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1.
BMC Public Health ; 21(1): 83, 2021 01 07.
Artículo en Inglés | MEDLINE | ID: mdl-33413218

RESUMEN

BACKGROUND: During the outbreak of SARS-CoV-2 in Italy, infection among health-care professionals and in the context of welfare and health-care facilities was a significant concern. It is known that the elderly or those with concomitant pathologies are at greater risk of a serious evolution of the disease if affected by COVID-19 and that health workers are a category with greater exposure to SARS-CoV-2 infection. Until now, there has been little information on the epidemiological features and transmission dynamics of the COVID-19 outbreak which did not involve health-care professionals or social and health-care facilities. For this reason, this paper aims to describe the epidemiological characteristics of SARS-CoV-2 infection in the general population outside these semi-closed communities. METHODS: The study was designed by analyzing the data of the 1371 SARS-CoV-2 positive subjects observed in Sardinia up to 9 July, 2020 and whose data were available in the public health department. Statistical analysis and graphic representation were performed using STATA and Adobe Illustrator, respectively. RESULTS: Of the positive cases analyzed, 323 (23.5%) are health-care workers and 563 (41.1%) reside in social or health-care facilities. The number of positive cases among the general population (subjects who do not belong to these semi-closed communities), is 399 (29.1%), 208 females and 191 males. The estimated Case Fatality Rate stands at 5.0%, which is almost half the rate reported for all the SARS-CoV-2 positive cases (9.8%). The geographical distribution of positive cases differs considerably from the distribution of the totality of cases in Sardinia. CONCLUSIONS: This review provides an insight into the COVID-19 situation in the general community, ie not involving health-care professionals or social and health-care facilities. Understanding the evolving epidemiology and transmission dynamics of the outbreak outside of these semi-closed communities would provide appropriate information to guide intervention policy. The COVID-19 pandemic has exacerbated the vulnerability of our health-care system. Severe disruptions in care, medicine shortages and unequal access to health-care are but a few examples of the challenges faced by people living in Italy and Europe, highlighting the importance of evidence-based approaches in supporting the development of prevention and response strategies for future pandemics.


Asunto(s)
/epidemiología , Instituciones de Salud , Personal de Salud/estadística & datos numéricos , Instituciones Residenciales , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Enfermedades Cardiovasculares/epidemiología , Niño , Preescolar , Enfermedad Crónica , Comorbilidad , Diabetes Mellitus/epidemiología , Brotes de Enfermedades , Femenino , Hogares para Ancianos , Hospitales , Humanos , Vida Independiente/estadística & datos numéricos , Lactante , Italia/epidemiología , Enfermedades Pulmonares/epidemiología , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Pandemias , Distribución por Sexo , Adulto Joven
3.
Braz J Med Biol Res ; 54(3): e10281, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33470389

RESUMEN

This study aimed to examine and summarize clinical characteristics of Kawasaki disease (KD) at different ages to further strengthen clinicians understanding of children with KD, improving the level of diagnosis, and reducing coronary artery complications of KD. A total of 398 patients with KD who were diagnosed between January 2016 and December 2017 were reviewed retrospectively. These participants were allocated into three groups according to age: group A (<1 year, n=62), group B (≥1 and <5 years, n=286), and group C (≥5 years, n=50). Clinical manifestations, laboratory results, and echocardiographic findings were compared among the groups. Most (71.86%) patients with KD were aged 1-5 years. The prevalence of cervical lymphadenopathy was lowest in group A. The duration of fever before admission was longest in group A. The rate of cervical lymphadenopathy and laboratory data were different among the groups. Group A had higher frequencies of gastrointestinal involvement, neurological symptoms, and redness at the Bacillus Calmette-Guerin inoculation site than the other groups. Infants aged <1 year with KD often have a longer duration of fever before admission, a lower prevalence of cervical lymphadenopathy, and a higher prevalence of gastrointestinal and neurological symptoms.


