Death In Elderly Research Articles

Abstract PO3-18-02: RISK FACTORS FOR DEATH IN ELDERLY PATIENTS WITH BREAST CANCER TREATED IN AN ONCOLOGY REFERENCE HOSPITAL IN THE CITY OF RECIFE, BRAZIL

Abstract Background: Breast cancer (BC) is the most common type of cancer among women in the world and in Brazil as well. Age is the most important risk factor for the development of cancer. The treatment of BC in elderly women is particularly challenging, as physiological changes, functional deficits, comorbidities and the use of polypharmacy can alter the risk of toxicity. We conducted this trial to determine the risk factors for deaths in less than 180 days after admission in elderly cancer patients with BC treated at the Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Brazil, and correlate with specific aspects of this type of cancer, such as type of treatment and immunohistochemical profile. Methods: Prospective cohort, in women aged ≥ 60 years, diagnosed with BC, admitted to the IMIP Oncogeriatric Service. At admission, sociodemographic and clinical variables and 10 tests that make up the CGA (Comprehensive Geriatric Assessment) were evaluated, including Mini Nutritional Assessment Short Form (MNA-SF), Polypharmacy and KPS (Karnofsky Performance Status). The follow-up period was at least six months. Descriptive, bivariate analysis using the Fisher and Chi-square tests, a survival study using the Kaplan-Meier method and univariate analysis were performed, including those with p < 0.20 in the multivariate Cox proportional hazards model controlled by Age and Tumor staging. All subjects involved in the research were informed about the objectives of the study and were only included after voluntarily agreeing to participate, signing the informed consent form. Results: The study sample consisted of 326 patients diagnosed with BC in the period from January 2015 to December 2020, all female, with a mean age of 73.46 years (SD ± 7.81). Sociodemographic, clinical and treatment characteristics are described in Table 1. Of the 326 patients, 46 (14,1%) died, and of these, 21 (45,7%) had an infection and 18 (39,1%) required hospitalization. Regarding the domains of the CGA, the characteristics of patients both in the general population and those who died are described in Table 2. After multivariate analysis by Cox regression of clinical variables related to the Comprehensive Geriatric Assessment (CGA) according to death, were identified as a risk factor for death: MNA-SF < 12 (HR = 2,76, IC95%, 1,49-9,48, p =0,001), KPS ≤ 50% (HR = 4,39, IC95%, 2,03-9,48,p < 0,001). Conclusions: In order to improve the efficacy and safety of the treatment of elderly women with BC and to improve their quality of life, the instruments of CGA should be performed routinely. In this population, KPS and Mini Nutritional Assessment Short Version (MNA – SF) were identified as important predictors of early death (180 days after admission). Therefore, in elderly patients with BC who are at risk for malnutrition and have low KPS, the treatment should be analyzed with caution, as well as the evaluation for concomitant early palliative care. Table 1. Sociodemographic, clinical and treatment characteristics of elderly patients treated for BC at IMIP, Recife, 2015-2020. Table 2. Characteristics of CGA (Compreensive Geriatric Assessment) of elderly patients treated for BC at IMIP, Recife, 2015-2020. Citation Format: Ana Cecilia De Vasconcelos, Candice Santos, Jurema Telles, Maria Julia Mello, Bárbara Luz. RISK FACTORS FOR DEATH IN ELDERLY PATIENTS WITH BREAST CANCER TREATED IN AN ONCOLOGY REFERENCE HOSPITAL IN THE CITY OF RECIFE, BRAZIL [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-18-02.

Sunny-Day Flooding and Mortality Risk in Coastal Florida

Sea-level rise is likely to worsen the impacts of hurricanes, storm surges, and tidal flooding on coastal access to basic services. We investigate the historical impact of tidal flooding on mortality rates of the elderly population in coastal Florida using administrative records of individual deaths, demographics, and residential location combined with tidal gauge and high-resolution elevation data. We incorporate data capturing storm and precipitation events into our empirical model to distinguish between disruptions from routine sunny-day flooding and less predictable tropical storm–induced flooding. We find that a 1-standard-deviation (20-millimeter) increase in tidal flooding depth increases mortality rates by 0.46% to 0.60% among those aged 65 or older. Our estimates suggest that future sea-level rises may contribute to an additional 130 elderly deaths per year in Florida relative to 2019, all else being equal. The enhanced risk is concentrated among residents living more than nine minutes away from the nearest hospital. Results suggest that tidal flooding may augment elderly mortality risk by delaying urgent medical care.

