COVID-19 patients' clinical characteristics, discharge rate, and fatality rate of meta-analysis.
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ABSTRACT:
SUBMITTER: Li LQ
PROVIDER: S-EPMC7228329 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundCoronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus. Although general and local public health report deathly cases, case fatality rates are still largely unknown. Thus, we sought to evaluate the mortality of COVID-19.MethodsWe searched PubMed and EMBASE databases for articles evaluating the clinical characteristics of COVID-19 patients that included clinical outcomes, between December 2020 and 24 April 2020. Two authors performed an independent selection using predefined terms of search.ResultsWe retrieved 33 studies with a total of 13,398 patients with COVID-19 diagnosis. The mortality rate of the COVID-19 patients was 17.1% (95% CI 12.7; 22.7, I2 = 96.9%). For general patients admitted to the hospital (excluding critical care-only studies) the mortality rate of the COVID-19 was 11.5% (95% CI 7.7; 16.9, I2 = 96.7%). Among critical illness studies (n = 7) we found a 40.5% mortality (95% CI 31.2; 50.6, I2 = 91.8%).ConclusionHigh COVID-19 mortality among general admitted patients and critical care cases should guide resources allocations and economic burden calculations during the pandemics.
| S-EPMC7920817 | biostudies-literature
Project description:When the population risk factors and reporting systems are similar, the assessment of the case-fatality (or lethality) rate (ratio of cases to deaths) represents a perfect tool for analyzing, understanding and improving the overall efficiency of the health system. The objective of this article is to estimate the influence of the hospital care system on lethality in metropolitan France during the inception of the COVID-19 epidemic, by analyzing the spatial variability of the hospital case-fatality rate (CFR) between French districts. In theory, the hospital age-standardized CFR should not display significant differences between districts, since hospital lethality depends on the virulence of the pathogen (the SARS-CoV-2 virus), the vulnerability of the population (mainly age-related), the healthcare system quality, and cases and deaths definition and the recording accuracy. We analyzed hospital data on COVID-19 hospitalizations, severity (admission to intensive care units for reanimation or endotracheal intubation) and mortality, from March 19 to May 8 corresponding to the first French lockdown. All rates were age-standardized to eliminate differences in districts age structure. The results show that the higher case-fatality rates observed by districts are mostly related to the level of morbidity. Time analysis shows that the case-fatality rate has decreased over time, globally and in almost all districts, showing an improvement in the management of severe patients during the epidemic. In conclusion, it appears that during the first critical phase of COVID-19 ramping epidemic in metropolitan France, the higher case-fatality rates were generally related to the higher level of hospitalization, then potentially related to the overload of healthcare system. Also, low hospitalization with high case-fatality rates were mostly found in districts with low population density, and could due to some limitation of the local healthcare access. However, the magnitude of this increase of case-fatality rate represents less than 10 per cent of the average case-fatality rate, and this variation is small compared to much greater variation across countries reported in the literature.
| S-EPMC7737987 | biostudies-literature
Project description:ObjectivesThe aim of this study was to evaluate the association of pre-existing cardiovascular comorbidities, including hypertension and coronary heart disease, with coronavirus disease 2019 (COVID-19) severity and mortality.MethodsPubMed, ScienceDirect, and Scopus were searched between January 1, 2020, and July 18, 2020, to identify eligible studies. Random-effect models were used to estimate the pooled event rates of pre-existing cardiovascular disease comorbidities and odds ratio (OR) with 95% confidence intervals (95% CIs) of disease severity and mortality associated with the exposures of interest.ResultsA total of 34 studies involving 19,156 patients with COVID-19 infection met the inclusion criteria. The prevalence of pre-existing cardiovascular disease in the included studies was 14.0%. Pre-existing cardiovascular disease in COVID-19 patients was associated with severe outcomes (OR, 4.1; 95% CI, 2.9 to 5.7) and mortality (OR, 6.1; 95% CI, 2.9 to 12.7). Hypertension and coronary heart disease increased the risk of severe outcomes by 2.6 times (OR, 2.6; 95% CI, 1.9 to 3.6) and 2.5 times (OR, 2.5; 95% CI, 1.7 to 3.8), respectively. No significant publication bias was indicated.ConclusionCOVID-19 patients with pre-existing cardiovascular comorbidities have a higher risk of severe outcomes and mortality. Awareness of pre-existing cardiovascular comorbidity is important for the early management of COVID-19.