Asunto(s)
Síndrome Mucocutáneo Linfonodular , Distribución por Edad , Niño , Preescolar , Vasos Coronarios , Humanos , Lactante , Síndrome Mucocutáneo Linfonodular/diagnóstico , Síndrome Mucocutáneo Linfonodular/epidemiología , Estudios Retrospectivos , Factores de Tiempo
5.
Clin Sports Med ; 40(1): 1-18, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33187601

RESUMEN

Sport-related concussions are common in the United States. Concussion rates have increased over time, likely due to improved recognition and awareness. Concussion rates vary across level (high school vs college), sex, and sport. Concussion rates are the highest among men, particularly in football, wrestling, ice hockey, and lacrosse where collisions and contact are inherent to the sports, although girls'/women's soccer rates are high. In gender-comparable sports, women have higher concussion rates. Continued data collection will increase understanding of sport-related concussion and provide areas for targeted prevention in the future.


Asunto(s)
Traumatismos en Atletas/epidemiología , Conmoción Encefálica/epidemiología , Distribución por Edad , Femenino , Fútbol Americano/lesiones , Hockey/lesiones , Humanos , Incidencia , Masculino , Deportes de Raqueta/lesiones , Distribución por Sexo , Fútbol/lesiones , Estados Unidos/epidemiología , Universidades , Lucha/lesiones
7.
Epidemiol Serv Saude ; 30(1): e2020750, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33331600

RESUMEN

OBJECTIVE: To describe the clinical and epidemiological profile of suspected COVID-19 cases admitted to a federal hospital in Rio de Janeiro, RJ, Brazil, and to identify factors associated with death. METHODS: This was a cross-sectional study using local epidemiological surveillance data as at epidemiological week 27 of 2020 and logistic regression. RESULTS: 376 hospitalized suspected COVID-19 cases were included; 52.9% were female, 57.4% were 50 years old or over and 80.1% had comorbidities. 195 (51.9%) COVID-19 cases were confirmed and their lethality was higher (37.9%) than among discarded cases (24.2%). In the adjusted analysis, death among confirmed cases was associated with being in the 50-69 age group (OR=11.65 - 95%CI 1.69;80.33), being aged 70 or over (OR=8.43 - 95%CI 1.22;58.14), presence of neoplasms (OR=4.34 - 95%CI 1.28;14.76) and use of invasive ventilatory support (OR=70.20 - 95%CI 19.09;258.19). CONCLUSION: High prevalence of comorbidities and lethality was found; the main factors associated with death were being older, neoplasms and invasive ventilatory support.


Asunto(s)
/epidemiología , Mortalidad Hospitalaria , Neoplasias/epidemiología , Respiración Artificial/estadística & datos numéricos , Adulto , Distribución por Edad , Factores de Edad , Anciano , Brasil/epidemiología , Estudios Transversales , Femenino , Hospitalización , Hospitales Federales , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Distribución por Sexo , Estados Unidos , Adulto Joven
8.
Eur Rev Med Pharmacol Sci ; 24(23): 12575-12578, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33336777

RESUMEN

OBJECTIVE: We aimed to compare the characteristics of coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in China, Italy, and South Korea. MATERIALS AND METHODS: Detailed national epidemiological information of COVID-19 was retracted from the latest statistics reports from China, Italy, and South Korea. Population-based analysis of the age distribution among confirmed cases was conducted and their crude case fatality ratio in each c RESULTS: The age distributions among COVID-19 cases were relatively similar between China and Italy with primarily elderly populations infected, which were considerably different from that in South Korea with primarily younger individuals infected. Most deaths occurred among elderly individuals who were older than 60 years in both Italy (98.0%) and South Korea (87.9%), consistent with the previous data from China (81.0%). CONCLUSIONS: Most deaths occurred among elderly individuals who were over 60 in China, Italy, and South Korea. South Korea's data suggest that younger individuals might be more susceptible to SARS-CoV-2 infection, which might be fully under detected in China and Italy.