Readiness to Face Death in Elderly in Nursing Homes, Indonesia

This qualitative research employs a phenomenological approach to investigate the readiness of elderly individuals to confront death. The study focuses on five elderly, aged 65 and above, residing in an elderly orphanage in Central Java, Indonesia. Data collection involved in-depth interviews guided by considerations of spiritual, social, psychological, and physical aspects. The analysis reveals multifaceted dimensions of psychological readiness among these elderly residents. The informants emphasize the importance of acknowledging the inevitability of death as a fundamental aspect of their life journey, providing them with a unique perspective on mortality. They find meaning in their lives, fostering a sense of fulfillment and completeness, and contemplate the possibility of an afterlife, which offers comfort and solace. Importantly, they express a remarkable lack of fear when facing death, demonstrating a profound acceptance and equanimity. Religious and spiritual practices, particularly worship, play a pivotal role in providing comfort and tranquility. This study's findings align with previous research and highlight the significance of life satisfaction, spirituality, and social connections in shaping elderly individuals' readiness to confront death. Additionally, physical well-being is recognized as a vital component of overall happiness in the context of aging. These insights shed light on the complex interplay of beliefs, meaning, and acceptance that contribute to the psychological readiness of elderly individuals to face the certainty of death. Keywords: Elderly, Death Readiness, Psychological Resilience

Deaths caused by osteoporotic fractures in Japan: An epidemiological study

BackgroundOsteoporosis is a global issue with a worldwide prevalence of 18.3%, and the presence of coexisting fragility fractures can reduce the survival rate by approximately 20%. In Japan, the prevalence of osteoporosis is estimated to be 12.8 million, and the annual occurrence of hip fractures is approximately 193,400. Remarkably, coexisting hip or spinal fragility fractures caused by slight external force meet the Japanese diagnostic criterion for osteoporosis regardless of bone mineral density. However, only 191 deaths due to osteoporosis were published in 2021 in Japan. With the concern that some cases of hip and spinal fragility fractures were assigned an underlying cause of death of traumatic fracture instead of osteoporosis, this study aimed to elucidate the actual number of deaths due to osteoporosis in Japan. MethodsWe used the data from Japan in 2018. First, the number of deaths due to osteoporosis and hip or spinal fractures was reviewed using published vital statistics. Second, we calculated the number of elderly deaths (age ≥80 years) resulting from hip or spinal fractures caused by falls on the same level using data from approximately 1.4 million annual individual death certificates. Combining the above data, the actual number of deaths due to osteoporosis was estimated. ResultsOnly 190 deaths due to osteoporosis were reported in the published data. The individual certificate data revealed 3437 elderly deaths due to hip or spinal fractures caused by falls on the same level, which could meet the criteria of osteoporotic fragility fractures. Accordingly, the estimated number of deaths caused by osteoporosis was calculated as 3,627, approximately 19 times the published value. ConclusionsAfter researching the individual death certificate data focusing on the coexisting hip or spinal fragility fracture, it was implied that osteoporosis may have a higher mortality rate in Japan than what is published.