| S-EPMC8907611 | biostudies-literature
Project description:Background and aimsRealizing the transmission potential and the magnitude of the coronavirus disease 2019 (COVID-19) aids public health monitoring, strategies, and preparation. Two fundamental parameters, the basic reproduction number (R 0) and case fatality rate (CFR) of COVID-19, help in this understanding process. The objective of this study was to estimate the R 0 and CFR of COVID-19 and assess whether the parameters vary in different regions of the world.MethodsWe carried out a systematic review to find the reported estimates of the R 0 and the CFR in articles from international databases between January 1 and August 31, 2020. Random-effect models and Forest plots were implemented to evaluate the mean effect size of R 0 and the CFR. Furthermore, R 0 and CFR of the studies were quantified based on geographic location, the tests/thousand population, and the median population age of the countries where the studies were conducted. To assess statistical heterogeneity among the selected articles, the I 2 statistic and the Cochran's Q test were used.ResultsForty-five studies involving R 0 and 34 studies involving CFR were included. The pooled estimation of R 0 was 2.69 (95% CI: 2.40, 2.98), and that of the CFR was 2.67 (2.25, 3.13). The CFR in different regions of the world varied significantly, from 2.49 (2.08, 2.94) in Asia to 3.40 (2.81, 4.04) in North America. We observed higher mean CFR values for the countries with lower tests (3.15 vs 2.16) and greater median population age (3.13 vs 2.27). However, R 0 did not vary significantly in different regions of the world.ConclusionsAn R 0 of 2.69 and a CFR of 2.67 indicate the severity of the COVID-19. Although R 0 and CFR may vary over time, space, and demographics, we recommend considering these figures in control and prevention measures.
| S-EPMC8093857 | biostudies-literature
Project description:Background: With the global spread of novel coronavirus disease 2019 (COVID-19), health care systems are facing formidable challenges. Scientists are conducting studies to explore this new disease, and numerous studies have been shared. However, the number of studies on children with COVID-19 is limited, and no meta-analysis of this group has been performed. Methods: A random-effect meta-analysis was conducted to determine the characteristics of children with COVID-19, including their demographic, epidemiological, clinical, laboratory, imaging features, and outcomes. Four databases and reference lists were screened. Percentages were calculated, and pooled prevalence with 95% confidence intervals (CIs) were reported. Results: Of 195 studies, 33 were selected, and 14 (371 patients) of them were included in the meta-analysis. Then, 19 case reports (25 patients) were summarized separately. Our meta-analysis revealed that 17.4% (95% CI = 9.1-27.3) of children had asymptomatic infection. Fever (51.2%, 95% CI = 40.2-62.2) and cough (37.0%, 95% CI = 25.9-48.8) were the most frequent symptoms. The prevalence of severe or critical illness was almost 0% (95% CI = 0-1.0). The most frequent abnormal laboratory findings, in pediatric patients, were leukopenia/lymphopenia (28.9%, 95% CI = 19.5-39.2) and increased creatine kinase (20.1%, 95% CI = 1.3-49.9). Ground-glass opacity was observed in the CT scan of 53.9% (95% CI = 38.4-68.7) of children diagnosed with pneumonia. Conclusions: Children are at a lower risk of developing COVID-19 and have a milder disease than adults. However, the evidence presented in this study is not satisfactory. Further investigations are urgently needed, and our data will be continuously updated.
| S-EPMC7350605 | biostudies-literature
Project description:The coronavirus disease-2019 (COVID-19) has been found to be caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, comprehensive knowledge of COVID-19 remains incomplete and many important features are still unknown. This manuscript conducts a meta-analysis and a sensitivity study to answer the questions: What is the basic reproduction number? How long is the incubation time of the disease on average? What portion of infections are asymptomatic? And ultimately, what is the case fatality rate? Our studies estimate the basic reproduction number to be 3.15 with the 95% CI (2.41-3.90), the average incubation time to be 5.08 days with the 95% CI (4.77-5.39) (in day), the asymptomatic infection rate to be 46% with the 95% CI (18.48%-73.60%), and the case fatality rate to be 2.72% with 95% CI (1.29%-4.16%) where asymptomatic infections are accounted for.