Asunto(s)
/mortalidad , Adolescente , Adulto , Distribución por Edad , Factores de Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , China/epidemiología , Femenino , Política de Salud , Humanos , Lactante , Recién Nacido , Internacionalidad , Italia/epidemiología , Masculino , Persona de Mediana Edad , Mortalidad , República de Corea/epidemiología , Adulto Joven
9.
N Z Med J ; 133(1527): 26-38, 2020 12 18.
Artículo en Inglés | MEDLINE | ID: mdl-33332326

RESUMEN

AIM: To describe the context surrounding the deaths of homeless people in New Zealand and to determine the proportion of deaths that could be considered amenable to healthcare. METHOD: We used coroners' findings related to 171 deaths of persons with "no fixed abode" at the time of death, from 2008 to 2019. Recent lists of amenable mortality from the New Zealand Ministry of Health and the Office of National Statistics in the UK were combined to determine the rate of amenable mortality. RESULTS: The life expectancy of homeless persons identified in this sample was 30 years shorter than in the housed population, with a mean age of death of 45.7 years. Deaths occurred mainly alone, in public spaces (56.1%) or in private vehicles (14%). Three-quarters (75.8%) of homeless persons died from conditions amenable to timely and effective healthcare interventions, mostly from natural causes (45.7%) and suicide (41.5%). CONCLUSION: Homeless people experience considerable challenges when accessing the healthcare system, as uncovered by the dramatic rate of amenable mortality. Our findings highlight the urgent need to implement specific models of care that are designed to meet the social and healthcare needs of homeless persons and address the significant health inequalities they experience.


Asunto(s)
Causas de Muerte , Certificado de Defunción , Personas sin Hogar/estadística & datos numéricos , Esperanza de Vida , Accidentes/mortalidad , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Trastornos Relacionados con Alcohol/mortalidad , Trastornos Relacionados con Alcohol/prevención & control , Enfermedades Cardiovasculares/mortalidad , Enfermedades Cardiovasculares/prevención & control , Niño , Etanol/envenenamiento , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mortalidad , Nueva Zelanda/epidemiología , Neumonía/mortalidad , Neumonía/prevención & control , Suicidio/prevención & control , Suicidio/estadística & datos numéricos , Adulto Joven
10.
Rev Saude Publica ; 54: 138, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33331530

RESUMEN

OBJECTIVE: To assess the prevalence of multimorbidity among Brazilian adults and its association with socioeconomic indicators. METHODS: Cross-sectional study that used data from the Pesquisa Nacional Sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM - Brazilian National Survey on Access, Use and Promotion of Rational Use of Medicines), carried out between 2013 and 2014. The definition of multimorbidity was the coexistence, in a single individual, of two or more chronic diseases, measured through a list of 14 morbidities (self-reported medical diagnosis throughout life). Economic status and educational level were the socioeconomic indicators used, being the inequalities assessed through the Slope Index of Inequality (SII) and the Concentration Index, stratified by gender. RESULTS: The study comprehended 23,329 adults (52.8% of which were women), with an average age of 37.9 years. Hypertension and high cholesterol levels were the most prevalent conditions. The prevalence of multimorbidity was of 10.9% (95%CI 10.1-11.7) representing nearly 11 million individuals in Brazil, of which 14.5% (95%CI 13.5-15.4) were women and 6.8% (95%CI 5.9-7.8) were men. The occurrence of multimorbidity was similar according to the socioeconomic indicators. In the inequality analysis, we observed absolute and relative differences in men with a higher purchasing power (SII = 3.7; 95%CI 0.3-7.0) and higher educational level (CIX = 7.1; 95%CI 0.9-14.7), respectively. CONCLUSIONS: The frequency of comorbidities in Brazilian adults is high, especially in absolute terms. We only observed socioeconomic inequalities in multimorbidities among men.


