Demystifying the varying case fatality rates (CFR) of COVID-19 in India: Lessons learned and future directions.
J Infect Dev Ctries
; 14(10): 1128-1135, 2020 Oct 31.
Article
en En
| MEDLINE
| ID: mdl-33175707
ABSTRACT
INTRODUCTION:
At the end of the second week of June 2020, the SARS-CoV-2 responsible for COVID-19 infected above 7.5 million people and killed over 400,000 worldwide. Estimation of case fatality rate (CFR) and determining the associated factors are critical for developing targeted interventions.METHODOLOGY:
The state-level adjusted case fatality rate (aCFR) was estimated by dividing the cumulative number of deaths on a given day by the cumulative number confirmed cases 8 days before, which is the average time-lag between diagnosis and death. We conducted fractional regression analysis to determine the predictors of aCFR.RESULTS:
As of 13 June 2020, India reported 225 COVID-19 cases per million population (95% CI224-226); 6.48 deaths per million population (95% CI6.34-6.61) and an aCFR of 3.88% (95% CI3.81-3.97) with wide variation between states. High proportion of urban population and population above 60 years were significantly associated with increased aCFR (p=0.08, p=0.05), whereas, high literacy rate and high proportion of women were associated with reduced aCFR (p<0.001, p=0.03). The higher number of cases per million population (p=0.001), prevalence of diabetes and hypertension (p=0.012), cardiovascular diseases (p=0.05), and any cancer (p<0.001) were significantly associated with increased aCFR. The performance of state health systems and proportion of public health expenditure were not associated with aCFR.CONCLUSIONS:
Socio-demographic factors and burden of non-communicable diseases (NCDs) were found to be the predictors of aCFR. Focused strategies that would ensure early identification, testing and effective targeting of non-literate, elderly, urban population and people with comorbidities are critical to control the pandemic and fatalities.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Neumonía Viral
/
Infecciones por Coronavirus
Tipo de estudio:
Etiology_studies
/
Prognostic_studies
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Risk_factors_studies
Límite:
Humans
País/Región como asunto:
Asia
Idioma:
En
Revista:
J Infect Dev Ctries
Asunto de la revista:
DOENCAS TRANSMISSIVEIS
Año:
2020
Tipo del documento:
Article
País de afiliación:
India