Infection fatality rate of COVID-19 in community-dwelling elderly populations

European Journal of Epidemiology - This mixed design synthesis aimed to estimate the infection fatality rate (IFR) of Coronavirus Disease 2019 (COVID-19) in community-dwelling elderly populations...     

基于马尔科夫链蒙特卡罗模拟方法的COVID-19年龄别病死率估计

目的 新型冠状病毒肺炎疫情已席卷全球,疫情结束前,其病死率的估计受现有确诊病例和发病到死亡时间分布的影响,且结论尚不明确,本研究旨在对新型冠状病毒肺炎的年龄别病死率进行估计。方法 收集国家卫生健康委员会和CDC发布的新型冠状病毒肺炎疫情数据信息,采用Gamma分布拟合发病到死亡时间分布规律,采用马尔科夫链蒙特卡罗模拟估计年龄别病死率。结果 新型冠状病毒肺炎的发病到死亡时间M=13.77（P₂₅～P₇₅：9.03～21.02）d,总病死率为4.1%（95% CI：3.7%～4.4%）,0～、10～、20～、30～、40～、50～、60～、70～和≥80岁组病死率分别为0.1%、0.4%、0.4%、0.4%、0.8%、2.3%、6.4%、14.0%和25.8%。结论 校正删失的马尔科夫链蒙特卡罗模拟方法适用于新发突发传染病疫情期间的病死率估计,尽早明确新型冠状病毒肺炎的病死率有助于疫情的防控。     

Demographics of COVID-19 hospitalisations and related fatality risk patterns

The assessment of hospitalisations and intensive care is crucial for planning health care resources needed over the course of the coronavirus disease 2019 (COVID-19) pandemic. Nonetheless, comparative empirical assessments of COVID-19 hospitalisations and related fatality risk patterns on a large scale are lacking.This paper exploits anonymised, individual-level data on SARS-CoV-2 confirmed infections collected and harmonized by the European Centre for Disease Prevention and Control to profile the demographics of COVID-19 hospitalised patients across nine European countries during the first pandemic wave (February – June 2020). We estimate the role of demographic factors for the risk of in-hospital mortality, and present a case study exploring individuals’ comorbidities based on a subset of COVID-19 hospitalised patients available from the Dutch health system.We find that hospitalisation rates are highest among individuals with confirmed SARS-CoV-2 infection who are not only older than 70 years, but also 50-69 years. The latter group has a longer median time between COVID-19 symptoms’ onset and hospitalisation than those aged 70+ years. Men have higher hospitalisation rates than women at all ages, and particularly above age 50. Consistently, men aged 50-59 years have a probability of hospitalisation almost double than women do. Although the gender imbalance in hospitalisation remains above age 70, the gap between men and women narrows at older ages. Comorbidities play a key role in explaining selection effects of COVID-19 confirmed positive cases requiring hospitalisation.Our study contributes to the evaluation of the COVID-19 burden on the demand of health-care during emergency phases. Assessing intensity and timing dimensions of hospital admissions, our findings allow for a better understanding of COVID-19 severe outcomes. Results point to the need of suitable calibrations of epidemiological projections and (re)planning of health services, enhancing preparedness to deal with infectious disease outbreaks.     

Clinico-Epidemiological Profile of Breakthrough COVID-19 Infection among Vaccinated Beneficiaries from a COVID-19 Vaccination Centre in Bihar,India

BackgroundWhen the whole world is fighting in an unprecedented pace against COVID-19 pandemic, the breakthrough COVID infections poise to dampen the rapid control of the same. We carried out this project with two objectives; first, to estimate the proportion of breakthrough COVID-19 infection among completely vaccinated individuals and second, to study the clinico-epidemiological profile of breakthrough COVID-19 infections among them.MethodsThis cross-sectional analytical study was conducted among 2703 fully vaccinated individuals from AIIMS, Patna COVID Vaccination Centre (CVC), Bihar, India. The participants were selected randomly using a systematic sampling technique from the list of beneficiaries maintained at the CVC. Telephonic interviews were made to collect the information by trained data collectors.ResultsA total of 274 fully vaccinated beneficiaries [10.1% (95% CI: 9.1%, 11.4%)] were diagnosed with breakthrough COVID-19 infection. The infections were more among males (10.4%) and the individuals aged ≤29 years (12.5%). The beneficiary categories, the healthcare-worker and the frontline-worker, were identified as predictors of the breakthrough COVID infections. Only one in three participants had adopted adequate COVID appropriate behaviour following the full vaccination. The majority of the breakthrough infections occurred during the second wave of COVID-19. The majority of the individuals with breakthrough infections were asymptomatic and no death was reported among them.ConclusionOne in every ten fully vaccinated individuals can get the breakthrough COVID infections. The healthcare-worker and the frontline-worker had independent risk of getting the breakthrough infections. Very few with breakthrough infections were serious and no death was reported among them.     