Asunto(s)
Escolaridad , Hipercolesterolemia/epidemiología , Hipertensión/epidemiología , Multimorbilidad , Clase Social , Adulto , Distribución por Edad , Brasil/epidemiología , Colesterol/sangre , Estudios Transversales , Femenino , Disparidades en el Estado de Salud , Encuestas Epidemiológicas , Humanos , Masculino , Distribución por Sexo
11.
Rev Bras Epidemiol ; 24: e210007, 2020.
Artículo en Español, Inglés | MEDLINE | ID: mdl-33331414

RESUMEN

OBJECTIVE: To update the estimation of tobacco attributable mortality (AM) in the Brazilian population aged 35 years old and older. METHODS: A prevalence-dependent analysis was applied based on the population attributed fraction. This method estimates the tobacco AM taking into account the mortality observed in Brazil (source: Brazilian Mortality Information System - 2016); the prevalence of smokers, former smokers, and never smokers (National Health Survey Brazil - 2013) and the excess of risk of death (relative risk) of smokers and former smokers in comparison to never smokers (derived from 5 North American cohorts). Estimates of overall AM are shown by gender, age group (35-54; 55-64; 65-74; and 75 years old and older) and 3 groups: malignant tumors, cardiometabolic diseases, and respiratory diseases. RESULTS: In 2016, tobacco consumption caused 163,831 deaths in Brazil, 67% (109,369) were in men and four out of ten (62,791) occurred before the age of 65. Without differences by gender, 42% of the AM is associated with cardiometabolic diseases, followed by respiratory diseases (34%) and malignant tumors (24%). CONCLUSION: During 2016, 14% of the deaths occurred in the Brazilian population aged 35 years old and older were attributed to tobacco consumption. Periodic tobacco AM estimations are mandatory to assess and strengthen smoking control strategies and policies.


Asunto(s)
Fumadores/estadística & datos numéricos , Fumar Tabaco/mortalidad , Adulto , Distribución por Edad , Anciano , Brasil/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mortalidad , Prevalencia , Distribución por Sexo , Fumar Tabaco/efectos adversos
12.
Euro Surveill ; 25(50)2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33334396

RESUMEN

High coronavirus incidence has prompted the Netherlands to implement a second lockdown. To elucidate the epidemic's development preceding this second wave, we analysed weekly test positivity in public test locations by population subgroup between 1 June and 17 October 2020. Hospitality and public transport workers, driving instructors, hairdressers and aestheticians had higher test positivity compared with a reference group of individuals without a close-contact occupation. Workers in childcare, education and healthcare showed lower test positivity.


Asunto(s)
Distribución por Edad , Control de Enfermedades Transmisibles/métodos , Ocupaciones/estadística & datos numéricos , Pandemias , /aislamiento & purificación , Adolescente , Adulto , Anciano , /prevención & control , Niño , Preescolar , Trazado de Contacto , Femenino , Accesibilidad a los Servicios de Salud , Hospitalización/estadística & datos numéricos , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Países Bajos/epidemiología , Exposición Profesional , Cuarentena , Riesgo , Adulto Joven
13.
Rev. esp. quimioter ; 33(6): 466-484, dic. 2020. ilus, tab, mapas, graf
Artículo en Español | IBECS | ID: ibc-195995

