bims-covirf 2020-12-13 papers

Issue of 2020–12–13
five papers selected by
Catherine Rycroft, BresMed

Healthc (Amst). 2020 Nov 21. pii: S2213-0764(20)30094-4. [Epub ahead of print]9(1): 100495

Association of race, ethnicity, and community-level factors with COVID-19 cases and deaths across U.S. counties.

Jose F Figueroa, Rishi K Wadhera, Winta T Mehtsun, Kristen Riley, Jessica Phelan, Ashish K Jha.

The United States currently has one of the highest numbers of cumulative COVID-19 cases globally, and Latino and Black communities have been disproportionately affected. Understanding the community-level factors that contribute to disparities in COVID-19 case and death rates is critical to developing public health and policy strategies. We performed a cross-sectional analysis of U.S. counties and found that a 10% point increase in the Black population was associated with 324.7 additional COVID-19 cases per 100,000 population and 14.5 additional COVID-19 deaths per 100,000. In addition, we found that a 10% point increase in the Latino population was associated with 293.5 additional COVID-19 cases per 100,000 and 7.6 additional COVID-19 deaths per 100,000. Independent predictors of higher COVID-19 case rates included average household size, the share of individuals with less than a high school diploma, and the percentage of foreign-born non-citizens. In addition, average household size, the share of individuals with less than a high school diploma, and the proportion of workers that commute using public transportation independently predicted higher COVID-19 death rates within a community. After adjustment for these variables, the association between the Latino population and COVID-19 cases and deaths was attenuated while the association between the Black population and COVID-19 cases and deaths largely persisted. Policy efforts must seek to address the drivers identified in this study in order to mitigate disparities in COVID-19 cases and deaths across minority communities.

DOI: https://doi.org/10.1016/j.hjdsi.2020.100495

PLoS One. 2020 ;15(12): e0243191

Prevalence and predictors of death and severe disease in patients hospitalized due to COVID-19: A comprehensive systematic review and meta-analysis of 77 studies and 38,000 patients.

Kunchok Dorjee, Hyunju Kim, Elizabeth Bonomo, Rinchen Dolma.

INTRODUCTION: Progression of COVID-19 to severe disease and death is insufficiently understood.
OBJECTIVE: Summarize the prevalence of risk factors and adverse outcomes and determine their associations in COVID-19 patients who were hospitalized.
METHODS: We searched Medline, Embase and Web of Science for case-series and observational studies of hospitalized COVID-19 patients through August 31, 2020. Data were analyzed by fixed-effects meta-analysis using Shore's adjusted confidence intervals to address heterogeneity.
RESULTS: Seventy-seven studies comprising 38906 hospitalized patients met inclusion criteria; 21468 from the US-Europe and 9740 from China. Overall prevalence of death [% (95% CI)] from COVID-19 was 20% (18-23%); 23% (19-27%) in the US and Europe and 11% (7-16%) for China. Of those that died, 85% were aged≥60 years, 66% were males, and 66%, 44%, 39%, 37%, and 27% had hypertension, smoking history, diabetes, heart disease, and chronic kidney disease (CKD), respectively. The case fatality risk [%(95% CI)] were 52% (46-60) for heart disease, 51% (43-59) for COPD, 48% (37-63) for chronic kidney disease (CKD), 39% for chronic liver disease (CLD), 28% (23-36%) for hypertension, and 24% (17-33%) for diabetes. Summary relative risk (sRR) of death were higher for age≥60 years [sRR = 3.6; 95% CI: 3.0-4.4], males [1.3; 1.2-1.4], smoking history [1.3; 1.1-1.6], COPD [1.7; 1.4-2.0], hypertension [1.8; 1.6-2.0], diabetes [1.5; 1.4-1.7], heart disease [2.1; 1.8-2.4], CKD [2.5; 2.1-3.0]. The prevalence of hypertension (55%), diabetes (33%), smoking history (23%) and heart disease (17%) among the COVID-19 hospitalized patients in the US were substantially higher than that of the general US population, suggesting increased susceptibility to infection or disease progression for the individuals with comorbidities.
CONCLUSIONS: Public health screening for COVID-19 can be prioritized based on risk-groups. Appropriately addressing the modifiable risk factors such as smoking, hypertension, and diabetes could reduce morbidity and mortality due to COVID-19; public messaging can be accordingly adapted.

DOI: https://doi.org/10.1371/journal.pone.0243191

Intervirology. 2020 Dec 09. 1-12

Association of Sex, Age, and Comorbidities with Mortality in COVID-19 Patients: A Systematic Review and Meta-Analysis.

Mohitosh Biswas, Shawonur Rahaman, Tapash Kumar Biswas, Zahirul Haque, Baharudin Ibrahim.