Burden of fine air pollution on mortality in the desert climate of Kuwait

BackgroundMiddle Eastern desert countries like Kuwait are known for intense dust storms and enormous petrochemical industries affecting ambient air pollution. However, local health authorities have not been able to assess the health impacts of air pollution due to limited monitoring networks and a lack of historical exposure data.ObjectiveTo assess the burden of PM2.5 on mortality in the understudied dusty environment of Kuwait.MethodsWe analyzed the acute impact of fine particulate matter (PM2.5) on daily mortality in Kuwait between 2001 and 2016. To do so, we used spatiotemporally resolved estimates of PM2.5 in the region. Our analysis explored factors such as cause of death, sex, age, and nationality. We fitted quasi-Poisson time-series regression for lagged PM2.5 adjusted for time trend, seasonality, day of the week, temperature, and relative humidity.ResultsThere was a total of 70,321 deaths during the study period of 16 years. The average urban PM2.5 was estimated to be 46.2 ± 19.8 µg/m3. A 10 µg/m3 increase in a 3-day moving average of urban PM2.5 was associated with 1.19% (95% CI: 0.59, 1.80%) increase in all-cause mortality. For a 10 µg/m3 reduction in annual PM2.5 concentrations, a total of 52.3 (95% CI: 25.7, 79.1) deaths each year could be averted in Kuwait. That is, 28.6 (95% CI: 10.3, 47.0) Kuwaitis, 23.9 (95% CI: 6.4, 41.5) non-Kuwaitis, 9.4 (95% CI: 1.2, 17.8) children, and 20.9 (95% CI: 4.3, 37.6) elderly deaths each year.Impact StatementThe overwhelming prevalence of devastating dust storms and enormous petrochemical industries in the Gulf and the Middle East has intensified the urgency to address air pollution and its detrimental health effects. Alarmingly, the region’s epidemiological research lags behind, hindered by a paucity of ground monitoring networks and historical exposure data. In response, we are harnessing the power of big data to generate predictive models of air pollution across time and space, providing crucial insights into the mortality burden associated with air pollution in this under-researched yet critically impacted area.

Corona Look of the Day

The authors created a photo and essay series entitled "Corona Look of the Day." Each day we took photos of outfits paired with colorful makeup and inspired text descriptions about the beauty in disability. These posts were formulated as resistance to the eugenic discourse pervading the early days of the pandemic that argued disabled and elderly deaths were acceptable and probable. In contrast to this bleak assessment, this artistic series sought to affirm disability through uplifting portraiture.

COVID-19 Biomarkers Comparison: Children, Adults and Elders.

Background and Objectives: this study aimed to research links between C-reactive protein (CRP), lactate dehydrogenase (LDH), creatinekinase (CK), 25-OH vitamin D (25-OHD), ferritin (FER), high-density lipoprotein cholesterol (HDL)cholesterol and clinical severity in patients from the western part of Romania, and compare their potential use as biomarkers for intensive care units (ICU) admission and death in children, adults and elders. Materials and Methods: this study is a retrospective cohort study, performed on patients positively diagnosed with COVID-19. Available CRP, LDH, CK 25-OH vitamin D, ferritin, HDL cholesterol and clinical severity were recorded. The following were assessed: median group differences, association, correlation and receiver operating characteristic. Results: 381 children, 614 adults and 381 elders were studied between 1 March 2021 and 1 March 2022. Most children and adults presented mild symptomatology (53.28%, 35.02%, respectively), while most elders presented severe symptomatology (30.04%). ICU admission was 3.67% for children, 13.19% for adults and 46.09% for elders, while mortality was 0.79% for children, 8.63% for adults and 25.1% for elders. With the exception of CK, all other biomarkers showed some significant associations with clinical severity, ICU admission and death. Conclusions: CRP, LDH, 25-OH vitamin D, ferritin and HDL are important biomarkers for COVID-19 positive patients, especially in the pediatric population, while CK was mostly within normal ranges.

Indigenous knowledge of astronomical star positions and temporal patterns for seasonal weather forecasting: the case of Borana Oromo Pastoralists of Southern Ethiopia

Background: Indigenous Knowledge-based (IK) prediction of weather is an activity as old as humanity. The objective of this study is to examine indigenous knowledge-based seasonal weather indicating features of astronomic stars. Methods: This study is based on primary data that were generated through using focus group discussion, key informant interviews, experimental groups, and direct observation. Results: The findings revealed that, in the study area, one of the widely used practices of indigenous-based weather indicating astronomic objects that exhibit change naturally within a continuum of varying temporal and spatial contexts are observable external features of stars. In the study area weather indicating outlooks of stars are: temporal patterns of star-moon alignment/defect of star-moon alignment; position/direction of the stars and physical/colors of stars. The indicators were displayed in a more than three months lead time ahead of the actual occurrence of weather events. The occurrence of the forecasting of the weather event actually happened in 2021. The severe drought of 2021/2022 was mainly caused by naturally driven defects of star-moon alignment. These practices are still regularly used in decision making. However, these practices are not yet mainstreamed in to formal structures. Conclusion: Curtailments of mobility, severity of drought, weakening of traditional institution, leaving of traditional life-style and death of the knowledgeable elders are the major challenging factors to these practices.