RESUMEN

La alta transmisibilidad del SARS-CoV-2 antes y poco después de la aparición de los síntomas sugiere que sólo diagnosticar y aislar a pacientes sintomáticos puede no ser suficiente para interrumpir la propagación de la infección; por ello son también necesarias medidas de salud pública como el distanciamiento social. Adicionalmente será importante detectar a los nuevos infectados que permanecen asintomáticos, que pueden ascender al 50% o más de los casos. Las técnicas moleculares son el patrón de referencia para el diagnóstico de infección por SARS-CoV-2. Sin embargo, el uso masivo de estas técnicas ha generado algunos problemas. Por un lado, la escasez de los recursos (analizadores, fungibles y reactivos), y por otro el retraso en la notificación de resultados. Estos dos hechos se traducen en un retraso en la aplicación de las medidas de aislamiento entre casos y contactos, lo que favorece la expansión de la infección. Las pruebas de detección de antígenos son también métodos de diagnóstico directo, con la ventaja de obtener el resultado en pocos minutos y en el mismo lugar de atención. Además, la sencillez y el bajo coste de estas pruebas permiten repetirlas en días sucesivos en determinados contextos clínicos. La sensibilidad de las pruebas de antígenos es generalmente menor que la de las que detectan ácidos nucleicos, si bien su especificidad es comparable. Se ha comprobado que las pruebas antigénicas tienen más validez en los días alrededor del inicio de síntomas, cuando la carga viral en nasofaringe es mayor. Disponer de un análisis de detección viral rápido y en tiempo real como la prueba de antígenos se ha demostrado más útil para controlar la expansión de la infección que pruebas más sensibles, pero de mayor coste y tiempo de respuesta, como son las pruebas moleculares. Las principales instituciones sanitarias como la OMS, los CDC y el propio Ministerio de Sanidad del Gobierno de España plantean el uso de las pruebas antigénicas en una amplia variedad de estrategias para responder a la pandemia. El presente documento pretende servir de apoyo a los médicos implicados en la atención de pacientes con sospecha de infección por SC2, en el contexto de una incidencia creciente en España desde septiembre de 2020 que representa ya la segunda onda pandémica de COVID-19


The high transmissibility of SARS-CoV-2 before and shortly after the onset of symptoms suggests that only diagnosing and isolating symptomatic patients may not be sufficient to interrupt the spread of infection; therefore, public health measures such as personal distancing are also necessary. Additionally, it will be important to detect the newly infected individuals who remain asymptomatic, which may account for 50% or more of the cases. Molecular techniques are the "gold standard" for the diagnosis of SARS-CoV-2 infection. However, the massive use of these techniques has generated some problems. On the one hand, the scarcity of resources (analyzers, fungibles and reagents), and on the other the delay in the notification of results. These two facts translate into a lag in the application of isolation measures among cases and contacts, which favors the spread of the infection. Antigen detection tests are also direct diagnostic methods, with the advantage of obtaining the result in a few minutes and at the very "pointof-care". Furthermore, the simplicity and low cost of these tests allow them to be repeated on successive days in certain clinical settings. The sensitivity of antigen tests is generally lower than that of nucleic acid tests, although their specificity is comparable. Antigenic tests have been shown to be more valid in the days around the onset of symptoms, when the viral load in the nasopharynx is higher. Having a rapid and real-time viral detection assay such as the antigen test has been shown to be more useful to control the spread of the infection than more sensitive tests, but with greater cost and response time, such as in case of molecular tests. The main health institutions such as the WHO, the CDC and the Ministry of Health of the Government of Spain propose the use of antigenic tests in a wide variety of strategies to respond to the pandemic. This document aims to support physicians involved in the care of patients with suspected SC2 infection, in the context of a growing incidence in Spain since September 2020, which already represents the second pandemic wave of COVID-19


Asunto(s)
Humanos , Masculino , Femenino , Lactante , Preescolar , Niño , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Antígenos Virales/sangre , Betacoronavirus/inmunología , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Pandemias , Enfermedad Aguda , Distribución por Edad , Trazado de Contacto , Incidencia , Nasofaringe/virología , Sensibilidad y Especificidad
14.
Epidemiol Psychiatr Sci ; 29: e180, 2020 Nov 13.
Artículo en Inglés | MEDLINE | ID: mdl-33183394

