bims-covirf 2021-06-20 papers

Issue of 2021–06–20
five papers selected by
Catherine Rycroft, BresMed

PLoS One. 2021 ;16(6): e0253193

Sex differences in the incidence, mortality, and fatality of COVID-19 in Peru.

Max Carlos Ramírez-Soto, Hugo Arroyo-Hernández, Gutia Ortega-Cáceres.

BACKGROUND: There is a worrying lack of epidemiological data on the sex differential in COVID-19 infection and death rates between the regions of Peru.
METHODS: Using cases and death data from the national population-based surveillance system of Peru, we estimated incidence, mortality and fatality, stratified by sex, age and geographic distribution (per 100,000 habitants) from March 16 to November 27, 2020. At the same time, we calculated the risk of COVID-19 death.
RESULTS: During the study period, 961894 cases and 35913 deaths were reported in Peru. Men had a twofold higher risk of COVID-19 death within the overall population of Peru (odds ratio (OR), 2.11; confidence interval (CI) 95%; 2.06-2.16; p<0.00001), as well as 20 regions of Peru, compared to women (p<0.05). There were variations in incidence, mortality and fatality rates stratified by sex, age, and region. The incidence rate was higher among men than among women (3079 vs. 2819 per 100,000 habitants, respectively). The mortality rate was two times higher in males than in females (153 vs. 68 per 100,000 habitants, respectively). The mortality rates increased with age, and were high in men 60 years of age or older. The fatality rate was two times higher in men than in women (4.96% vs. 2.41%, respectively), and was high in men 50 years of age or older.
CONCLUSIONS: These findings show the higher incidence, mortality and fatality rates among men than among women from Peru. These rates vary widely by region, and men are at greater risk of COVID-19 death. In addition, the mortality and fatality rates increased with age, and were most predominant in men 50 years of age or older.

DOI: https://doi.org/10.1371/journal.pone.0253193

J Investig Med. 2021 Jun 16. pii: jim-2021-001858. [Epub ahead of print]

Epidemiological and clinical characteristics of non-severe and severe pediatric and adult COVID-19 patients across different geographical regions in the early phase of pandemic: a systematic review and meta-analysis of observational studies.

Pearleen Ee Yong Chua, Shimoni Urvish Shah, Hao Gui, Jiayun Koh, Jyoti Somani, Junxiong Pang.

This systematic and meta-review aimed to compare clinical presentation, outcomes, and care management among patients with COVID-19 during the early phase of the pandemic. A total of 77 peer-reviewed publications were identified between January 1, 2020 and April 9, 2020 from PubMed, Google Scholar, and Chinese Medical Journal databases. Subsequently, meta-analysis of 40 non-overlapping studies, comprising of 4844 patients from seven countries, was conducted to see differences in clinical characteristics and laboratory outcomes across patients from different geographical regions (Wuhan, other parts of China and outside China), severity (non-severe, severe and fatal) and age groups (adults and children). Patients from Wuhan had a higher mean age (54.3 years) and rates of dyspnea (39.5%) compared with patients from other parts of China and outside China. Myalgia, fatigue, acute respiratory distress syndrome (ARDS) and fatalities were also significantly more prevalent among Wuhan patients. A significant dose-response increase in prevalence of diabetes, D-dimer, white blood cells, neutrophil levels and ARDS was seen from non-severe to severe and fatal outcomes. A significant increase in mean duration of symptom onset to admission was seen between non-severe cases (4.2 days) and severe and fatal cases (6.3 days and 8.8 days, respectively). Proportion of asymptomatic cases was higher in children (20%) compared with adults (2.4%). In conclusion, patients with COVID-19 from Wuhan displayed more severe clinical disease during the early phase of the pandemic, while disease severity was significantly lesser among pediatric cases. This review suggests that biomarkers at admission may be useful for prognosis among patients with COVID-19.

Keywords: COVID-19

DOI: https://doi.org/10.1136/jim-2021-001858

Disaster Med Public Health Prep. 2021 May 03. 1-6

Mortality Rate of Patients With COVID-19 Based on Underlying Health Conditions.

Won-Young Choi.

OBJECTIVE: The aim of this study was to evaluate the mortality rates of 566,602 patients with coronavirus disease (COVID-19) based on sex, age, and the presence or absence of underlying diseases and determine whether the underlying disease provides prognostic information specifically related to death.
METHODS: The mortality rate was evaluated using conditional probability to identify the significant factors, and adjusted odds ratios (ORs) using a multivariable logistic regression analysis were estimated.
RESULTS: The mortality rate of patients with underlying health conditions was 12%, which was 4 times higher than that of patients without underlying health conditions. Furthermore, the mortality rates of women and men with underlying health conditions were 5.5 and 3.4 times higher than the mortality rates of patients without underlying health conditions, respectively. In a multivariable logistic regression analysis including sex, age, and underlying health conditions, male sex (OR: 1.83), age ≥ 41 y (ORs > 2.70), and underlying health conditions (OR: 2.20) were confirmed as risk factors for death.
CONCLUSIONS: More attention should be paid to older patients with underlying diseases and male patients with underlying diseases as the probability of death in this population was significantly higher.