Meta-Analysis the Effects of Social Isolation and Loneliness on Cardiovascular Disease and Death in Elderly

Background: The impact of social isolation and loneliness on health and well-being is recognized globally as a public health problem. Social isolation can be experienced at any age, especially the elderly. This study aims to analyze and estimate the influence of social isolation and loneliness on cardiovascular disease and death in the elderly.Subjects and Method: The meta-analysis was carried out according to the PRISMA flow chart and the PICO model. P: Elderly, I: Social isolation and loneliness, C: Not social isolation and not lonely, O: Cardiovascular disease and death. Search for articles in this study through databases that include PubMed, Google Scholar, Science Direct and Scopus with keywords "social isolation" AND "loneliness" AND "cardiovascular disease" AND "elderly". “Social isolation” AND “loneliness” AND “mortality” AND “elderly”. Full paper article with cohort design, adjusted Hazard Ratio for effect size, research outcome are cardiovascular disease and death. Analysis was performed using Revman 5.3.Results: There were 18 articles with cohort designs originating from America, Finland, Canada, Tai-wan, Australia, the United States, Japan, Denmark, Amsterdam, England, Sweden, Jerusalem, Europe with a total of 1,375,816 research samples. A meta-analysis of 13 cohort studies concluded that seniors who were socially isolated had a 1.23 times the risk of developing cardiovascular disease compared to those who were not socially isolated, and the effect was statistically significant (aHR= 1.23; 95% CI= 1.10 to 1.38; p= 0.003). In addition, the elderly who are socially isolated have a risk of dying 1.16 times compared to those who are not socially isolated, and this effect is statistically significant (aHR= 1.16; 95% CI= 1.07 to 1.21; p= 0.003). A meta-analysis of 13 cohort studies concluded that lonely elderly people had a 1.10 times greater risk of developing cardiovascular disease compared to lonely people, and the effect was statistically significant (aHR= 1.10; 95% CI= 1.01 to 1.20; p= 0.003). In addition, lonely elderly people have a risk of dying 1.19 times compared to being lonely, and the effect is statistically significant (aHR= 1.19; 95% CI= 1.02 to 1.39; p= 0.002).Conclusion: Social isolation and loneliness increase the risk of cardiovascular disease and death in elderly. Keywords: social isolation, loneliness, cardiovascular, death, elderly. Correspondence:Ayu Novita Wulandari. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta, Jawa Tengah. Email: ayunovitawulandari98@gmail.com. Mobile: +6282281301325.

Elderly Mortality due to Ambulatory Care Sensitive Conditions and Primary Health Care Coverage in the Federal District.

To describe the mortality coefficients of elderly due to primary care sensitive conditions, from 2008 to 2018, and determine its association with the coverage of the Primary Health Care (Family Health Strategy and Basic Care models) in the Federal District. Ecological time series of mortality in Federal District elderly, from 2008 to 2018. The Poisson regression model was applied, considering as significant those with p<0.05, with a CI of 95%. There were 70,503 deaths. There was a decrease in the risk of death of elders due to cardiovascular diseases and diabetes. Higher primary care coverage decreased the chance of death by sensitive conditions, both in Basic Care (OR: 0.994, CI: 0.990-0.998) and in the Family Health Strategy (OR: 0.997, CI: 0.995-0.999). Primary Care coverage was associated with a lower chance of death of the elderly due to Ambulatory Care Sensitive Conditions, especially in Basic Care.

Novel Study of Excess Elderly Deaths in Ontario: Updated to 2022

Novel Study of Excess Elderly Deaths in Ontario: Updated to 2022

Hubungan Tingkat Pengetahuan Tentang Covid-19 dengan Tingkat Kecemasan pada Lansia di Kelurahan Jebres

