scholarly journals Decreasing case fatality rate following invasive pneumococcal disease, North East England, 2006–2016

2019 ◽  
Vol 147 ◽  
Author(s):  
C. Houseman ◽  
K. E. Chapman ◽  
P. Manley ◽  
R. Gorton ◽  
D. Wilson ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Case Fatality Rate ◽  
Pneumococcal Disease ◽  
Demographic Data ◽  
Case Fatality ◽  
Risk Groups ◽  
Significant Decline ◽  
Fatality Rate ◽  
North East ◽  
Increased Risk

AbstractDeclining mortality following invasive pneumococcal disease (IPD) has been observed concurrent with a reduced incidence due to effective pneumococcal conjugate vaccines. However, with IPD now increasing due to serotype replacement, we undertook a statistical analysis to estimate the trend in all-cause 30-day case fatality rate (CFR) in the North East of England (NEE) following IPD. Clinical, microbiological and demographic data were obtained for all laboratory-confirmed IPD cases (April 2006–March 2016) and the adjusted association between CFR and epidemiological year estimated using logistic regression. Of the 2510 episodes of IPD included in the analysis, 486 died within 30 days of IPD (CFR 19%). Increasing age, male sex, a diagnosis of septicaemia, being in ⩾1 clinical risk groups, alcohol abuse and individual serotypes were independently associated with increased CFR. A significant decline in CFR over time was observed following adjustment for these significant predictors (adjusted odds ratio 0.93, 95% confidence interval 0.89–0.98; P = 0.003). A small but significant decline in 30-day all-cause CFR following IPD has been observed in the NEE. Nonetheless, certain population groups remain at increased risk of dying following IPD. Despite the introduction of effective vaccines, further strategies to reduce the ongoing burden of mortality from IPD are needed.

scholarly journals Age-Dependent Serotype-Associated Case-Fatality Rate in Invasive Pneumococcal Disease in the Autonomous Community of Madrid between 2007 and 2020

2021 ◽  
Vol 9 (11) ◽  
pp. 2286
Author(s):  
Sara De Miguel ◽  
Pello Latasa ◽  
José Yuste ◽  
Luis García ◽  
María Ordobás ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Case Fatality Rate ◽  
Pneumococcal Disease ◽  
Case Fatality ◽  
Fatality Rate ◽  
Incidence And Mortality ◽  
High Incidence ◽  
Common Serotypes ◽  
Low Levels ◽  
Quellung Reaction

The aim of this study was to investigate the serotype-associated fatality rate in cases of invasive pneumococcal disease (IPD) in the Spanish region of Madrid between 2007 and 2020. Serotyping was performed by Pneumotest Latex and the Quellung reaction using commercial antisera. Case-fatality rate was estimated as the ratio between the number of deaths at hospital discharge and the number of cases attributable to each serotype. To evaluate the association measures, the odds ratios with a 95% confidence interval were calculated. Twenty five pneumococcal serotypes were associated to mortality and comprised 87.8% of the total number of isolates characterized. Serotypes 8, 3, 19A, 1, 7F, 22F, 12F, and 11A were the most prevalent (≥3% each). Serotypes 31, 11A, and 19F were significantly associated to high case-fatality rates (>20% each). The lower significantly associated case-fatality rate (<10% each) was found in serotypes 5, 1, 12B, 7F, 12F, 8, 33, and 10A. The serotypes with higher mortality levels (≥0.04 per 100,000 population) were 11A (fatality 24.0%), 3 (fatality 18.7%), 19A (fatality 12.5%), and 8 (fatality 7.2%). Serotype 3 was worrisome because it is associated with important fatality levels combined with very high incidence and mortality rates. Serotype 11A also showed a high fatality with marked incidence and mortality levels. Some few frequent serotypes as 31, 19F, and 15A despite its high fatality had low levels of mortality. By contrast other serotypes as 8 showing low fatality had high mortality ranges because it shows a wide extended distribution. Finally, common serotypes, such as 1 and 5, presented small mortality length, due to their low case-fatality rates.

scholarly journals Invasive pneumococcal disease in hospitalised children from Lima, Peru before and after introduction of the 7-valent conjugated vaccine

