scholarly journals Risk factors affecting COVID-19 case fatality rate: A quantitative analysis of top 50 affected countries

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Poh Hui Goh ◽  
Wafiah Ilyani Mahari ◽  
Norhadyrah Izazie Ahad ◽  
Li Ling Chaw ◽  
Nurolaini Kifli ◽  
...  

Background: Latest clinical data on treatment on coronavirus disease 2019 (COVID-19) indicated that older patients and those with underlying history of smoking, hypertension or diabetes mellitus might have poorer prognosis of recovery from COVID-19. We aimed to examine the relationship of various prevailing population-based risk factors in comparison with mortality rate and case fatality rate (CFR) of COVID-19.Methods: Demography and epidemiology data were used, which have been identified as verified or postulated risk factors for mortality of adult inpatients with COVID-19. The number of confirmed cases and the number of deaths until April 16, 2020 for all affected countries were extracted from Johns Hopkins University COVID-19 websites. Datasets for indicators that are prevailing or postulated factors of COVID-19 mortality were extracted from the World Bank database. Out of 185 affected countries, the top 50 countries were selected for analysis in this study. The following seven variables were included in the analysis, based on data availability and completeness: 1) proportion of people aged 65 above, 2) proportion of male in the population, 3) smoking prevalence, and 4) number of hospital beds. Linear regression analysis was carried out to determine the relationship between CFR and the aforementioned risk factors.Results: United States shows approximately 0.20% of confirmed cases and it has about 4.85% of CFR. Luxembourg shows the highest percentage of confirmed cases of 0.55% but a low 2.05% of CFR, showing that a high percentage of confirmed cases does not necessarily lead to high CFR. There is a significant association between CFR, people aged 65 and above (β=4.70; p = 0.035).Conclusion: Countries with high proportion of older people above 65 years old have a significant risk of having high CFR from COVID-19. Nevertheless, gender differences and smoking prevalence failed to prove a significant relationship with COVID-19 mortality rate and CFR.

Author(s):  
Hui Poh Goh ◽  
Wafiah Ilyani Mahari ◽  
Norhadyrah Izazie Ahad ◽  
Li Ling Chaw ◽  
Nurolaini Kifli ◽  
...  

AbstractBackgroundLatest clinical data on treatment on coronavirus disease 2019 (COVID-19) indicated that older patients and those with underlying history of smoking, hypertension or diabetes mellitus might have poorer prognosis of recovery from COVID-19. We aimed to examine the relationship of various prevailing population-based risk factors in comparison with mortality rate and case fatality rate (CFR) of COVID-19.MethodsDemography and epidemiology data which have been identified as verified or postulated risk factors for mortality of adult inpatients with COVID-19 were used. The number of confirmed cases and the number of deaths until April 16, 2020 for all affected countries were extracted from Johns Hopkins University COVID-19 websites. Datasets for indicators that are fitting with the factors of COVID-19 mortality were extracted from the World Bank database. Out of about 185 affected countries, only top 50 countries were selected to be analyzed in this study. The following seven variables were included in the analysis, based on data availability and completeness: 1) proportion of people aged 65 above, 2) proportion of male in the population, 3) diabetes prevalence, 4) smoking prevalence, 5) current health expenditure, 6) number of hospital beds and 7) number of nurses and midwives. Quantitative analysis was carried out to determine the correlation between CFR and the aforementioned risk factors.ResultsUnited States shows about 0.20% of confirmed cases in its country and it has about 4.85% of CFR. Luxembourg shows the highest percentage of confirmed cases of 0.55% but a low 2.05% of CFR, showing that a high percentage of confirmed cases does not necessarily lead to high CFR. There is a significant correlation between CFR, people aged 65 and above (p = 0.35) and diabetes prevalence (p = 0.01). However, in our study, there is no significant correlation between CFR of COVID-19, male gender (p = 0.26) and smoking prevalence (p = 0.60).ConclusionOlder people above 65 years old and diabetic patients are significant risk factors for COVID-19. Nevertheless, gender differences and smoking prevalence failed to prove a significant relationship with COVID-19 mortality rate and CFR.


2015 ◽  
Vol 144 (1) ◽  
pp. 198-206 ◽  
Author(s):  
R.-F. WANG ◽  
S.-H. SHEN ◽  
A. M.-F. YEN ◽  
T.-L. WANG ◽  
T.-N. JANG ◽  
...  

