COVID-19 Case Fatality Rates Research Articles

COVID-19 Severity in Europe and the USA: Could the Seasonal Influenza Vaccination Play a Role?

The factors affecting COVID-19 infection risk and disease severity have been widely discussed. The role that seasonal influenza vaccinations may play is generally not included in the debate. We performed an analysis investigating a possible link between the vaccination coverage rate (VCR) in the elderly (≥ 65 years of age) and COVID-19 infection risk or disease severity. Data from Europe (country-wise) and the USA (state-wise) were investigated separately. We found statistically significant positive correlations between the VCR and reported COVID-19 incidence, as well as mortality for Europe and the USA. A statistically significant positive correlation was also found between the VCR and the COVID-19 case fatality rate (CFR) for Europe. For the USA, the VCR/CFR correlation was not statistically significant. Our analysis indicates that receiving seasonal influenza vaccination(s) in the past might be an additional risk factor for the elderly in terms of enhanced susceptibility to infection with SARS-CoV-2 and higher likelihood of a lethal outcome in case of infection. More research about this possible risk factor is urgently needed.

Evidence Linking Ultraviolet-B (UVB) Radiation to Deaths Attributed to COVID-19

Background. Prior studies indicate the protective role of Ultraviolet-B (UVB) radiation in human health, mediated by vitamin D synthesis. In this observational study, we empirically outline a negative association of UVB radiation as measured by ultraviolet index (UVI) with the number of COVID-19 deaths.Methods. We apply a fixed-effect log-linear regression model to a panel dataset of 152 countries over 108 days (n=6524). We use the cumulative number of COVID-19 deaths and case-fatality rate (CFR) as the main dependent variables and isolate the UVI effect from potential confounding factors.Findings. After controlling for time-constant and time-varying factors, we find that a permanent unit increase in UVI is associated with a 1.2 percentage points decline in daily growth rates of cumulative COVID-19 deaths [p Interpretation. We find a significant negative association between UVI and COVID-19 deaths, indicating evidence of the protective role of UVB in mitigating COVID-19 deaths. If confirmed via clinical studies, then the possibility of mitigating COVID-19 deaths via sensible sunlight exposure or vitamin D intervention would be very attractive.

Estimating the cure rate and case fatality rate of the ongoing epidemic COVID-19

<p indent="0mm">The COVID-19 outbreak has been associated with over 250000 confirmed infections and over 11000 confirmed deaths worldwide. The epidemic poses a huge challenge to global public health security. Cure rate (CR)/case fatality rate (CFR) is an important data to assess the severity of an epidemic disease and an important consideration to evaluate the therapeutic effect. The current calculation of CR or CFR for COVID-19 epidemic is based on formula: number of cure or deaths/number of diagnosed. This calculation method was called crude CR/CFR. However, there is no more scientific method to calculate the CR and CFR of the epidemic due to the changing data of the epidemic, especially the large increase of the number of diagnosed and hospitalized. The estimated CFR calculated by the basic formula is called crude CFR. Considering a large number of hospitalized patients, we revised the calculation method for CR, which is the ratio of cumulative discharges on a given day to the sum of cumulative discharges on a given day and cumulative deaths before <italic>j</italic> days is used to estimate the CR. In addition, the CFR can be estimated accordingly. According to statistical theory, if the COVID-19 epidemic event satisfies the statistical random event hypothesis, the estimated daily CR and CFR rate should be basically stable without considering the discovery of future special drugs and special medical methods. Therefore, the <italic>j</italic> value is selected with the minimum variance or coefficient of variation of the daily estimate of CR as the selection index, and the best value of <italic>j</italic> is determined by reference to clinical observation statistics. According to the results, the coefficient of variation of the estimated CR of Wuhan, Hubei, China, Hubei excluding Wuhan and China excluding Hubei reached the minimum value at<italic> j</italic>=8,10,10,10 and 12, respectively, indicating that this is the least difference in the estimated value of each day. When <italic>j</italic>=9, the CR of COVID-19 was estimated to be about 95.8% in China, while the CFR was estimated to be about 4.2%, which is lower than that of the SARS epidemic in mainland China in 2003; the CR in Wuhan was estimated to be about 94.5%, while the CFR in Wuhan was estimated to be about 5.5%. Because of the large number of cases and low cure rate in Wuhan, the cure rate in Hubei Province is lower than the national average. The CR of Hubei excluding Wuhan was similar to the national average. The CR of China excluding Hubei Province is the highest, which may be related to the factors of more imported cases, different age structure of imported cases, relatively few patients and better treatment conditions in the other provinces. This method of estimating the CR optimized the calculation method of crude CR, considering the influence of the population still in hospital on the valuation. So the comparatively accurate CR/CFR predictions for the ongoing epidemics are conducive to decision making regarding epidemic prevention and control as well as evaluating the curative effects of availed treatments.

Regional vulnerability for COVID-19 in Cameroon

Introductionfew studies have assessed risk for coronavirus disease 2019 (COVID-19) within African countries. Here we examine differences in vulnerability to COVID-19 among the ten administrative regions and two major cities of Cameroon based on epidemiological risk factors and access to healthcare resources.Methods:regional epidemiological and healthcare access vulnerability indices were created and compared with cumulative COVID-19 cases, case fatality rates, co-morbidities, and healthcare resources in Cameroon.Resultsbased on epidemiological risk factors, populations in the East Region, Douala (in the Littoral Region), West Region, and Yaoundé (in the Center Region) are at highest risk for COVID-19. Meanwhile, the North, Far North, East, and Adamawa Regions had the most healthcare access vulnerability. COVID-19 cases per population were highest in the Center, Littoral, and East Regions. Case fatality rates were greatest in the North Region. Potential co-morbidities with greater prevalence among COVID-19 patients included male sex, hypertension, and diabetes.Conclusionepidemiological risk factors for COVID-19 and access to healthcare varies between the regions of Cameroon. These discrepancies are potentially reflected in regional differences of COVID-19 cases and case fatality rates. In particular, the East Region has high epidemiological risk factors and low healthcare accessibility compared to other regions. Understanding the relationships between epidemiological risk factors, access to healthcare resources, and COVID-19 cases in Cameroon could aid decision-making among national policymakers and inform further research.

