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1.
Rev Bras Epidemiol ; 24: e210015, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33825775

RESUMEN

OBJECTIVE: To evaluate all-cause mortality in approximately three years of follow-up and related sociodemographic, behavioral and health factors in community-dwelling older adults in Pelotas, RS. METHODS: This was a longitudinal observational study that included 1,451 older adults (≥ 60 years) who were interviewed in 2014. Information on mortality was collected from their households in 2016-2017 and confirmed with the Epidemiological Surveillance department of the city and by documents from family members. Associations between mortality and independent variables were assessed by crude and multiple Cox regression, with hazard ratio with respective 95% confidence intervals (95%CI). RESULTS: Almost 10% (n = 145) of the participants died during an average of 2.5 years of follow-up, with a higher frequency of deaths among males (12.9%), ?80 years (25.2%), widowhood (15.0%), no education (13.8%) and who did not work (10.5%). Factors associated with higher mortality were: being a male (HR = 2.8; 95%CI 1.9 - 4.2), age ?80 years (HR = 3.9; 95%CI 2.4 - 6.2), widowhood (HR = 2.2; 95%CI 1.4 - 3.7), physical inactivity (HR = 2.3; 95%CI 1.1 - 4..6), current smoking (HR = 2.1; 95%CI 1.2 - 3.6), hospitalizations in the previous year (HR = 2.0; 95%CI 1.2 - 3.2), depressive symptoms (HR = 2.0; 95%CI 1.2 - 3,4) and dependence for two or more daily life activities (HR = 3.1; 95%CI 1,7 - 5.7). CONCLUSION: The identification of factors that increased the risk of early death makes it possible to improve public policies aimed at controlling the modifiable risk factors that can lead to aging with a better quality of life.


Asunto(s)
Vida Independiente , Mortalidad , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Causas de Muerte/tendencias , Femenino , Humanos , Vida Independiente/estadística & datos numéricos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Mortalidad/tendencias , Factores de Riesgo , Factores Socioeconómicos
2.
MMWR Morb Mortal Wkly Rep ; 70(14): 519-522, 2021 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-33830988

RESUMEN

CDC's National Vital Statistics System (NVSS) collects and reports annual mortality statistics using data from U.S. death certificates. Because of the time needed to investigate certain causes of death and to process and review data, final annual mortality data for a given year are typically released 11 months after the end of the calendar year. Daily totals reported by CDC COVID-19 case surveillance are timely but can underestimate numbers of deaths because of incomplete or delayed reporting. As a result of improvements in timeliness and the pressing need for updated, quality data during the global COVID-19 pandemic, NVSS expanded provisional data releases to produce near real-time U.S. mortality data.* This report presents an overview of provisional U.S. mortality data for 2020, including the first ranking of leading causes of death. In 2020, approximately 3,358,814 deaths† occurred in the United States. From 2019 to 2020, the estimated age-adjusted death rate increased by 15.9%, from 715.2 to 828.7 deaths per 100,000 population. COVID-19 was reported as the underlying cause of death or a contributing cause of death for an estimated 377,883 (11.3%) of those deaths (91.5 deaths per 100,000). The highest age-adjusted death rates by age, race/ethnicity, and sex occurred among adults aged ≥85 years, non-Hispanic Black or African American (Black) and non-Hispanic American Indian or Alaska Native (AI/AN) persons, and males. COVID-19 death rates were highest among adults aged ≥85 years, AI/AN and Hispanic persons, and males. COVID-19 was the third leading cause of death in 2020, after heart disease and cancer. Provisional death estimates provide an early indication of shifts in mortality trends and can guide public health policies and interventions aimed at reducing numbers of deaths that are directly or indirectly associated with the COVID-19 pandemic.