| S-EPMC7283745 | biostudies-literature
Project description:Rationale: Initial reports of case fatality rates (CFRs) among adults with coronavirus disease (COVID-19) receiving invasive mechanical ventilation (IMV) are highly variable.Objectives: To examine the CFR of patients with COVID-19 receiving IMV.Methods: Two authors independently searched PubMed, Embase, medRxiv, bioRxiv, the COVID-19 living systematic review, and national registry databases. The primary outcome was the "reported CFR" for patients with confirmed COVID-19 requiring IMV. "Definitive hospital CFR" for patients with outcomes at hospital discharge was also investigated. Finally, CFR was analyzed by patient age, geographic region, and study quality on the basis of the Newcastle-Ottawa Scale.Measurements and Results: Sixty-nine studies were included, describing 57,420 adult patients with COVID-19 who received IMV. Overall reported CFR was estimated as 45% (95% confidence interval [CI], 39-52%). Fifty-four of 69 studies stated whether hospital outcomes were available but provided a definitive hospital outcome on only 13,120 (22.8%) of the total IMV patient population. Among studies in which age-stratified CFR was available, pooled CFR estimates ranged from 47.9% (95% CI, 46.4-49.4%) in younger patients (age ≤40 yr) to 84.4% (95% CI, 83.3-85.4%) in older patients (age >80 yr). CFR was also higher in early COVID-19 epicenters. Overall heterogeneity is high (I2 >90%), with nonsignificant Egger's regression test suggesting no publication bias.Conclusions: Almost half of patients with COVID-19 receiving IMV died based on the reported CFR, but variable CFR reporting methods resulted in a wide range of CFRs between studies. The reported CFR was higher in older patients and in early pandemic epicenters, which may be influenced by limited ICU resources. Reporting of definitive outcomes on all patients would facilitate comparisons between studies.Systematic review registered with PROSPERO (CRD42020186997).
| S-EPMC7781141 | biostudies-literature
Project description:The coronavirus disease 2019 (COVID-19) pandemic is still rapidly spreading globally. To probe high-risk cities and the impacts of air pollution on public health, this study explores the relationship between the long-term average concentration of air pollution and the city-level case fatality rate (CFR) of COVID-19 globally. Then, geographically weighted regression (GWR) is applied to examine the spatial variability of the relationships. Six air pollution factors, including nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), PM2.5 (particles with diameter ≤2.5 μm), PM10 (particles with diameter ≤10 μm), and air quality index (AQI), are positively associated with the city-level COVID-19 CFR. Our results indicate that a 1-unit increase in NO2 (part per billion, PPB), SO2 (PPB), O3 (PPB), PM2.5 (microgram per cubic meter, μg/m3), PM10 (μg/m3), AQI (score), is related to a 1.450%, 1.005%, 0.992%, 0.860%, 0.568%, and 0.776% increase in the city-level COVID-19 CFR, respectively. Additionally, the effects of NO2, O3, PM2.5, AQI, and probability of living with poor AQI on COVID-19 spatially vary in view of the estimation of the GWR. In other words, the adverse impacts of air pollution on health are different among the cities. In summary, long-term exposure to air pollution is negatively related to the COVID-19 health outcome, and the relationship is spatially non-stationary. Our research sheds light on the impacts of slashing air pollution on public health in the COVID-19 pandemic to help governments formulate air pollution policies in light of the local situations.
| S-EPMC8724597 | biostudies-literature
Project description:The first COVID-19 case in Nepal was reported on January 23, 2020. Then infection, then, started to spread gradually, and October marked the most devastating increase in COVID-19 cases of the year 2020. Compared with the October 2020 peak in Nepal, the May 2021 peak of COVID-19 observed 2- and 10-fold rise in new cases and deaths per day, respectively. Given that this surprising increase in the death rate was not observed in other countries, this study analyzed the COVID-19 case fatality rates between the two peaks in Nepal. We found an increase in death rates among younger adults and people without comorbidities.
| S-EPMC8653381 | biostudies-literature
Project description:The emergence of COVID-19 virus has led to a pandemic with staggering morbidity and mortality. There is evidence showing that pre-existing conditions and environmental factors are associated with worse COVID-19 outcomes. Among these conditions, altitude is of particular interest. Altitude has been shown to influence the morbidity and mortality of multiple chronic pathologies such as cardiovascular disease, chronic obstructive pulmonary disease and lung cancer. COVID-19 fatality rate has been associated with as altitude as well, but findings are disputed. Therefore, we revisit this assessment with a comprehensive analysis of the relationship between COVID-19 fatality rates and altitude for the Mountain region of the United States while considering the effect of additional comorbidities and sociodemographic factors. A Generalized Additive Model (GAM) approach using one year of county data adjusted by population density was performed to evaluate associations within states and for the whole region. Our analysis revealed a consistent effect where COVID-19 case-fatality rate is decreased with higher altitude, even when controlling for pre-existing conditions and certain demographic variables. In summary, the work presented provides evidence that suggests that the protective effects of high altitude are likely to be influenced by physiologic factors but demographic trends that are associated with life at high altitude must also be considered.
| S-EPMC9610325 | biostudies-literature