2019 ◽  
Vol 147 ◽  
Author(s):  
A. Luna-Muschi ◽  
F. Castillo-Tokumori ◽  
M. P. Deza ◽  
E. H. Mercado ◽  
M. Egoavil ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Case Fatality Rate ◽  
Pneumococcal Disease ◽  
Case Fatality ◽  
Fatality Rate ◽  
Erythromycin Resistance ◽  
National Immunisation ◽  
National Immunisation Program ◽  
Before And After ◽  
Sterile Site

AbstractThe objective of this study was to determine the serotype distribution and antibiotic resistance of invasive pneumococcal disease (IPD) strains in children from Lima, Peru, before and after the introduction of the 7-valent pneumococcal conjugate vaccine (PCV7), which was introduced in the national immunisation program on 2009. We conducted a prospective, multicentre, passive surveillance IPD study during 2006–2008 and 2009–2011, before and right after the introduction of PCV7 in Peru. The study was performed in 11 hospitals and five private laboratories in Lima, Peru, in patients <18 years old, with sterile site cultures yielding Streptococcus pneumoniae. In total 159 S. pneumoniae isolates were recovered. There was a decrease in the incidence of IPD in children <2 years old after the introduction of PCV7 (18.4/100 000 vs. 5.1/100 000, P = 0.004). Meningitis cases decreased significantly in the second period (P = 0.036) as well as the overall case fatality rate (P = 0.025), including a decreased case fatality rate of pneumonia (16.3% to 0%, P = 0.04). PCV7 serotypes showed a downward trend. Vaccine-preventable serotypes caused 78.9% of IPD cases, mainly 14, 6B, 5, 19F and 23F. A non-significant increase in erythromycin resistance was reported. Our findings suggest that the introduction of PCV7 led to a significant decrease of IPD in children under 2 years old and in the overall case fatality rate.

scholarly journals 1309. Incidence and Epidemiology of Invasive Pneumococcal Disease due to Serotype 3 in South-Central Ontario

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S743-S743
Author(s):  
Allison McGeer ◽  
Agron Plevneshi ◽  
Kazi Hassan ◽  
Wayne Gold ◽  
Larissa Matukas ◽  
...  
Keyword(s):  
Older Adults ◽  
Invasive Pneumococcal Disease ◽  
Case Fatality Rate ◽  
Pneumococcal Disease ◽  
Case Fatality ◽  
Population Based ◽  
Fatality Rate ◽  
South Central ◽  
Study Laboratory ◽  
Over Time

Abstract Background In our population, the most common serotype (ST) of S. pneumoniae causing invasive pneumococcal disease (IPD) is now ST 3. We undertook an analysis of population based surveillance for IPD to examine the incidence and epidemiology of ST 3 disease over the last 25 years. Methods The Toronto Invasive Bacterial Diseases Network has performed population-based surveillance for IPD in Toronto/Peel region (pop’n 4.5M) since 1995. All sterile site isolates of S. pneumoniae are reported to a central study laboratory, isolates are serotyped, and clinical and vaccination data are collected via patient and physician interview and chart review. Population data are obtained from Statistics Canada. Results From 1995-2020, 11032 episodes of IPD occurred; 10015 had STs available, and 10484 clinical data. Overall, ST 3 comprised 9.2% of cases (N=931). Compared to other patients with IPD, those with ST 3 IPD were older (median age 65 vs. 58.5, P&lt; .001), more likely to have underlying lung (22.7% v 16.0%, P&lt; .0001) and cardiac (21.7 v 18.4, P=.02) disease and less likely to be immunocompromised (IC) (23.1% v 29.0% P&lt; .0001). ST3 episodes were more likely to be pneumonia (81% v 65%), less likely to be bacteremia without focus (7.6% v 18.9%), and more likely to require ICU admission (42.3% v 25.1%) and to die (27.1% v 16.6%). In multivariable analysis, patients with ST 3 disease remained more likely to die (OR 1.65; 95%CI1.3-2.0). Over time, the proportion of patients with ST 3 IPD who were nursing home (NH) residents (18/171 in 1995-2000 vs. 4/215 in 2016-2020, P=.0002), and who were IC (46/169 in 1995-2000 vs 39/204 in 2016-2020, P=.007) decreased significantly; in IPD due to other STs, the proportion who were NH residents declined, but the proportion IC increased significantly. The case fatality rate (CFR) declined significantly in IPD due to ST3 but not other STs (Figure 1). Changes in incidence are shown in Figure 2. Figure 2: Incidence of serotype 3 IPD over time, Toronto/Peel, 1995-2020 The incidence of ST3 IPD in children and adults under 65 did not change significantly from 1995/96 to 2019/20. In older adults, the annual incidence of disease declined from 4.98 per 100,000 per year in 1995-2000 to 3.53 per 100,000 per year in 2001-2010 (IRR 0.71, 95%CI 0.56-0.90), then to 2.23 per 100,000 per year in 2011-2020 (IRR compared to 2001-2010 0.63, 95%CI 0.50-0.79) FIgure 2: Case fatality rate of IPD due to serotype 3 and other serotypes over time, 1995-2020, Toronto-Peel The case fatality rate of IPD due to ST3 declined from 37.6% (56/149) in 1995-2000 to 50/235 (21.3%) in 2015-2020 (P&lt;.0001). The CFR in other serotypes did not change. Conclusion The epidemiology of IPD due to ST3 has changed significantly over time and the CFR has declined. The incidence of ST3 disease in children and younger adults has not changed significantly, although the power to detect change is low in children. In older adults the incidence of ST3 disease declined significantly after PPV23 introduction in 1995/6 and again after PCV13 introduction for children. Disclosures All Authors: No reported disclosures