RESUMEN

AIMS: Suicide emerges as a threat to national health of USA with Whites being at extra risk. More information is needed regarding the increased suicide among Whites to improve national suicide prevention strategies. This study aims to characterise the age pattern of suicide among Whites by suicide methods adjusting for time period and birth cohort. METHODS: Suicide mortality data by age of 15-84 years during 1999-2017 were derived from the Wide-Ranging Online Data for Epidemiological Research, prepared by US Center for Disease Control and Prevention. Mortality data for three common suicide methods, firearms, suffocation and poisoning were analysed using the age-period-cohort (APC) model. Period-cohort adjusted mortality rates by age were estimated based on results from APC modelling. RESULTS: Period-cohort adjusted rates indicated that the overall age pattern for males contained five phases, including three increasing phases (ages 15-20, 30-50 and 65+), connected by two declining phases (ages 20-30 and 50-65); and the age pattern for females was a parabolic with an increasing phase from 15 years of age up to 50, followed by a declining phase after age 50. Furthermore, the age pattern for different suicide methods differed substantially for males, but did not for females. Among males, suicide by firearms contained two rapid increasing phases, one during adolescence and another in older ages; suicide by suffocation showed a high plateau across an age span from 20 to 55 years; and suicide by poisoning followed a parabolic, increasing by age up to 45 before it declined. Age patterns revealed by the unadjusted crude rates were biased because of significant linear period effect and W-shaped cohort effect. CONCLUSIONS: This study is the first to quantify the age patterns of suicide by different methods for US Whites using period-cohort adjusted rates. Study findings provide valid evidence supporting precision interventions to reduce the extra suicide mortality among Whites by targeting specific age ranges with different suicide methods.


Asunto(s)
Grupo de Ascendencia Continental Europea/psicología , Mortalidad/tendencias , Suicidio/estadística & datos numéricos , Adolescente , Adulto , Distribución por Edad , Factores de Edad , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Suicidio/etnología , Estados Unidos/epidemiología , Adulto Joven
15.
Pan Afr Med J ; 35(Suppl 2): 145, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33193960

RESUMEN

Introduction: available evidence suggests that children infected with COVID-19 tend to have a less severe form of the disease. However, most of the studies that have established this largely emanate from outside sub-Saharan Africa. The pandemic nature of the infection makes it instructive to evaluate its pattern among children across different climes, including ours. This study was set out to describe the clinical characteristics of children with COVID-19 in Bauchi State, North-East Nigeria. Methods: this was a cross sectional study that involved 53 children between the ages of 0 and 18 years, who had RT-PCR confirmed COVID-19 infection between March and June 2020 in Bauchi State, Nigeria. Data on epidemiological and clinical characteristics was analysed using IBM SPSS Statistics V 21.® Relationship between categorical variables was established using the chi square test. The level of statistical significance was set at < 0.05, at a confidence interval (CI) of 95%. Results: the mean age was 12.63 ± 4.31 years with a slight preponderance of males (1.1: 1). Majority were asymptomatic (60.4%), while 32.1% and 7.5% had mild and moderate diseases respectively. The most common symptoms were cough (20.8%), fever (17%), and sneezing (15.1%). Five children (9.4%) complained of loss of taste while anosmia was documented in one child (1.9%). We observed a significant relationship between age category and the presence of symptoms. In fact, children younger than 10 years (pre-adolescents) were five times more likely to be symptomatic when compared to those above this age (p = 0.029, C I 1.08-21.56). Conclusion: our findings have shown a mild pattern of disease and good outcome among infected children. However, we must be mindful of the higher vulnerability among younger children, especially those below 10 years.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/epidemiología , Adolescente , Distribución por Edad , Infecciones Asintomáticas/epidemiología , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Nigeria/epidemiología , Distribución por Sexo , Evaluación de Síntomas , Resultado del Tratamiento
16.
BMJ Open ; 10(11): e043560, 2020 11 03.
Artículo en Inglés | MEDLINE | ID: mdl-33148769