Coronavirus Disease as known as Covid-19 is an infectious disease caused by Sars Cov-2. Covid-19 can be transmitted in direct through saliva, droplets, and bad air.The prevalence of Covid-19 cases in the elderly in Indonesia the age range of ≥60 years, which is 47.3% of cases and the number of elderly deaths due to Covid-19 is 15,023 people. The decline of the immune system in elderly can increase the risk of Covid-19, even to death. One of the effect of Covis-19 is psychological disorders of anxiety. To know relationship between levels of knowledge of covid-19 and levels of anxiety among elderly at kelurahan jebres. The design of this research used quantitative and analytical cross sectional study design, and the number of samples was determined using Slovin’s formula, there are 98 respondents. Data results were analyzed using statistical software with a Spearman Rank test. The results showed that relation between level of knowledge of Covid-19 and level of anxiety among elderly at Kelurahan Jebres was found (p-value = 0,001 (p&lt;0,05)). So, there was relation observed between the level of knowledge and level of anxiety. Data results showed that the level of knowledge about Covid-19 is classified good (54,1%) and the level of anxiety is mild anxiety (58,2%). There is a relationship between level of knowledge of Covid-19 and level of anxiety among elderly at Kelurahan Jebres.

HUBUNGAN PENGETAHUAN DAN SIKAP LANSIA DENGAN PEMANFAATAN POSYANDU LANSIA DI DESA UJUNG LABUHAN KECAMATAN NAMORAMBE KABUPATEN DELI SERDANG TAHUN 2021

WHO in 2018 noted that of the 675 million elderly deaths in the world due to degenerative diseases, 225 million (33.33% proportion) were in developed countries and 450 million (66.66 proportions) were in developing countries. The elderly population is estimated at almost 600 million people, which is projected to be 2 billion in 2050. Problems that often occur in the elderly include physical changes: cell decline, changes in the cardiovascular system, decreased respiration. Efforts to improve the health status of the elderly in the community are through&#x0D; Posyandu services for the elderly. Utilization of Posyandu for the Elderly is low even though it provides the benefits needed for the health of the elderly. This study is an analytic observational study with a cross sectional approach to analyze whether or not there is a relationship between knowledge and attitudes of the elderly with the use of posyandu for the elderly. The elderly population in Ujung Labuhan Village, Namorambe District, Deli Serdang Regency in 2021, as many as 72, the sample was taken by purposive sampling with a total of 45 elderly. Data analysis using chi square test. Most of the respondents have a low level of knowledge, namely 26 respondents (57.8%), a small proportion have good knowledge, 19 respondents (42.2%). Most of the respondents had a positive attitude towards the elderly posyandu as many as 23 people (51.1%), a small number of respondents had a negative attitude as many as 22 people (48.9%). Based on the results of the chi square test, it is known that the value of p = 0.000 &lt;0.05 means that there is a relationship between attitudes and the use of posyandu for the elderly. There is a relationship between knowledge and attitudes of the elderly with the use of posyandu for the elderly. The elderly population in Ujung Labuhan Village, Namorambe District, Deli Serdang Regency in 2021. It is hoped that health workers will take a more innovative approach in providing health services to the elderly while still implementing health protocols.

Indigenous astronomical knowledge based seasonal weather forecast: evidence from Borana Oromo pastoralists of Southern Ethiopia.

Indigenous knowledge is still widely used by communities around the world to overcome social-ecological challenges. Borana Oromo pastoralists of Southern Ethiopia have been searching for future weather phenomena using their indigenous knowledge. This study examines indigenous knowledge-based seasonal weather forecasts through using observable physical and temporal patterns of astronomic objects. Data were generated through using focus group discussion, experimental knowledgeable groups and direct observation in the year 2021. The finding reveals that Borana Oromo pastoralists commonly define physical and temporal outlooks of the Moon that are changed and/ or displayed periodically within a range of varying contexts. The observation of the Moon features have been offering sufficient lapse time in a more than/within ahead of a season/ and is relatively more accurate than the other traditional forecasting objects. The study showed that both temporal and spatial dimensions of the forecasting were actually happened in Ganna (March to May rainfall), Adolessa dry season (June to September) and Hgayya rainfall (October to November) seasons of 2021. This indigenous weather forecasting practices are still regularly used in every livelihood decision making process. However, this indigenous weather knowledge of Borana Oromo pastoralists of Southern Ethiopia is not yet mainstreamed in the formal institutional structures. Curtailments of mobility, severity of drought, weakening of traditional institution, leaving of traditional life style and death of the knowledgeable elders are the major factors that are challenging the potential effects of the indigenous weather forecasting indicators of the features of moon in the study area.