SUMMARYInformation is lacking on the integrated evaluation of mortality rates in healthcare-associated infections (HAIs). Our aim was to differentiate the risk factors responsible for the incidence from those for the case-fatality rates in association with HAIs. We therefore examined the time trends of both incidence and case-fatality rates over a 20-year period at a tertiary-care teaching medical centre in Taiwan and the mortality rate was expressed as the product of the incidence rate and the case-fatality rate. During the study period the overall mortality rate fell from 0·46 to 0·32 deaths/1000 patient-days and the incidence rate fell from 3·41 to 2·31/1000 patient-days, but the case-fatality rate increased marginally from 13·5% to 14·0%. The independent risk factors associated with incidence of HAIs were age, gender, infection site, admission type, and department of hospitalization. Significant prognostic factors for HAI case-fatality were age, infection site, intensive care, and clinical department. We conclude that the decreasing trend for the HAI mortality rate was accompanied by a significant decline in the incidence rate and this was offset by a slightly increasing trend in the case-fatality rate. This deconstruction approach could provide further insights into the underlying complex causes of mortality for HAIs.


2005 ◽  
Vol 134 (1) ◽  
pp. 103-110 ◽  
Author(s):  
I. SMITH ◽  
A. T. BJØRNEVIK ◽  
I. M. B. AUGLAND ◽  
A. BERSTAD ◽  
T. WENTZEL-LARSEN ◽  
...  

SUMMARYIn a retrospective epidemiological study, 293 meningococcal disease patients hospitalized during 1985–2002, were examined for fatality and risk factors related to death. The overall case fatality rate (CFR) was 8·2%, but increased from 4% during 1985–1993 to 17% during 1994–2002. The latter 9-year period was characterized by more serogroup C infections and more patients with thrombocytopenia on admission to hospital. All patients categorized as meningitis on admission survived. Of the 24 patients who died, 21 had meningococcal skin rash on admission, 23 had an onset to admission time of ⩽24 h, and 16 had severe septicaemia with hypotension and/or ecchymoses without meningitis on admission. By multivariate analyses, a short onset to admission time, >50 petechiae, thrombocytopenia and severe septicaemia on admission were associated with fatality. More lives could be saved through earlier admission to hospital. This can be achieved through more information to the public about the early signs of meningococcal septicaemia, with the recommendation to look for skin rash in patients with acute fever during the first day and night.


Author(s):  
Hua Zhang ◽  
Han Han ◽  
Tianhui He ◽  
Kristen E Labbe ◽  
Adrian V Hernandez ◽  
...  

Abstract Background Previous studies have indicated coronavirus disease 2019 (COVID-19) patients with cancer have a high fatality rate. Methods We conducted a systematic review of studies that reported fatalities in COVID-19 patients with cancer. A comprehensive meta-analysis that assessed the overall case fatality rate and associated risk factors was performed. Using individual patient data, univariate and multivariable logistic regression analyses were used to estimate odds ratios (OR) for each variable with outcomes. Results We included 15 studies with 3019 patients, of which 1628 were men; 41.0% were from the United Kingdom and Europe, followed by the United States and Canada (35.7%), and Asia (China, 23.3%). The overall case fatality rate of COVID-19 patients with cancer measured 22.4% (95% confidence interval [CI] = 17.3% to 28.0%). Univariate analysis revealed age (OR = 3.57, 95% CI = 1.80 to 7.06), male sex (OR = 2.10, 95% CI = 1.07 to 4.13), and comorbidity (OR = 2.00, 95% CI = 1.04 to 3.85) were associated with increased risk of severe events (defined as the individuals being admitted to the intensive care unit, or requiring invasive ventilation, or death). In multivariable analysis, only age greater than 65 years (OR = 3.16, 95% CI = 1.45 to 6.88) and being male (OR = 2.29, 95% CI = 1.07 to 4.87) were associated with increased risk of severe events. Conclusions Our analysis demonstrated that COVID-19 patients with cancer have a higher fatality rate compared with that of COVID-19 patients without cancer. Age and sex appear to be risk factors associated with a poorer prognosis.


