Predictors of COVID-19 Fatality: A Worldwide Analysis of the Pandemic over Time and in Latin America

SARS-CoV-2 has infected over one hundred million people worldwide and has affected Latin America particularly severely in terms of both cases and deaths. This study aims to determine the association between SARS-CoV-2 testing and COVID-19 fatality rate worldwide over 8 months and to examine how this relationship differs between Latin America and all other countries. This cross-sectional study used March 2021 data from 169 countries. Multivariate regressions predicted COVID-19 fatality (outcome) from the number of SARS-CoV-2 tests (exposure), while controlling for other predictors. Results for March 2021 were compared to results from June 2020. Additionally, results for Latin America were also compared to all other countries except Latin American for March 2021. SARS-CoV-2 testing was associated with a significant decrease in COVID-19 fatality rate in both June 2020 and March 2021 (RR = 0.92; 95% CI 0.87–0.96 and RR = 0.86; 95% CI 0.74–1.00, respectively). SARS-CoV-2 testing was associated with a significant decrease in COVID-19 fatality rate in Latin American countries but not in all other countries (RR = 0.45; 95% CI 0.23–0.89 and RR = 0.95; 95% CI 0.82–1.11, respectively). However, the difference between the risk ratios for June 2020 and March 2021 and between the risk ratios for Latin America and all other countries were not statistically significant. Increased SARS-CoV-2 testing may be a significant predictor of lower COVID-19 case fatality rate, specifically in Latin American countries, due to the existence of a strong association, which may have driven the worldwide results.

The risk of COVID-19 death is much greater and age-dependent with type I IFN autoantibodies

SARS-CoV-2 infection fatality rate (IFR) doubles with every five years of age from childhood onward. Circulating autoantibodies neutralizing IFN-α, IFN-ω, and/or IFN-β are found in ~20% of deceased patients across age groups. In the general population, they are found in ~1% of individuals aged 20-70 years and in >4% of those >70 years old. With a sample of 1,261 deceased patients and 34,159 uninfected individuals, we estimated both IFR and relative risk of death (RRD) across age groups for individuals carrying autoantibodies neutralizing type I IFNs, relative to non-carriers. For autoantibodies neutralizing IFN-α2 or IFN-ω, the RRD was 17.0[95% CI:11.7-24.7] for individuals under 70 years old and 5.8[4.5-7.4] for individuals aged 70 and over, whereas, for autoantibodies neutralizing both molecules, the RRD was 188.3[44.8-774.4] and 7.2[5.0-10.3], respectively. IFRs increased with age, from 0.17%[0.12-0.31] for individuals <40 years old to 26.7%[20.3-35.2] for those ≥80 years old for autoantibodies neutralizing IFN-α2 or IFN-ω, and from 0.84%[0.31-8.28] to 40.5%[27.82-61.20] for the same two age groups, for autoantibodies neutralizing both molecules. Autoantibodies against type I IFNs increase IFRs, and are associated with high RRDs, particularly those neutralizing both IFN-α2 and -ω. Remarkably, IFR increases with age, whereas RRD decreases with age. Autoimmunity to type I IFNs appears to be second only to age among common predictors of COVID-19 death.

Choosing the right COVID-19 indicator: crude mortality, case fatality, and infection fatality rates influence policy preferences, behaviour, and understanding

Individuals worldwide are overwhelmed with news about COVID-19. In times of pandemic, media alternate the usage of different COVID-19 indicators, ranging from the more typical crude mortality rate to the case fatality rate, and the infection fatality rate continuously. In this article, we used experimental methods to test whether and how the treatment of individuals with different types of information on COVID-19 is able to change policy preferences, individual and social behaviours, and the understanding of COVID-19 indicators. Results show that while the usage of the crude mortality rate proves to be more efficient in terms of supporting policy preferences and behaviours to contain the virus, all indicators suffer from a significant misunderstanding on behalf of the population.

An Assessment of the Philippine Hospital Resources as Predictors of the Case Fatality Rate of COVID – 19

In the heightened effects of the pandemic, health resources have been in constant limbo as supplies and availability of hospital resources take a toll as COVID-19 cases surge, resulting in shortages. Thus, health systems are overwhelmed, resulting in a higher fatality rate since the capacity to provide medical attention is diminished. In this paper, hospital resources refer to mechanical ventilators, ICU, isolation, and ward beds which are the critical factors of the case fatality rate (CFR) of COVID-19 in the Philippines. Data were retrieved from the Department of Health (DOH) Case Bulletins from October 26, 2020, to June 30, 2021, with 248 total observations. This research used the Ordinary Least Squares (OLS) Multiple Regression to determine if hospital resources are the predictors of the case fatality rate of COVID-19. Furthermore, the results show a significant relationship between the hospital resources and the case fatality rate of COVID-19 in the Philippines. This study can become a framework for further research concerned about hospital resources as the predictors of case fatality rates of different diseases in a pandemic.