Keywords: COVID-19; health condition; mortality rate; underlying disease

DOI: https://doi.org/10.1017/dmp.2021.139

J Clin Endocrinol Metab. 2021 Jun 17. pii: dgab439. [Epub ahead of print]

Vitamin D deficiency is associated with higher hospitalisation risk from COVID-19: a retrospective case-control study.

Edward B Jude, Stephanie F Ling, Rebecca Allcock, Beverly X Y Yeap, Joseph M Pappachan.

CONTEXT: One of the risk factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is postulated to be vitamin D deficiency. To understand better the role of vitamin D deficiency in the disease course of COVID-19, we undertook a retrospective case-control study in the North West of England (NWE).
OBJECTIVE: To examine whether hospitalisation with COVID-19 is more prevalent in individuals with lower vitamin D levels.
METHODS: The study included individuals with results of serum 25-hydroxyvitamin D (25[OH]D) between 1 st April 2020 and 29th January 2021. Patients were recruited from two districts in NWE. The last 25(OH)D level in the previous 12 months was categorised as 'deficient' if less than 25 nmol/L and 'insufficient' if 25-50 nmol/L.
RESULTS: 80,670 participants were entered into the study. Of these, 1,808 were admitted to hospital with COVID-19, of whom 670 died. In a primary cohort, median serum 25(OH)D in participants who were not hospitalised with COVID-19 was 50.0 [interquartile range, IQR 34.0-66.7] nmol/L versus 35.0 [IQR 21.0-57.0] nmol/L in those admitted with COVID-19 (p <0.005). There were similar findings in a validation cohort (median serum 25(OH)D 47.1 [IQR 31.8-64.7] nmol/L in non-hospitalised versus 33.0 [IQR 19.4-54.1] nmol/L in hospitalised patients). Age-, sex- and seasonal variation-adjusted odds ratios for hospital admission were 2.3-2.4 times higher among participants with serum 25(OH)D <50 nmol/L, compared to those with normal serum 25(OH)D levels, without any excess mortality risk.
CONCLUSIONS: Vitamin D deficiency is associated with higher risk of COVID-19 hospitalisation. Widespread measurement of serum 25(OH)D and treating any unmasked insufficiency or deficiency through testing may reduce this risk.

Keywords: COVID-19; Hospitalisation; Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); Vitamin D deficiency

DOI: https://doi.org/10.1210/clinem/dgab439

Eur J Epidemiol. 2021 Jun 16.

Ethnic differences in COVID-19 mortality during the first two waves of the Coronavirus Pandemic: a nationwide cohort study of 29 million adults in England.

Vahé Nafilyan, Nazrul Islam, Rohini Mathur, Daniel Ayoubkhani, Amitava Banerjee, Myer Glickman, Ben Humberstone, Ian Diamond, Kamlesh Khunti.

Ethnic minorities have experienced disproportionate COVID-19 mortality rates in the UK and many other countries. We compared the differences in the risk of COVID-19 related death between ethnic groups in the first and second waves the of COVID-19 pandemic in England. We also investigated whether the factors explaining differences in COVID-19 death between ethnic groups changed between the two waves. Using data from the Office for National Statistics Public Health Data Asset, a linked dataset combining the 2011 Census with primary care and hospital records and death registrations, we conducted an observational cohort study to examine differences in the risk of death involving COVID-19 between ethnic groups in the first wave (from 24th January 2020 until 31st August 2020) and the first part of the second wave (from 1st September to 28th December 2020). We estimated age-standardised mortality rates (ASMR) in the two waves stratified by ethnic groups and sex. We also estimated hazard ratios (HRs) for ethnic-minority groups compared with the White British population, adjusted for geographical factors, socio-demographic characteristics, and pre-pandemic health conditions. The study population included over 28.9 million individuals aged 30-100 years living in private households. In the first wave, all ethnic minority groups had a higher risk of COVID-19 related death compared to the White British population. In the second wave, the risk of COVID-19 death remained elevated for people from Pakistani (ASMR: 339.9 [95% CI: 303.7-376.2] and 166.8 [141.7-191.9] deaths per 100,000 population in men and women) and Bangladeshi (318.7 [247.4-390.1] and 127.1 [91.1-171.3] in men and women) background but not for people from Black ethnic groups. Adjustment for geographical factors explained a large proportion of the differences in COVID-19 mortality in the first wave but not in the second wave. Despite an attenuation of the elevated risk of COVID-19 mortality after adjusting for sociodemographic characteristics and health status, the risk was substantially higher in people from Bangladeshi and Pakistani background in both the first and the second waves. Between the first and second waves of the pandemic, the reduction in the difference in COVID-19 mortality between people from Black ethnic background and people from the White British group shows that ethnic inequalities in COVID-19 mortality can be addressed. The continued higher rate of mortality in people from Bangladeshi and Pakistani background is alarming and requires focused public health campaign and policy changes.

Keywords: COVID-19; Ethnicity; Mortality

DOI: https://doi.org/10.1007/s10654-021-00765-1