Children orphaned by COVID-19: A grim picture and the need of urgent actions

The COVID-19 had caused as a global pandemic and resulted in enormous burdens. In addition, faced with the proliferation of SARS-CoV 2 variant strains, this pandemic is continuing unremitting. The world seemed to focus primarily on middle-aged and elderly deaths, however the interest of the impact of COVID-19 on children is limited. Scientists have estimated that orphanhood and caregiver death related to COVID-19 had increased twice in the last six months compared with the first 14 months of the pandemic. Orphans face directly the health consequences.

Assessing government policies' impact on the COVID-19 pandemic and elderly deaths in East Asia.

This study assesses governments' long-term non-pharmaceutical interventions upon the coronavirus disease 2019 (COVID-19) pandemic in East Asia. It advances the literature towards a better understanding of when and which control measures are effective. We (1) provide time-varying case fatality ratios and focus on the elderly's mortality and case fatality ratios, (2) measure the correlations between daily new cases (daily new deaths) and each index based on multiple domestic pandemic waves and (3) examine the lead-lag relationship between daily new cases (daily new deaths) and each index via the cross-correlation functions on the pre-whitened series. Our results show that the interventions reduce COVID-19 infections for some periods before the period of the Omicron variant. Moreover, there is no COVID-19 policy lag in Taiwan between daily new confirmed cases and each index. As of March 2022, the case fatality ratios of the elderly group in Japan, Hong Kong and South Korea are 4.69%, 4.72% and 1.48%, respectively, while the case fatality ratio of the elderly group in Taiwan is 25.01%. A government's COVID-19 vaccination distribution and prioritisation policies are pivotal for the elderly group to reduce the number of deaths. Immunising this specific group as best as possible should undoubtedly be a top priority.

AIFMS Autonomous Intelligent Fall Monitoring System for the Elderly Persons

Falls are the major cause of injuries and death of elders who live alone at home. Various research works have provided the best solution to the fall detection approach during day vision. However, fall occurs more at the night due to many factors such as low or zero lighting conditions, intake of medication/ drugs, frequent urination due to nocturia disease, and slippery restroom. Based on the required factors, an autonomous monitoring system based on night condition has been proposed through retro-reflective stickers pasted on their upper cloth and infrared cameras installed in the living environment of elders. The developed system uses features such as changes in orientation angle and distance between the retro-reflective stickers to identify the human shape and its characteristics for fall identification. Experimental analysis has also been performed on various events of fall and non-fall activities during the night exclusively in the living environment of the elder, and the system achieves an accuracy of 96.2% and fall detection rate of 92.9%.

Elcare: Elderly Care With Fall Detection

Continuous growth in the aged population over the years around the globe suggests advancements in medical facilities to ensure good medical health of people. The elder population is vulnerable to many medical problems as the immune system as well as the musculoskeletal system weakens with time. Falls are the major cause leading to serious medical conditions such as paralysis or even death for elders. Early fall detection can help in reducing the severity of these accidents and provide immediate medical assistance. To detect falls this paper discusses the use of pose estimation and sensor-based mobile devices. The system makes use of MediaPipe’s Pose Detection method to form a skeletal structure of the person. Exploiting the features such as drastic change in coordinate axes, angle of inclination while falling, and the sudden change in velocity during a fall helps to verify the authenticity of the fall. The sensor-based method makes use of mobile sensors and records the change in their values to decide whether the activity is a fall or not. The combination of both these methods allows for an accurate fall detection mechanism where the system finally notifies the concerned authorities via real-time feedback techniques such as text, message, or push notification.