scholarly journals Meta-analysis and metaregression of risk factors associated with mortality in hip fracture patients during the COVID-19 pandemic

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Firas J. Raheman ◽  
Djamila M. Rojoa ◽  
Jvalant Nayan Parekh ◽  
Reshid Berber ◽  
Robert Ashford
Keyword(s):  
Hip Fracture ◽  
Hip Fractures ◽  
Case Fatality Rate ◽  
Excess Mortality ◽  
Meta Analysis ◽  
Case Fatality ◽  
Pooled Analysis ◽  
Fatality Rate ◽  
Increased Risk ◽  
The Impact

AbstractIncidence of hip fractures has remained unchanged during the pandemic with overlapping vulnerabilities observed in patients with hip fractures and those infected with COVID-19. We aimed to investigate the independent impact of COVID-19 infection on the mortality of these patients. Healthcare databases were systematically searched over 2-weeks from 1st–14th November 2020 to identify eligible studies assessing the impact of COVID-19 on hip fracture patients. Meta-analysis of proportion was performed to obtain pooled values of prevalence, incidence and case fatality rate of hip fracture patients with COVID-19 infection. 30-day mortality, excess mortality and all-cause mortality were analysed using a mixed-effects model. 22 studies reporting 4015 patients were identified out of which 2651 (66%) were assessed during the pandemic. An excess mortality of 10% was seen for hip fractures treated during the pandemic (OR 2.00, p = 0.007), in comparison to the pre-pandemic controls (5%). Estimated mortality of COVID-19 positive hip fracture patients was four-fold (RR 4.59, p < 0.0001) and 30-day mortality was 38.0% (HR 4.73, p < 0.0001). The case fatality rate for COVID-19 positive patients was 34.74%. Between-study heterogeneity for the pooled analysis was minimal (I2 = 0.00) whereas, random effects metaregression identified subgroup heterogeneity for male gender (p < 0.001), diabetes (p = 0.002), dementia (p = 0.001) and extracapsular fractures (p = 0.01) increased risk of mortality in COVID-19 positive patients.

scholarly journals Clinical Characteristics and Outcomes of COVID-19–Infected Cancer Patients: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Hua Zhang ◽  
Han Han ◽  
Tianhui He ◽  
Kristen E Labbe ◽  
Adrian V Hernandez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Case Fatality Rate ◽  
Meta Analysis ◽  
Univariate Analysis ◽  
Case Fatality ◽  
The United States ◽  
Fatality Rate ◽  
Patients With Cancer ◽  
Increased Risk