COVID-19 mortality rate in nine high-income metropolitan regions.

We analyzed the spread of the COVID-19 epidemic in 9 metropolitan regions of the world with similar socio-demographic characteristics, daytime commuting population and business activities: the New York State, Bruxelles-Capital, the Community of Madrid, Catalonia, the Île-de-France Region, the Greater London county, Stockholms län, Hovedstaden (Copenhagen) and the Lombardy Region. The Lombardy region reported the highest COVID-19 crude mortality rate (141.0 x 100,000) 70-days after the onset of the epidemic, followed by the Community of Madrid (132.8 x 100,000) New York State (120.7 x 100,000). The large variation in COVID-19 mortality and case-fatality rates for COVID-19 in different age strata suggested a more accurate analysis and interpretation of the epidemic dynamics after standardization of the rates by age. The share of elder populations (>70 years) over total population varies widely in the considered study settings, ranging from 6.9% in Catalonia to 17.0% in Lombardy. When taking age distribution into consideration the highest standardized mortality rate was observed in the State of New York (257.9 x 100,000); with figures in most of the European regions concentrated between 123.3 x 100,000 in Greater London and 177.7 x 100,000 in Bruxelles-Capital, lower in French and Danish regions. We also report and critical appraise, when available, COVID-19 mortality figures in capital cities, nursing homes, as well as excess mortality at country level. Our data raise awareness on the need for a more in-depth epidemiological analysis of the current COVID-19 public health emergency that further explores COVID-19 mortality determinants associated with health services delivery, community-level healthcare, testing approaches and characteristics of surveillance systems, including classification of COVID-19 deaths. (www.actabiomedica.it)

The impact of COVID-19 in diabetic kidney disease and chronic kidney disease: A population-based study.

Background:The spectrum of pre-existing renal disease is known as a risk factor for severe COVID-19 outcomes. However, little is known about the impact of COVID-19 on patients with diabetic nephropathy in comparison to patients with chronic kidney disease.Methods:We used the Mexican Open Registry of COVID-19 patients 11 to analyze anonymized records of those who had symptoms related to COVID-19 to analyze the rates of SARS-CoV-2 infection, development of COVID-19 pneumonia, admission, intubation, Intensive Care Unit admission and mortality. Robust Poisson regression was used to relate sex and age to each of the six outcomes and find adjusted prevalences and adjusted prevalence ratios. Also, binomial regression models were performed for those outcomes that had significant results to generate probability plots to perform a fine analysis of the results obtained along age as a continuous variable.Results:The adjusted prevalence analysis revealed that that there was an 87.9% higher probability of developing COVID-19 pneumonia in patients with diabetic nephropathy, a 5% higher probability of being admitted, a 101.7% higher probability of intubation and a 20.8% higher probability of a fatal outcome due to COVID-19 pneumonia in comparison to CKD patients (p<0.01).Conclusions:Patients with diabetic nephropathy had nearly a twofold rate of COVID-19 pneumonia, a higher probability of admission, a twofold probability of intubation and a higher chance of death once admitted compared to patients with chronic kidney disease alone. Also, both diseases had higher COVID-19 pneumonia rates, intubation rates and case-fatality rates compared to the overall population.

Use of Databases Available on the Web to Describe COVID-19 Morbidity and Mortality Trends

In December 2019, an infectious pandemic outbreak occurred in the city of Wuhan in the Province of Hubei, China. The pathogen was identified as a novel coronavirus - COVID-19. This virus belongs to a family of viruses that cause Severe Acute Respiratory Syndrome, known as SARS-COV. The disease is characterized by a high mortality rate among adults aged 60 years or above, particularly those with chronic comorbidities. Databases available on the web provide updated, real-time data on the incidence and mortality rates ascribed to the COVID-19 pandemic in various countries. However, to draw accurate epidemiologic conclusions, demographic data (population density, age distribution, and urbanization level), as well as clinical data (number of screening tests and number of days since the first detected disease case in the country) must be taken into consideration. Informed use of these data affords reliable epidemiologic analysis. For example, a comparison of COVID-19 case fatality rates between Germany and Iran – two countries similar in population size and urbanization level – reveals that the mortality rate in Iran is significantly higher than that of Germany, while the active morbidity burden is much higher in Germany. This may seem surprising, given that Germany’s population is considerably older than that of Iran and four times as dense. It may be surmised that the quality and availability of health services in Germany are superior to those in Iran, offering a higher number of screening tests and more effective clinical treatment. Another important factor affecting morbidity spread is the timing of a lockdown policy implementation. For example, a comparison between China and the USA – two countries with similar land area and median age – reveals that in spite of the fact that in China population density is about 4.25 times higher than in the USA, morbidity rate is considerably lower than in the USA. Two factors can be considered responsible for this lower rate: lower urbanization and an earlier lockdown policy compared with the USA.

Colorectal cancer reporting.

<h3>BACKGROUND:</h3> Estimates of the case-fatality rate (CFR) associated with coronavirus disease 2019 (COVID-19) vary widely in different population settings. We sought to estimate and compare the COVID-19 CFR in Canada...