bims-covirf 2021-05-30 papers

Issue of 2021–05–30
three papers selected by
Catherine Rycroft, BresMed

Clin Infect Dis. 2021 May 27. pii: ciab493. [Epub ahead of print]

Risk Factors for Death Among the First 80 543 COVID-19 Cases in China: Relationships Between Age, Underlying Disease, Case Severity, and Region.

BACKGROUND: Knowledge of COVID-19 epidemiology remains incomplete and crucial questions persist. We aimed to examine risk factors for COVID-19 death.
METHODS: A total of 80 543 COVID-19 cases reported in China, nationwide, through April 8, 2020 were included. Risk factors for death were investigated by Cox proportional hazards regression and stratified analyses.
RESULTS: Overall national case fatality ratio (CFR) was 5.64%. Risk factors for death were older age (≥80: adjusted hazard ratio [aHR]=12.58, 95% confidence interval [CI]=6.78-23.33), presence of underlying disease (aHR=1.33, CI=1.19-1.49), worse case severity (severe: aHR=3.86, CI=3.15-4.73; critical: aHR=11.34, CI=9.22-13.95), and near-epicenter region (Hubei: aHR=2.64, CI=2.11-3.30; Wuhan: aHR=6.35, CI=5.04-8.00). CFR increased from 0.35% (30-39 years) to 18.21% (≥70 years) without underlying disease. Regardless of age, CFR increased from 2.50% for no underlying disease to 7.72% for 1, 13.99% for 2, and 21.99% for ≥3. CFR increased with worse case severity from 2.80% (mild), to 12.51% (severe) and 48.60% (critical) regardless of region. Compared to other regions, CFR was much higher in Wuhan regardless of case severity (mild: 3.83% versus 0.14% in Hubei and 0.03% elsewhere; moderate: 4.60% versus 0.21% and 0.06%; severe: 15.92% versus 5.84% and 1.86%; and critical: 58.57% versus 49.80% and 18.39%).
CONCLUSIONS: Older patients regardless of underlying disease and patients with underlying disease regardless of age were at elevated risk of death. Higher death rates near the outbreak epicenter and during the surge of cases reflect the deleterious effects of allowing health systems to become overwhelmed.

Keywords: COVID-19; Case fatality ratio; China; SARS-CoV-2; risk factors

DOI: https://doi.org/10.1093/cid/ciab493

Int J Clin Pract. 2021 May 22. e14383

Correlation of Racial Effect with Severity of Disease and In-Hospital Outcome in Individuals Diagnosed with COVID-19.

Abdullah Rashid Alotaibi, Tarek Ezzeldin, Intisar Ahmed Siddiqui, Mosa Saeed Alzahrani, Mohammed Ahmed Alghamdi, Wijdan Hasan Alotaibi, Malik Zwaid Almutairi, Naif Khalid Alqannas.

INTRODUCTION: Many countries have diverse population and hence, studies have been conducted to find the relation between ethnic or racial groups within a society and incidence or mortality due to COVID-19.
OBJECTIVES: Aim of the study was to evaluate the racial effect on severity of disease and in-hospital outcome in individuals diagnosed with COVID-19.
MATERIAL AND METHODS: This retrospective study based on records of 804 tested positive COVID-19 patients presented at Dammam Medical Complex and Braira quarantine during March to May 2020 was conducted after approval from the ethical board. Patient's records included the routine patient's consent statement about explanation of all the investigations and procedures prior to be performed. Data were retrieved included in analysis were age, gender, country of origin, racial background (Arab, Caucasian, Asian, Black, Latin, and Hispanic), severity of COVID-19 and outcome.
RESULTS: Out of total 804 confirmed patients of covid-19, there were 647 (80.5%) males and 157 (19.5%) females (M: F ratio = 4.1: 1). Male preponderance was seen in all racial groups, and significantly higher in Asian than the Middle Eastern race (91.2% vs. 70.3%, p=0.000). Mean age of Asians was significantly higher than the mean age of the Middle Eastern and Black & Caucasian races (42.8±10.0 vs. 39.6±16.3 vs. 37.0±10.3, p=0.003). proportion of deaths was significantly high among Asians (5.4%) compare to Middle Eastern patients (1.2%) (p-value 0.001).
CONCLUSION: Severity and in-hospital outcome were varying significantly among the racial groups. East & South Asian COVID-19 patients had more severe symptoms and less recovery rate compare to other groups, late presentation may be a contributory reason.

Keywords: COVID-19; In-hospital Outcome; Racial Effect; severity

DOI: https://doi.org/10.1111/ijcp.14383

Turk J Med Sci. 2021 May 23.

Malignancy is a risk factor for higher COVID-19 severity:A meta-analysis.

G E Liu, Wei Cai, Huan Liu, Hai Hong Jiang, Yong Yi Bi, Hong Wang.

BACKGROUND: The outbreak of coronavirus disease 2019 (COVID-19) has been an almost global pandemic with significant public health impacts. The increasing prevalence of malignancy has become a leading cause of human mortality. However, conflicting findings have been published on the association between malignancy and COVID-19 severity. This study aims to assess the pooled proportion of malignancy amongst 2019-nCov patients and to investigate the association between malignancy and COVID-19 severity.
METHODS: Correlative studies were identi?ed by systematically searching electronic databases (PubMed, Web of Sciences and Embase) up to September 2, 2020. All data analyses were carried out using Stata 15.0.
RESULTS: Twenty-nine studies consisting of 9475 confirmed COVID-19 patients (median age 54.4 years [IQR 49-62], 54.0% men) were included. The overall proportion of malignancy was 2.5% (95% CI 1.6%-3.4%). The proportion of malignancy was higher in patients with severe/critical 2019-nCoV than those in non-severe/non-critical group (3.9% [95% CI 2.0-6.3] vs 1.4% [95% CI 0.8-2.2]). Furthermore, pre-existing malignancy was associated with more than twofold higher risk of severe/critical patients with COVID-19 (OR 2.25, 95% CI 1.65-3.06 I2 = 0.0%).
CONCLUSION: Malignancy was associated with up to 2.3-fold higher risk of severe/critical COVID-19 and may serve as a clinical predictor for adverse outcomes.

Keywords: 2019-nCoV; COVID-19; malignancy; meta-analysis

DOI: https://doi.org/10.3906/sag-2101-192