Diphtheria resurgence in Sada'a-Yemen, 2017–2020

Background Diphtheria is a contagious vaccine-preventable disease that contributes to the high morbidity and mortality among under 5 children, especially in Yemen. As a consequence of war and collapse of the health system, a fatal epidemic occurred at the end of 2017. This study aims to describe the epidemiology of diphtheria by time, place, and person and vaccination status of affected children. Methods A study was conducted in Sada'a governorate by using accumulative line list of diphtheria from November 2017 to September 2020 at electronic Integrated Disease Early Warning System (eIDEWS). The case definition of WHO was adopted. Data was analyzed by Microsoft Excel and Epi info- version 7.2 and multivariable logistic analysis used for identifying significant associated factors. Results 747 cases were met of WHO case definition. The annual peak of cases started during week 31 and weak 49. Males were slightly more than females (51% vs 49%) and about 35% of cases involved children aged 10 to < 15 years. The overall incidence of diphtheria and case fatality rate (CFR) were 69/ 100,000 and 6.4%, respectively. The highest CFR was among age groups under 5 years 11% (P < 0.001) and among females was 8%. Dysphagia and swollen lymph nodes were the predominant symptoms 98%, 92%, respectively. Based on the Vaccination status, the percentage of unvaccinated and unknown were 53% and 41% respectively, with CFR 11% among cases who received one dose. Furthermore, the most case were from Sahar 40% with case fatality rate 8% and the highest CFR was significantly higher among cases in border and ongoing conflict district (P < 0.05). Conclusions The findings highlight that diphtheria is still an ongoing cause of morbidity and mortality among under 5 children in Sada'a that is rising with the low diphtheria immunization coverage. Therefore, concomitant efforts should now focus on improving and monitoring routine immunization across all age groups and healthcare services, especially in borders and continuing conflict districts.

Omicron Impact in India: An Early Analysis of the Ongoing COVID-19 Third Wave

India is currently experiencing the third wave of COVID-19, which began on around 28 Dec. 2021. Although genome sequencing data of a sufficiently large sample is not yet available, the rapid growth in the daily number of cases, comparable to South Africa, United Kingdom, suggests that the current wave is primarily driven by the Omicron variant. The logarithmic regression suggests the growth rate of the infections during the early days in this wave is nearly four times than that in the second wave. Another notable difference in this wave is the relatively concurrent arrival of outbreaks in all the states; the effective reproduction number (Rt) although has significant variations among them. The test positivity rate (TPR) also displays a rapid growth in the last 10 days in several states. Preliminary estimates with the SIR model suggest that the peak to occur in late January 2022 with peak caseload exceeding that in the second wave. Although the Omicron trends in several countries suggest a decline in case fatality rate and hospitalizations compared to Delta, a sudden surge in active caseload can temporarily choke the already stressed healthcare India is currently experiencing the third wave of COVID-19, which began on around 28 Dec. 2021. Although genome sequencing data of a sufficiently large sample is not yet available, the rapid growth in the daily number of cases, comparable to South Africa, United Kingdom, suggests that the current wave is primarily driven by the Omicron variant. The logarithmic regression suggests the growth rate of the infections during the early days in this wave is nearly four times than that in the second wave. Another notable difference in this wave is the relatively concurrent arrival of outbreaks in all the states; the effective reproduction number (Rt) although has significant variations among them. The test positivity rate (TPR) also displays a rapid growth in the last 10 days in several states. Preliminary estimates with the SIR model suggest that the peak to occur in late January 2022 with peak caseload exceeding that in the second wave. Although the Omicron trends in several countries suggest a decline in case fatality rate and hospitalizations compared to Delta, a sudden surge in active caseload can temporarily choke the already stressed healthcare infrastructure. Therefore, it is advisable to strictly adhere to COVID-19 appropriate behavior for the next few weeks to mitigate an explosion in the number of infections.

Salivary Diagnosis of COVID-19

Dear Editor, It is indeed an honour for us to contribute towards the ongoing research regarding the latest contagion, Coronavirus disease (COVID-19) as caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) leading to global pandemic with variable clinical outcomes. COVID-19 positive individuals present with a variety of signs and symptoms as sore throat, cough, fever, dyspnoea, headache, myalgia, nausea, and vomiting whereas, some develop severe acute respiratory distress syndrome with a fatality rate of about 10%.1 Possible oral findings include xerostomia, hypogeusia, and chemosensory alterations. Common routes of transmission being person-to-person via direct sneeze, cough, and droplet inhalation or by contact through mucosa of eyes, nose and saliva.