Asunto(s)
/mortalidad , Mortalidad/tendencias , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Causas de Muerte/tendencias , Niño , Preescolar , Grupos de Población Continentales/estadística & datos numéricos , Grupos Étnicos/estadística & datos numéricos , Femenino , Disparidades en el Estado de Salud , Humanos , Lactante , Masculino , Persona de Mediana Edad , Mortalidad/etnología , Estados Unidos/epidemiología , Estadísticas Vitales , Adulto Joven
3.
Natl Vital Stat Rep ; 70(1): 1-18, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33814036

RESUMEN

Objectives-This report presents complete period life tables for each of the 50 states and the District of Columbia by sex based on age-specific death rates in 2018. Methods-Data used to prepare the 2018 state-specific life tables include 2018 final mortality statistics; July 1, 2018 population estimates based on the 2010 decennial census; and 2018 Medicare data for persons aged 66-99. The methodology used to estimate the state-specific life tables is the same as that used to estimate the 2018 national life tables, with some modifications. Results-Among the 50 states and the District of Columbia, Hawaii had the highest life expectancy at birth, 81.0 years in 2018, and West Virginia had the lowest, 74.4 years. Life expectancy at age 65 ranged from 17.5 years in Kentucky to 21.1 years in Hawaii. Life expectancy at birth was higher for females in all states and the District of Columbia. The difference in life expectancy between females and males ranged from 3.8 years in Utah to 6.2 years in New Mexico.


Asunto(s)
Esperanza de Vida/tendencias , Tablas de Vida , Mortalidad/tendencias , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Grupos Étnicos/estadística & datos numéricos , Femenino , Hispanoamericanos/estadística & datos numéricos , Humanos , Lactante , Recién Nacido , Esperanza de Vida/etnología , Masculino , Persona de Mediana Edad , Mortalidad/etnología , Distribución por Sexo , Estados Unidos/epidemiología , Adulto Joven
4.
Lancet Glob Health ; 9(4): e409-e417, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33662320

RESUMEN

BACKGROUND: The global health community is devoting considerable attention to adolescents and young people, but risk of death in this population is poorly measured. We aimed to reconstruct global, regional, and national mortality trends for youths aged 15-24 years between 1990 and 2019. METHODS: In this systematic analysis, we used all publicly available data on mortality in the age group 15-24 years for 195 countries, as compiled by the UN Inter-agency Group for Child Mortality Estimation. We used nationally representative vital registration data, estimated the completeness of death registration, and extracted mortality rates from surveys with sibling histories, household deaths reported in censuses, and sample registration systems. We used a Bayesian B-spline bias-reduction model to generate trends in 10q15, the probability that an adolescent aged 15 years would die before reaching age 25 years. This model treats observations of the 10q15 probability as the product of the actual risk of death and an error multiplier that varies depending on the data source. The main outcome that we assessed was the levels of and trends in youth mortality and the global and regional mortality rates from 1990 to 2019. FINDINGS: Globally, the probability of an individual dying between age 15 years and 24 years was 11·2 deaths (90% uncertainty interval [UI] 10·7-12·5) per 1000 youths aged 15 in 2019, which is about 2·5 times less than infant mortality (28·2 deaths [27·2-30·0] by age 1 year per 1000 live births) but is higher than the risk of dying from age 1 to 5 (9·7 deaths [9·1-11·1] per 1000 children aged 1 year). The probability of dying between age 15 years and 24 years declined by 1·4% per year (90% UI 1·1-1·8) between 1990 and 2019, from 17·1 deaths (16·5-18·9) per 1000 in 1990; by contrast with this total decrease of 34% (27-41), under-5 mortality declined by 59% (56-61) in this period. The annual number of deaths declined from 1·7 million (90% UI 1·7-1·9) in 1990 to 1·4 million (1·3-1·5) in 2019. In sub-Saharan Africa, the number of deaths increased by 20·8% from 1990 to 2019. Although 18·3% of the population aged 15-24 years were living in sub-Saharan Africa in 2019, the region accounted for 37·9% (90% UI 34·8-41·9) of all worldwide deaths in youth. INTERPRETATION: It is urgent to accelerate progress in reducing youth mortality. Efforts are particularly needed in sub-Saharan Africa, where the burden of mortality is increasingly concentrated. In the future, a growing number of countries will see youth mortality exceeding under-5 mortality if current trends continue. FUNDING: UN Children's Fund, Bill & Melinda Gates Foundation, United States Agency for International Development.