Abstract Background Previous studies have indicated coronavirus disease 2019 (COVID-19) patients with cancer have a high fatality rate. Methods We conducted a systematic review of studies that reported fatalities in COVID-19 patients with cancer. A comprehensive meta-analysis that assessed the overall case fatality rate and associated risk factors was performed. Using individual patient data, univariate and multivariable logistic regression analyses were used to estimate odds ratios (OR) for each variable with outcomes. Results We included 15 studies with 3019 patients, of which 1628 were men; 41.0% were from the United Kingdom and Europe, followed by the United States and Canada (35.7%), and Asia (China, 23.3%). The overall case fatality rate of COVID-19 patients with cancer measured 22.4% (95% confidence interval [CI] = 17.3% to 28.0%). Univariate analysis revealed age (OR = 3.57, 95% CI = 1.80 to 7.06), male sex (OR = 2.10, 95% CI = 1.07 to 4.13), and comorbidity (OR = 2.00, 95% CI = 1.04 to 3.85) were associated with increased risk of severe events (defined as the individuals being admitted to the intensive care unit, or requiring invasive ventilation, or death). In multivariable analysis, only age greater than 65 years (OR = 3.16, 95% CI = 1.45 to 6.88) and being male (OR = 2.29, 95% CI = 1.07 to 4.87) were associated with increased risk of severe events. Conclusions Our analysis demonstrated that COVID-19 patients with cancer have a higher fatality rate compared with that of COVID-19 patients without cancer. Age and sex appear to be risk factors associated with a poorer prognosis.

scholarly journals Protection offered by COVID-19 vaccines in reducing SARS-CoV-2 infection frequency; severity and mortality, among Indian Healthcare Workers: Multicenter, pan-Fortis study

2021 ◽  
Author(s):  
Subrat Acharya ◽  
Gaurav Mahindra ◽  
Purushottam Nirala ◽  
Sulabh Tripathi ◽  
Bishnu Panigrahi ◽  
...  
Keyword(s):  
General Population ◽  
Healthcare Workers ◽  
Case Fatality Rate ◽  
Population Control ◽  
Real Life ◽  
Case Fatality ◽  
Infection Frequency ◽  
Fatality Rate ◽  
Indian States ◽  
Increased Risk

Abstract During COVID-19 pandemic, Healthcare Workers (HCWs) were at increased risk for exposure to SARS-CoV-2 virus and prioritized for early administration of COVID-19 vaccines in India. Real-life scenario information among vaccinated HCWs acquiring COVID-19 infection, is scarce. We retrospectively analyzed COVID-19 infection frequency, severity, and associated mortality among healthcare workers, immunized with either Covishield or Covaxin vaccines at 27 Fortis Hospitals across 11 Indian states. Positive cases were identified based on RT-PCR or rapid antigen tests for SARS-CoV-2 between 16th January 2021 till 15th May 2021. 20034 HCWs received vaccination. 3971 received 1 dose, 16063 received 2 doses. Post-vaccination, 1139 HCWs acquired COVID-19 infection, 180 (4.53%) and 959 (5.97%) among partially and fully vaccinated category, respectively. Breakthrough infection occurred among 913 (5.68%) HCWs. Concurrently, Case Positivity Rate was 11.9%, among general population (control). Among 1139 positive cases, mild, moderate, and severe infections were 1059 (93%), 71 (6.2%) and 9 (0.8%), respectively with Case Fatality Rate of 0.18%, compared to 0.92% among general population (p=0.0043). The Case Fatality Rate in vaccinated HCWs was found to be 80% less than that in general population (control). Hence, COVID-19 vaccines available in India seem to be effective against SARS-CoV-2 virus.

Morbidity, mortality and spatial distribution of meningococcal disease, 1974–2007

2009 ◽  
Vol 137 (11) ◽  
pp. 1631-1640 ◽  
Author(s):  
M. HOWITZ ◽  
L. LAMBERTSEN ◽  
J. B. SIMONSEN ◽  
J. J. CHRISTENSEN ◽  
K. MØLBAK
Keyword(s):  
Risk Factors ◽  
Spatial Distribution ◽  
Meningococcal Disease ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Incidence Rates ◽  
Fatality Rate ◽  
Risk Of Death ◽  
Increased Risk ◽  
High Age

SUMMARYTo identify determinants for mortality and sequelae and to analyse the spatial distribution of meningococcal disease, we linked four national Danish registries. In the period 1974–2007, 5924 cases of meningococcal disease were registered. Our analysis confirms known risk factors for a fatal meningococcal disease outcome, i.e. septicaemia and high age (>50 years). The overall case-fatality rate was 7·6%; two phenotypes were found to be associated with increased risk of death; C:2a:P1.2,5 and B:15:P1.7,16. B:15:P1.7,16 was also associated with excess risk of perceptive hearing loss. The incidence rates of meningococcal disease were comparable between densely and less densely populated areas, but patients living further from a hospital were at significantly higher risk of dying from the infection. To improve control of meningococcal disease, it is important to understand the epidemiology and pathogenicity of virulent ‘successful clones’, such as C:2a:P1.2,5 and B:15:P1.7,16, and, eventually, to develop vaccines against serogroup B.