2009 ◽  
Vol 30 (11) ◽  
pp. 1036-1044 ◽  
Author(s):  
Omar M. AL-Rawajfah ◽  
Frank Stetzer ◽  
Jeanne Beauchamp Hewitt

Background.Although many studies have examined nosocomial bloodstream infection (BSI), US national estimates of incidence and case-fatality rates have seldom been reported.Objective.The purposes of this study were to generate US national estimates of the incidence and severity of nosocomial BSI and to identify risk factors for nosocomial BSI among adults hospitalized in the United States on the basis of a national probability sample.Methods.This cross-sectional study used the US Nationwide Inpatient Sample for the year 2003 to estimate the incidence and case-fatality rate associated with nosocomial BSI in the total US population. Cases of nosocomial BSI were defined by using 1 or more International Classification of Diseases, 9th Revision, Clinical Modification codes in the secondary field(s) that corresponded to BSIs that occurred at least 48 hours after admission. The comparison group consisted of all patients without BSI codes in their NIS records. Weighted data were used to generate US national estimates of nosocomial BSIs. Logistic regression was used to identify independent risk factors for nosocomial BSI.Results.The US national estimated incidence of nosocomial BSI was 21.6 cases per 1,000 admissions, while the estimated case-fatality rate was 20.6%. Seven of the 10 leading causes of hospital admissions associated with nosocomial BSI were infection related. We estimate that 541,081 patients would have acquired a nosocomial BSI in 2003, and of these, 111,427 would have died. The final multivariate model consisted of the following risk factors: central venous catheter use (odds ratio [OR], 4.76), other infections (OR, 4.61), receipt of mechanical ventilation (OR, 4.97), trauma (OR, 1.98), hemodialysis (OR, 4.83), and malnutrition (OR, 2.50). The total maximum rescaled R2 was 0.22.Conclusions.The Nationwide Inpatient Sample was useful for estimating national incidence and case-fatality rates, as well as examining independent predictors of nosocomial BSI.


2019 ◽  
Author(s):  
Simon Mrema ◽  
Anthony Massinde ◽  
Dismas Matovelo ◽  
Albert Kihunrwa ◽  
Richard Rumanyika ◽  
...  

Abstract Background Uterine rupture is one of the major obstetric complications, associated with adverse fetal and maternal outcomes including hemorrhage, genital urinary injury, low Apgar scores, fetomaternal deaths. There is a paucity of data regarding uterine rupture and its consequences among pregnant women in Mwanza, Tanzania. As a result, it is difficult to know the magnitude of the problem and formulate appropriate measures to reduce its incidence. This study was thus conducted to determine the cumulative incidence, risk factors, fetal and maternal outcomes among women with uterine rupture managed at Bugando Medical Centre (BMC), Mwanza-Tanzania.Methods This was a 5-year (2013 to 2017) retrospective descriptive study of cases of uterine rupture at BMC. The case files were collected from medical records department and maternal demographic information, clinical presentation, risk factors, interventions and feto-maternal outcomes were extracted using a checklist. Data were analyzed using STATA software version 13.Results There were 37,763 deliveries within five years. Caesarean section accounted for a quarter (n=9,136) of these deliveries. During this period 81 cases of ruptured uterus were identified, making a cumulative incidence of 2.2 cases per 1,000 deliveries. Common risk factors for uterine rupture were history of previous caesarean section 54% (n=36), obstructed labor 37% (n=25), grandmultiparity 19.4% (n=13) and use of oxytocin 21% (n=14). Maternal case fatality rate in this study was 1.5% (n=1). More than half of cases had hysterectomy while about a third (n=25) had uterine repair without bilateral tubal ligation (BTL). Over 80% (n=55) of cases required blood transfusion. Sepsis developed in 21% (n=14) of cases and vesicovaginal fistula (VVF) in 12% (n=8). Perinatal case fatality rate was 72% (n=48). Out of the 24 babies who were born alive, 37.5% (n=9) had low Apgar scores and 20.8% (n=5) died before discharge.Conclusion The leading risk factor for uterine rupture seen was previous caesarean scar and obstructed labor associated with high perinatal case fatality rate. Improvement in monitoring of patients in labor is necessary to detect early features of uterine rupture, obstructed labour and fetal compromise. This will contribute to reduced incidence of uterine rupture and improve fetomaternal outcomes.


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