Associations of pre-existing cardiovascular morbidity with severity and the fatality rate in COVID-19 patients: a systematic review and meta-analysis

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 3 times (OR, 3.2; 95% CI, 2.0 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.     

火神山医院新冠肺炎感染病房感控管理措施

目的探讨新型冠状病毒肺炎疫情期间感染病房的管理措施,避免交叉感染,促进患者快速康复。方法密切关注疫情动态,根据国家传染病防治相关法律法规及卫生行政部门发布的规范性文件,结合火神山医院感染病房实际情况,对火神山医院感染病房感控管理措施进行总结,梳理工作要点。结果新冠疫情期间,火神山医院感控工作安全有序开展,患者无交叉感染,医护人员“零感染”。结论感控管理措施科学有效,可为其他感染病房疫情防控提供参考     

COVID-19 spatiotemporal research with workflow-based data analysis

Given the pertinence and acceleration of the spread of COVID-19, there is an increased need for the replicability of data models to verify the veracity of models and visualize important data. Most of these visualizations lack reproducibility, credibility, or accuracy, and are static, which makes it difficult to analyze the spread over time. Furthermore, most current visualizations depicting the spread of COVID-19 are at a global or country level, meaning there is a dearth of regional analysis within a country. Keeping these issues in mind, a replicable, efficient, and simple method to generate regional COVID-19 visualizations mapped with time was created by using the KNIME software, an open-source data analytics platform that can create user-friendly applications or workflows. For this analysis, Albania, Sweden, Ukraine, Denmark, Russia, India, and Australia were closely observed. Among the maps generated for the aforementioned countries, it was noticed that regions with a high population or high population density were often the epicenters within their respective country. The regions caused the virus to spread to their neighboring regions: kickstarting the “domino effect”, leading to the infection of another region until the country is overwhelmed with cases—what we call a proximity trend. These dynamic maps are crucial to fighting the pandemic because they can provide insight as to how COVID-19 spreads by providing researchers or officials with an accurate and insightful tool to aid their analysis. By being able to visualize the spread, health and government officials can dive deeper to identify the sources of transmission and attempt to stop or reverse them accordingly.     

新型冠状病毒肺炎疫情期间孕产妇感染防控模式探索

孕产妇是新型冠状病毒易感人群,一旦感染,病情发展迅速,易进展为重症,因此,应高度重视孕产妇新型冠状病毒肺炎防控,避免孕产妇院内感染暴发。结合医院实际,从新型冠状病毒肺炎疫情期间孕产妇分级防控体系、分区分类管理、接诊处理、信息报送、日常督查及出院远程随访等内容进行探讨,旨在探索综合医院新型冠状病毒肺炎疫情期间孕产妇感染防控管理模式。     