Convergence of Comorbidity and COVID-19 Infection to Fatality: An investigation based on health assessment and vaccination among older adults in Kerala, India

OBJECTIVE: To investigate the impact of age, comorbidity, and vaccination in the fatality of older COVID-19 patients in the state of Kerala, India. METHODS: A cross sectional study, adopting a mixed method approach was used and conducted among the older population in Kerala. To study the health profile of study participants 405 older people were surveyed and 102 people were interviewed in-depth at their households between June to November 2020. The results of the study were triangulated with elderly COVID-19 fatality data available from the citizen-science dashboards of the research team and Department of Health, Kerala. Vaccination data was retrieved from the Co-WIN government website (cowin.gov.in) to study its impact. The data was analyzed using the IBM SPSS version 22.0. RESULTS: Age is a predictor of COVID-19 fatality. Diabetes, hypertension, CAD, CKD and COPD are the significant predictors of elderly COVID-19 fatality in Kerala. The current comorbidity profile of the total older population matches with the comorbidities of the COVID-19 elderly death cases. CFR and IFR have declined even when the CMR is high in the second wave of COVID-19 with more deaths. This is attributable to vaccination even though there exists a lesser chance for breakthrough infection. CONCLUSIONS: Age and comorbidities can predict potential fatality among older COVID-19 patients. Timely and accurate health data and better knowledge of high-risk factors such as comorbidity can easily guide the healthcare system and authorities to efficient prevention and treatment methodologies. Knowledge on prevailing NCDs can drive early preparedness before it converges with an epidemic like the present zoonotic disease. Vaccination is an effective tool in preventing infection compared to the unvaccinated even though the chance for breakthrough infection is there, particularly, in people with comorbidities.

Spread of COVID-19 Vaccine Misinformation in the Ninth Inning: Retrospective Observational Infodemic Study.

BackgroundShortly after Pfizer and Moderna received emergency use authorizations from the Food and Drug Administration, there were increased reports of COVID-19 vaccine-related deaths in the Vaccine Adverse Event Reporting System (VAERS). In January 2021, Major League Baseball legend and Hall of Famer, Hank Aaron, passed away at the age of 86 years from natural causes, just 2 weeks after he received the COVID-19 vaccine. Antivaccination groups attempted to link his death to the Moderna vaccine, similar to other attempts misrepresenting data from the VAERS to spread COVID-19 misinformation.ObjectiveThis study assessed the spread of misinformation linked to erroneous claims about Hank Aaron’s death on Twitter and then characterized different vaccine misinformation and hesitancy themes generated from users who interacted with this misinformation discourse.MethodsAn initial sample of tweets from January 31, 2021, to February 6, 2021, was queried from the Twitter Search Application Programming Interface using the keywords “Hank Aaron” and “vaccine.” The sample was manually annotated for misinformation, reporting or news media, and public reaction. Nonmedia user accounts were also classified if they were verified by Twitter. A second sample of tweets, representing direct comments or retweets to misinformation-labeled content, was also collected. User sentiment toward misinformation, positive (agree) or negative (disagree), was recorded. The Strategic Advisory Group of Experts Vaccine Hesitancy Matrix from the World Health Organization was used to code the second sample of tweets for factors influencing vaccine confidence.ResultsA total of 436 tweets were initially sampled from the Twitter Search Application Programming Interface. Misinformation was the most prominent content type (n=244, 56%) detected, followed by public reaction (n=122, 28%) and media reporting (n=69, 16%). No misinformation-related content reviewed was labeled as misleading by Twitter at the time of the study. An additional 1243 comments on misinformation-labeled tweets from 973 unique users were also collected, with 779 comments deemed relevant to study aims. Most of these comments expressed positive sentiment (n=612, 78.6%) to misinformation and did not refute it. Based on the World Health Organization Strategic Advisory Group of Experts framework, the most common vaccine hesitancy theme was individual or group influences (n=508, 65%), followed by vaccine or vaccination-specific influences (n=110, 14%) and contextual influences (n=93, 12%). Common misinformation themes observed included linking the death of Hank Aaron to “suspicious” elderly deaths following vaccination, claims about vaccines being used for depopulation, death panels, federal officials targeting Black Americans, and misinterpretation of VAERS reports. Four users engaging with or posting misinformation were verified on Twitter at the time of data collection.ConclusionsOur study found that the death of a high-profile ethnic minority celebrity led to the spread of misinformation on Twitter. This misinformation directly challenged the safety and effectiveness of COVID-19 vaccines at a time when ensuring vaccine coverage among minority populations was paramount. Misinformation targeted at minority groups and echoed by other verified Twitter users has the potential to generate unwarranted vaccine hesitancy at the expense of people such as Hank Aaron who sought to promote public health and community immunity.