RESUMEN

OBJECTIVE: To investigate the influence of demographic and socioeconomic factors on the COVID-19 case-fatality rate (CFR) globally. DESIGN: Publicly available register-based ecological study. SETTING: Two hundred and nine countries/territories in the world. PARTICIPANTS: Aggregated data including 10 445 656 confirmed COVID-19 cases. PRIMARY AND SECONDARY OUTCOME MEASURES: COVID-19 CFR and crude cause-specific death rate were calculated using country-level data from the Our World in Data website. RESULTS: The average of country/territory-specific COVID-19 CFR is about 2%-3% worldwide and higher than previously reported at 0.7%-1.3%. A doubling in size of a population is associated with a 0.48% (95% CI 0.25% to 0.70%) increase in COVID-19 CFR, and a doubling in the proportion of female smokers is associated with a 0.55% (95% CI 0.09% to 1.02%) increase in COVID-19 CFR. The open testing policies are associated with a 2.23% (95% CI 0.21% to 4.25%) decrease in CFR. The strictness of anti-COVID-19 measures was not statistically significantly associated with CFR overall, but the higher Stringency Index was associated with higher CFR in higher-income countries with active testing policies (regression coefficient beta=0.14, 95% CI 0.01 to 0.27). Inverse associations were found between cardiovascular disease death rate and diabetes prevalence and CFR. CONCLUSION: The association between population size and COVID-19 CFR may imply the healthcare strain and lower treatment efficiency in countries with large populations. The observed association between smoking in women and COVID-19 CFR might be due to the finding that the proportion of female smokers reflected broadly the income level of a country. When testing is warranted and healthcare resources are sufficient, strict quarantine and/or lockdown measures might result in excess deaths in underprivileged populations. Spatial dependence and temporal trends in the data should be taken into account in global joint strategy and/or policy making against the COVID-19 pandemic.


Asunto(s)
Enfermedades Cardiovasculares/mortalidad , Control de Enfermedades Transmisibles/estadística & datos numéricos , Infecciones por Coronavirus/mortalidad , Diabetes Mellitus/epidemiología , Producto Interno Bruto/estadística & datos numéricos , Neumonía Viral/mortalidad , Densidad de Población , Regresión Espacial , Distribución por Edad , Betacoronavirus , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/diagnóstico , Política de Salud , Indicadores de Salud , Humanos , Esperanza de Vida , Mortalidad , Pandemias , Prevalencia , Fumar/epidemiología , Análisis Espacial
17.
Epidemiol Serv Saude ; 29(5): e2020644, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33175011

RESUMEN

OBJECTIVE: To describe the profile of deaths and the lethality of Severe Acute Respiratory Syndrome (SARS) due to COVID-19 in hospitalized children and adolescents in Brazil. METHODS: This was a cross-sectional study conducted with data from the SARS notification forms of children and adolescents (0 to 19 years old) with laboratory-confirmed COVID-19. Notifications with complete progression of SARS due to COVID-19 were included, up to the 38th Epidemiological Week of 2020. RESULTS: 6,989 hospitalizations were investigated, 661 died, resulting in 9.5% hospital lethality. Higher lethality rates were observed among children under 1 year of age (14.2%), female children and adolescents (9.7%), the indigenous (23.0%), and those living in rural areas (18.1 %), as well as in the Northeast (15.4%) and North (9.7%) regions of Brazil. CONCLUSION: Differences in hospital mortality were found according to sociodemographic characteristics and marked regional inequalities.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/mortalidad , Mortalidad Hospitalaria , Neumonía Viral/mortalidad , Síndrome Respiratorio Agudo Grave/mortalidad , Adolescente , Distribución por Edad , Brasil/epidemiología , Niño , Preescolar , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/epidemiología , Estudios Transversales , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Indios Sudamericanos/estadística & datos numéricos , Lactante , Recién Nacido , Masculino , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/epidemiología , Características de la Residencia/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Síndrome Respiratorio Agudo Grave/etiología , Distribución por Sexo , Adulto Joven
18.
Artículo en Inglés | MEDLINE | ID: mdl-33147428

