (deaths/cases) were established, and compared with the national statistics for the same age group. T-test was used for continuous variables and Fisher's exact test for categorical variables. Results 175 patients were included. Eleven patients presented CIS (11/175, 6.3%), 84/175 (48.0%) Ta and 68/175 (38.9%) T1. Average number of instillations = 13.25 ± 7.4. One hundred sixty-seven patients (95.4%) had complete induction. Forty-three patients (cumulative incidence 24.6%) were diagnosed with COVID-19. There is no difference between COVID-19 and NO-COVID group in age, gender or proportion of maintenance completed. COVID-19 group fatality rate = 1/43 (2.3%). Accumulated Chilean incidence 70–79 years = 6.3%. Chilean fatality rate 70–79 years = 14%. Conclusions According to our results, patients with NMIBC submitted to instillations with BCG have a lower case-fatality rate than the national registry of patients between 70 and 79 years (2.3% vs. 14%, respectively). Intravesical BCG could decrease the mortality due to COVID-19, so instillation schemes should not be suspended in a pandemic.

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Sociodemographic and clinical determinants of in-facility case fatality rate for 938 Ebola patients treated in Sierra Leone

10.21203/rs.2.10746/v1 ◽

2019 ◽

Author(s):

Jia Bainga Kangbai ◽

Christian Heumann ◽

Michael Hoelscher ◽

Foday Sahr ◽

Guenter Froeschl

Keyword(s):

Sierra Leone ◽

Muscle Pain ◽

Case Fatality Rate ◽

Case Fatality ◽

Police Training ◽

Small Sample ◽

Fatality Rate ◽

Conjunctival Injection ◽

Incidence And Mortality ◽

Time Of Admission

Abstract Background The 2013 – 2016 West Africa Ebola Virus Disease (EVD) outbreak recorded the highest incidence and mortality since the discovery of the virus in Zaire in 1976. Studies relating to previous outbreaks usually involved small sample sizes. In this study we are set to identify those sociodemographic and clinical features that predict in-facility mortality among EVD patients using a large sample size. Methods We analysed the anonymized medical records of 938 laboratory-confirmed EVD patients 15 years old and above that received treatment at the 34 Military Hospital and the Police Training School EVD Treatment Centers in Sierra Leone in the period June 2014 to April 2015. We used both univariable and multivariable logistic regression to determine the predictors for in-facility mortality of these patients based on their sociodemographic and clinical characteristics. Results The median age of the EVD cases was 33 years (interquartile range = 25 to 40 years). The majority of the EVD cases were male (59.0%) and had secondary level education (79.3%). A low overall in-facility case fatality rate of 26.4% was shown. The associations between case fatality rates and EVD patients who reported fever, abdominal pain, cough, diarrhoea, vomiting, fatigue, haemorrhage, dysphagia, conjunctival injection, dyspnoea, and skin rash at the time of admission were statistically significant (p < 0.05). Our preferred model with age group of EVD patients and the presence of the symptoms diarrhoea, vomiting, fatigue, dysphagia, conjunctival injection, dyspnoea and muscle pain produced a receiver operating characteristic (ROC) curve with an AUC (area under the curve) value of 0.94. Conclusions The age of EVD patients, as well those patients who reported vomiting, diarrhoea, fatigue, dysphagia, conjunctival injection, dyspnoea and muscle pain have increased odds of dying during treatment and hence will require prompt and intensive treatment at the time of admission. We argue that the high proportion of individuals with higher educational levels may have been a critical determinant for the low case fatality rate.

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Mortality in Digestive Cancers, 2012: International Data and Data from Romania

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld.2014.1121.244.rom ◽

2015 ◽

Vol 24 (4) ◽

pp. 507-514 ◽

Cited By ~ 1

Author(s):

Simona Valean ◽

Monica Acalovschi ◽

Mircea Diculescu ◽

Mircea Manuc ◽

Adrian Goldis ◽

...

Keyword(s):

Colorectal Cancer ◽

Human Development ◽

Human Development Index ◽

Case Fatality Rate ◽

Case Fatality ◽

Fatality Rate ◽

Development Index ◽

Incidence And Mortality ◽

Digestive Cancers ◽

The Difference

We aimed to compare the difference in case fatality rate between more developed and very high Human Development Index (HDI) regions, less developed and low HDI regions, and Romania. The incidence and mortality rates for digestive cancers were obtained from the IARC/WHO 2012 database. World mean mortality-to-incidence ratios registered the highest values in pancreatic cancer (0.97/0.94), and liver cancer (0.93/0.96) in males/females, respectively. The lowest values were recorded in colorectal cancer (0.48 in both sexes). Mortality-to-incidence ratios were generally higher in less developed areas, low HDI populations, and in Romania. The difference in case fatality rate between different areas showed higher variations for colorectal, gastric and gallbladder cancers, and smaller variations for esophageal, liver, and pancreatic cancers. In summary, mortality-to-incidence ratios of digestive cancers were high in 2012; higher values were registered in less developed and low HDI regions, and in Romania. Mortality-to-incidence ratios were similar in both sexes, even though the incidence was generally higher in men. Digestive cancer mortality variation suggests the necessity of finding better strategies for prevention, early diagnosis and treatment of digestive cancers. Abbreviations: ASRWs: age-standardized rate (World Standard Population) per 100,000 population; CRC: colorectal cancer; GC: gastric cancer; HDI: Human Development Index; HCC: hepatocellular carcinoma; IARC: International

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Association between air pollution in Lima and the high incidence of COVID-19: findings from a post hoc analysis

BMC Public Health ◽

10.1186/s12889-021-11232-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Bertha V. Vasquez-Apestegui ◽

Enrique Parras-Garrido ◽

Vilma Tapia ◽

Valeria M. Paz-Aparicio ◽

Jhojan P. Rojas ◽

...

Keyword(s):

Air Pollution ◽

Case Fatality Rate ◽

Case Fatality ◽

Fatality Rate ◽

Food Markets ◽

Republic Of China ◽

Early Implementation ◽

High Incidence ◽

Post Hoc

Abstract Background Coronavirus disease 2019 (COVID-19) originated in the People’s Republic of China in December 2019. Thereafter, a global logarithmic expansion of cases occurred. Some countries have a higher rate of infections despite the early implementation of quarantine. Air pollution might be related to high susceptibility to the virus and associated case fatality rates (deaths/cases*100). Lima, Peru, has the second highest incidence of COVID-19 in Latin America and also has one the highest levels of air pollution in the region. Methods This study investigated the association of levels of PM2.5 exposure in previous years (2010–2016) in 24 districts of Lima with cases, deaths and case fatality rates for COVID-19. Multiple linear regression was used to evaluate this association controlled by age, sex, population density and number of food markets per district. The study period was from March 6 to June 12, 2020. Results There were 128,700 cases in Lima and 2382 deaths due to COVID-19. The case fatality rate was 1.93%. Previous exposure to PM2.5 (2010—2016) was associated with the number of COVID-19- cases (β = 0.07; 95% CI: 0.034–0.107) and deaths (β = 0.0014; 95% CI: 0.0006–0.0.0023) but not with the case fatality rate. Conclusions After adjusting for age, sex and number of food markets, the higher rates of COVID-19 in Metropolitan Lima are attributable to the increased PM2.5 exposure in the previous years, among other reasons. Reduction in air pollution from a long-term perspective and social distancing are needed to prevent the spread of virus outbreaks.

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