scholarly journals Risk factors for mortality in hospitalized patients with COVID-19 at the start of the pandemic in Belgium: a retrospective cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Karlijn van Halem ◽  
Robin Bruyndonckx ◽  
Jeroen van der Hilst ◽  
Janneke Cox ◽  
Paulien Driesen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Case Fatality Rate ◽  
Clinical Characteristics ◽  
Severe Disease ◽  
Univariate Analysis ◽  
Case Fatality ◽  
Fatality Rate ◽  
Risk Of Death ◽  
Increased Risk

Abstract Background Belgium was among the first countries in Europe with confirmed coronavirus disease 2019 (COVID-19) cases. Since the first diagnosis on February 3rd, the epidemic has quickly evolved, with Belgium at the crossroads of Europe, being one of the hardest hit countries. Although risk factors for severe disease in COVID-19 patients have been described in Chinese and United States (US) cohorts, good quality studies reporting on clinical characteristics, risk factors and outcome of European COVID-19 patients are still scarce. Methods This study describes the clinical characteristics, complications and outcomes of 319 hospitalized COVID-19 patients, admitted to a tertiary care center at the start of the pandemic in Belgium, and aims to identify the main risk factors for in-hospital mortality in a European context using univariate and multivariate logistic regression analysis. Results Most patients were male (60%), the median age was 74 (IQR 61–83) and 20% of patients were admitted to the intensive care unit, of whom 63% needed invasive mechanical ventilation. The overall case fatality rate was 25%. The best predictors of in-hospital mortality in multivariate analysis were older age, and renal insufficiency, higher lactate dehydrogenase and thrombocytopenia. Patients admitted early in the epidemic had a higher mortality compared to patients admitted later in the epidemic. In univariate analysis, patients with obesity did have an overall increased risk of death, while overweight on the other hand showed a trend towards lower mortality. Conclusions Most patients hospitalized with COVID-19 during the first weeks of the epidemic in Belgium were admitted with severe disease and the overall case fatality rate was high. The identified risk factors for mortality are not easily amenable at short term, underscoring the lasting need of effective therapeutic and preventative measures.

scholarly journals Protection offered by COVID-19 vaccines in reducing SARS-CoV-2 infection frequency; severity and mortality, among Indian Healthcare Workers: Multicenter, pan-Fortis study

2021 ◽  
Author(s):  
Subrat Acharya ◽  
Gaurav Mahindra
Keyword(s):  
General Population ◽  
Healthcare Workers ◽  
Case Fatality Rate ◽  
Population Control ◽  
Real Life ◽  
Case Fatality ◽  
Infection Frequency ◽  
Fatality Rate ◽  
Indian States ◽  
Increased Risk

Abstract During COVID-19 pandemic, Healthcare Workers (HCWs) were at increased risk for exposure to SARS-CoV-2 virus and prioritized for early administration of COVID-19 vaccines in India. Real-life scenario information among vaccinated HCWs acquiring COVID-19 infection, is scarce. We retrospectively analyzed COVID-19 infection frequency, severity, and associated mortality among healthcare workers, immunized with either Covishield or Covaxin vaccines at 27 Fortis Hospitals across 11 Indian states. Positive cases were identified based on RT-PCR or rapid antigen tests for SARS-CoV-2 between 16th January 2021 till 15th May 2021. 20034 HCWs received vaccination. 3971 received 1 dose, 16063 received 2 doses. Post-vaccination, 1139 HCWs acquired COVID-19 infection, 180 (4.53%) and 959 (5.97%) among partially and fully vaccinated category, respectively. Breakthrough infection occurred among 913 (5.68%) HCWs. Concurrently, Case Positivity Rate was 11.9%, among general population (control). Among 1139 positive cases, mild, moderate, and severe infections were 1059 (93%), 71 (6.2%) and 9 (0.8%), respectively with Case Fatality Rate of 0.18%, compared to 0.92% among general population (p=0.0043). The Case Fatality Rate in vaccinated HCWs was found to be 80% less than that in general population (control). Hence, COVID-19 vaccines available in India seem to be effective against SARS-CoV-2 virus.

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