RESUMEN

Abstract: Since the introduction of COVID-19-related public health measures, notifications for most nationally notifiable diseases have declined when compared to previous years. Physical distancing, travel restrictions, and emphasis on hygiene are likely to have affected the number of expected notifications, with the greatest reductions observed among disease spread via person-to-person contact such as influenza, and among overseas-acquired infections such as dengue virus and measles. However, quantifying the magnitude of the effect of COVID-19 public health measures on communicable diseases in Australia will be difficult, due to confounding factors such as: changes in testing priorities in laboratories; diversion of resources to the COVID-19 response; changes in health-seeking behaviours; greater utilisation of telehealth practices; and financial impacts such as income loss and ability to afford healthcare. It is considered likely that these other factors will have also impacted notification numbers.


Asunto(s)
Betacoronavirus , Enfermedades Transmisibles/epidemiología , Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/epidemiología , Vigilancia de la Población , Viaje , Distribución por Edad , Australia/epidemiología , Notificación de Enfermedades , Femenino , Humanos , Masculino
19.
Science ; 370(6517): 691-697, 2020 11 06.
Artículo en Inglés | MEDLINE | ID: mdl-33154136

RESUMEN

Although most cases of coronavirus disease 2019 (COVID-19) have occurred in low-resource countries, little is known about the epidemiology of the disease in such contexts. Data from the Indian states of Tamil Nadu and Andhra Pradesh provide a detailed view into severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission pathways and mortality in a high-incidence setting. Reported cases and deaths have been concentrated in younger cohorts than would be expected from observations in higher-income countries, even after accounting for demographic differences across settings. Among 575,071 individuals exposed to 84,965 confirmed cases, infection probabilities ranged from 4.7 to 10.7% for low-risk and high-risk contact types, respectively. Same-age contacts were associated with the greatest infection risk. Case fatality ratios spanned 0.05% at ages of 5 to 17 years to 16.6% at ages of 85 years or more. Primary data from low-resource countries are urgently needed to guide control measures.


Asunto(s)
Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/transmisión , Neumonía Viral/mortalidad , Neumonía Viral/transmisión , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Betacoronavirus , Niño , Preescolar , Trazado de Contacto , Femenino , Humanos , Incidencia , India/epidemiología , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Pandemias , Adulto Joven
20.
Artículo en Inglés | MEDLINE | ID: mdl-33167564

RESUMEN

Background: The novel Severe Acute Respiratory Syndrome Coronavirus-2 has led to a global pandemic in which case fatality rate (CFR) has varied from country to country. This study aims to identify factors that may explain the variation in CFR across countries. Methods: We identified 24 potential risk factors affecting CFR. For all countries with over 5000 reported COVID-19 cases, we used country-specific datasets from the WHO, the OECD, and the United Nations to quantify each of these factors. We examined univariable relationships of each variable with CFR, as well as correlations among predictors and potential interaction terms. Our final multivariable negative binomial model included univariable predictors of significance and all significant interaction terms. Results: Across the 39 countries under consideration, our model shows COVID-19 case fatality rate was best predicted by time to implementation of social distancing measures, hospital beds per 1000 individuals, percent population over 70 years, CT scanners per 1 million individuals, and (in countries with high population density) smoking prevalence. Conclusion: Our model predicted an increased CFR for countries that waited over 14 days to implement social distancing interventions after the 100th reported case. Smoking prevalence and percentage population over the age of 70 years were also associated with higher CFR. Hospital beds per 1000 and CT scanners per million were identified as possible protective factors associated with decreased CFR.


Asunto(s)
Infecciones por Coronavirus/mortalidad , Modelos Estadísticos , Neumonía Viral/mortalidad , Distribución por Edad , Betacoronavirus , Control de Enfermedades Transmisibles/tendencias , Capacidad de Camas en Hospitales , Humanos , Internacionalidad , Pandemias , Fumar , Tomógrafos Computarizados por Rayos X/provisión & distribución
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