Inferring rubella outbreak risk from seroprevalence data in Belgium

Rubella is usually a mild disease for which infections often pass by unnoticed. In approximately 50% of the cases, there are no or only few clinical symptoms. However, rubella contracted during early pregnancy could lead to spontaneous abortion, to central nervous system defects, or to one of a range of other serious and debilitating conditions in a newborn such as the congenital rubella syndrome. Before the introduction of mass vaccination, rubella was a common childhood infection occurring all over the world. However, since the introduction of rubella antigen-containing vaccines, the incidence of rubella has declined dramatically in high-income countries. Recent large-scale mumps outbreaks, one of the components in the combined measles-mumps-rubella vaccine, occurring in countries throughout Europe with high vaccination coverage, provide evidence of pathogen-specific waning of vaccine-induced immunity and primary vaccine failure. In addition, recent measles outbreaks affecting populations with suboptimal vaccination coverages stress the importance of maintaining high vaccination coverages. In this paper, we focus on the assessment of rubella outbreak risk using a previously developed method to identify geographic regions of high outbreak potential. The methodology relies on 2006 rubella seroprevalence data and vaccination coverage data from Belgium and information on primary and secondary vaccine failure obtained from extensive literature reviews. We estimated the rubella outbreak risk in Belgium to be low, however maintaining high levels of immunisation and surveillance are of utmost importance to avoid future outbreaks.     

Multisystem Inflammatory Syndrome after SARS-CoV-2 Infection and COVID-19 Vaccination

We report 3 patients in California, USA, who experienced multisystem inflammatory syndrome (MIS) after immunization and severe acute respiratory syndrome coronavirus 2 infection. During the same period, 3 adults who were not vaccinated had MIS develop at a time when ≈7% of the adult patient population had received >1 vaccine.     

基于网络数据的新型冠状病毒肺炎流行特征分析

目的  分析新型冠状病毒肺炎(coronavirus disease 2019, COVID-19, 简称“新冠肺炎”)的流行病学特征与部分临床特征,为新冠肺炎的防控提供参考依据。 方法  通过爬虫技术爬取“今日头条”网站发布的新冠肺炎确诊病例及其活动轨迹信息,进行统计分析。 结果  2020年1月8日-2020年2月16日,共收集到病例6 814例,省会及直辖市病例数占15.13%,地级市及县镇病例数占63.98%,农村病例数占比13.41%;新冠肺炎确诊人数呈先增加后减少的趋势;男性确诊患者数量较女性确诊患者数量多5.85%,不同年龄段的性别构成差异有统计学意义(x² =36.466,P < 0.001);患者年龄中位数为45岁,18~45岁分段人数最多,占44.35%;患者潜伏期中位数为8 d,潜伏期在1~14 d内的患者占86%,不同年龄段分组,男女潜伏期天数的差异均无统计学意义(均有P>0.05)。 结论  人群对新型冠状病毒普遍易感,潜伏期符合一般病毒的规律。由于我国疫情防控措施得当,且传播风险期短,疫情的发展得到遏制。新冠肺炎流行病学特征的研究成果将为我国新冠肺炎新一波疫情防控和复工复学的策略制定提供参考依据。     

A Neighborhood Analysis of Time Trends in COVID-19 Infection in NYC

To understand how observed COVID-19 diagnostic testing disparities across New York City (NYC) have impacted infection rates and COVID-19 spread, we examined neighborhood-level factors associated with, and the spatial distribution of, antibody test and infection rates, and compared changes over time by NYC ZIP code tabulation area (ZCTA). Data were obtained from 2019 American Community Survey 5-year estimates to create an SES index by ZCTA. Other predictors obtained from 2018 census data were the proportions of white residents, Hispanic residents and residents ≥ 65 years old. Multivariable Poisson regressions were performed to assess the rate of change for antibody testing and positivity, and to assess the independent associations with SES, race and age. Results: There was a significant association between the rate of antibody tests and SES quartiles (Q1: β_adj = 0.04, Q2: β_adj = 0.03 and Q3: β_adj = ? 0.03, compared to Q4), and the proportion of residents who are white (β_adj = 0.004, p < .0001), Hispanic   (β_adj = 0.001, p < .0001), and ≥ 65 years (β_adj = 0.01, p < .0001). Total number of positive antibody tests was significantly inversely associated with SES quartile (Q1: β_adj = 0.50, Q2: β_adj = 0.48 and Q3: β_adj = 0.29, compared to Q4), and proportion of white residents (β = ? 0.001, p < .0001) and ≥ 65 years (β = ? 0.02, p < .0001), and significantly positively associated with proportion of Hispanic residents (β = 0.003, p < .0001). There are disparities in antibody testing and positivity, reflecting disproportionate impacts and undercounts of COVID-19 infection across NYC ZCTAs. Future public health response should increase testing in these vulnerable areas to diminish infection spread.