INTRODUCTION: Although severe acute respiratory syndrome coronavirus-2 infection is causing mortality in considerable proportion of coronavirus disease-2019 (COVID-19) patients, however, evidence for the association of sex, age, and comorbidities on the risk of mortality is not well-aggregated yet. It was aimed to assess the association of sex, age, and comorbidities with mortality in COVID-2019 patients.
METHODS: Literatures were searched using different keywords in various databases. Relative risks (RRs) were calculated by RevMan software where statistical significance was set as p < 0.05.
RESULTS: COVID-19 male patients were associated with significantly increased risk of mortality compared to females (RR 1.86: 95% confidence interval [CI] 1.67-2.07; p < 0.00001). Patients with age ≥50 years were associated with 15.4-folds significantly increased risk of mortality compared to patients with age <50 years (RR 15.44: 95% CI 13.02-18.31; p < 0.00001). Comorbidities were also associated with significantly increased risk of mortality; kidney disease (RR 4.90: 95% CI 3.04-7.88; p < 0.00001), cereborovascular disease (RR 4.78; 95% CI 3.39-6.76; p < 0.00001), cardiovascular disease (RR 3.05: 95% CI 2.20-4.25; p < 0.00001), respiratory disease (RR 2.74: 95% CI 2.04-3.67; p < 0.00001), diabetes (RR 1.97: 95% CI 1.48-2.64; p < 0.00001), hypertension (RR 1.95: 95% CI 1.58-2.40; p < 0.00001), and cancer (RR 1.89; 95% CI 1.25-2.84; p = 0.002) but not liver disease (RR 1.64: 95% CI 0.82-3.28; p= 0.16).
CONCLUSION: Implementation of adequate protection and interventions for COVID-19 patients in general and in particular male patients with age ≥50 years having comorbidities may significantly reduce risk of mortality associated with COVID-19.

Keywords: Coronavirus disease-2019; Demographic characteristics; Risk of mortality; Severe acute respiratory syndrome coronavirus-2

DOI: https://doi.org/10.1159/000512592

Med J Islam Repub Iran. 2020 ;34 88

Investigating the factors affecting the survival rate in patients with COVID-19: A retrospective cohort study.

Babak Eshrati, Hamid Reza Baradaran, Saeed Erfanpoor, Arash Mohazzab, Yousef Moradi.

Background: As hospitalized patients with COVID-19, especially those who are admitted to ICU or die afterwards, generally have comorbidities, the aim of this study was to determine the factors affecting the survival rate of COVID-19 patients in Iran using a retrospective cohort. Methods: This retrospective cohort study was conducted on patients with COVID-19 who referred to medical centers under the supervision of Iran University of Medical Sciences, Tehran, Iran, from February 22 to March 25, 2020. The final date of follow-up was April 19, 2020. All consecutive inpatients with laboratory-confirmed COVID-19 were included in this study. Clinical laboratory, radiological, treatment, and demographic data were collected and analyzed. The associations among gender, immune disease, diabetes, liver disease, cardiovascular disease, kidney disease, chronic pulmonary disease, cancer, chronic nervous disease, type of treatment, and risk of death were analyzed. The Kaplan-Meier and Log-rank tests were used to estimate survival rate and compare survival rates, respectively. Results: The total number of deaths or desired event in the study was 329 (10.3%).The risk of death in the age groups of 50-60 years, 60-70 years, and >70 years compared to the 30-40 age group was 2.17 (95% CI: 1.03, 4.55; p: 0.040); 3.72 (95 % CI: 1.80, 7.68; p: 0.001) and 5.09 (95 % CI: 2.49, 10.40; p: 0.001), respectively. The results showed men had 11.5% more risk of deaths than women (HR: 1.11; 95 % CI: 0.89, 1.39; p: 0.341). Kidney disease increased the risk of death by 52.3% in these patients, which was not statistically significant (HR: 1.78; 95 % CI: 1.04, 3.04; p: 0.035). Also, chronic pulmonary diseases and diabetes increased the risk of death in COVID-19 patients by 89.5% and 41.3% compared to COVID-19 patients without chronic pulmonary diseases and diabetes [(HR: 1.89; 95 % CI: 1.17, 3.04; p: 0.008), (HR: 1.41; 95 % CI: 1.01, 1.96; p: 0.038)]. Conclusion: Based on the results of this study, more attention and care should be paid to COVID-19 patients with underlying diseases, such as chronic obstructive pulmonary disease, diabetes, and kidney disease to reduce the number of deaths.

Keywords: COVID-19; Death; Iran; Risk Factors; Survival Rate

DOI: https://doi.org/10.34171/mjiri.34.88

Saudi J Biol Sci. 2020 Dec 03.

Combination of obesity and co-morbidities leads to unfavorable outcomes in COVID-19 patients.

Saba Al Heialy, Mahmood Yaseen Hachim, Ibrahim Yaseen Hachim, Kashif Bin Naeem, Haifa Hannawi, Issa Al Salmi, Suad Hannawi.

Objective: Obesity has been described as a significant independent risk factors of COVID-19. We aimed to study the association between obesity, co-morbidities and clinical outcomes of COVID-19.
Methods: Clinical data from 417 patients were collected retrospectively from the Al Kuwait Hospital, Ministry of Health and Prevention (MOHAP), Dubai, United Arab Emirates, who were admitted between March and June 2020. Patients were divided according to their body mass index (BMI). Various clinical outcomes were examined: presenting symptoms, severity, major co-morbidities, ICU admission, death, ventilation, ARDS, septic shock and laboratory parameters.
Results: The average BMI was 29 ± 6.2 kg/m2. BMI alone was not associated with the outcomes examined. However, class II obese patients had more co-morbidities compared to other groups. Hypertension was the most significant co-morbidity associated with obesity. Patients with BMI above the average BMI (29 kg/m2) and presence of underlying co-morbidities showed significant increase in admission to ICU compared to patients below 29 kg/m2 and underlying co-morbidities (21.7% Vs. 9.2%), ARDS development (21.7% Vs. 10.53%), need for ventilation (8.3% Vs. 1.3%), and mortality (10% Vs. 1.3%).
Conclusions: Our data suggests that presence of underlying co-morbidities and high BMI work synergistically to affect the clinical outcomes of COVID-19.

Keywords: COVID-19; co-morbidities; obesity; severity

DOI: https://doi.org/10.1016/j.sjbs.2020.11.081