Asunto(s)
Salud del Adolescente/tendencias , Salud Global/tendencias , Modelos Estadísticos , Mortalidad/tendencias , Adolescente , Salud del Adolescente/estadística & datos numéricos , Teorema de Bayes , Bases de Datos Factuales/estadística & datos numéricos , Geografía , Salud Global/estadística & datos numéricos , Humanos , Organización Mundial de la Salud , Adulto Joven
6.
CMAJ Open ; 9(1): E149-E156, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33653770

RESUMEN

BACKGROUND: Information on the epidemiology of patients in hospital with laboratory-confirmed coronavirus disease 2019 (COVID-19) in Canadian acute care hospitals is needed to inform infection prevention and control strategies and public health measures. The aim of this surveillance was to describe the epidemiology of patients in hospital with laboratory-confirmed COVID-19 in a network of Canadian acute care hospitals between Mar. 1 and Aug. 31, 2020. METHODS: Through prospective surveillance, we identified adult and pediatric patients in hospital with laboratory-confirmed COVID-19 using a standard definition between Mar. 1 and Aug. 31, 2020, through the Canadian Nosocomial Infection Surveillance Program (CNISP), a network of 78 hospitals. Patient demographic and clinical characteristics and data on treatment, interventions and outcomes were reviewed and described. RESULTS: As of Aug. 31, 2020, the CNISP had received data for 1906 patients in hospital with COVID-19 in 49 sentinel hospitals in 9 provinces. The majority of patients in hospital with COVID-19 were older (median age 71 yr) and had underlying medical conditions (85.8%). Few children with COVID-19 were admitted to a participating hospital (n = 37, 1.9%). Acquisition of COVID-19 in hospitals was infrequent (6.4% of all cases). A total of 32.8% of patients were admitted from a long-term care facility or retirement home. Health care workers constituted 10.6% of adult patients aged 18-65 years in hospital with COVID-19. Thirty-day attributable mortality was 16.2%. Hospital admission rates peaked in mid-April and were highest in Ontario and Quebec. INTERPRETATION: Surveillance findings indicate that a high proportion of Canadian patients in hospital with COVID-19 during the first 6 months of the pandemic were older adults with underlying medical conditions. Active surveillance of patients in hospital with COVID-19 is critical to enhancing our knowledge of the epidemiology of COVID-19 and to identifying populations at risk for severe outcomes, which will help guide Canada's response in the coming months.


Asunto(s)
/diagnóstico , Servicio Ambulatorio en Hospital/estadística & datos numéricos , /genética , Adulto , Anciano , Anciano de 80 o más Años , /mortalidad , Niño , Preescolar , Infección Hospitalaria/epidemiología , Infección Hospitalaria/prevención & control , Monitoreo Epidemiológico , Femenino , Personal de Salud/estadística & datos numéricos , Hospitalización/estadística & datos numéricos , Humanos , Lactante , Masculino , Persona de Mediana Edad , Mortalidad/tendencias , Ontario/epidemiología , Estudios Prospectivos , Quebec/epidemiología
7.
Bone Joint J ; 103-B(3): 469-478, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33641419

RESUMEN

AIMS: To develop and externally validate a parsimonious statistical prediction model of 90-day mortality after elective total hip arthroplasty (THA), and to provide a web calculator for clinical usage. METHODS: We included 53,099 patients with cemented THA due to osteoarthritis from the Swedish Hip Arthroplasty Registry for model derivation and internal validation, as well as 125,428 patients from England and Wales recorded in the National Joint Register for England, Wales, Northern Ireland, the Isle of Man, and the States of Guernsey (NJR) for external model validation. A model was developed using a bootstrap ranking procedure with a least absolute shrinkage and selection operator (LASSO) logistic regression model combined with piecewise linear regression. Discriminative ability was evaluated by the area under the receiver operating characteristic curve (AUC). Calibration belt plots were used to assess model calibration. RESULTS: A main effects model combining age, sex, American Society for Anesthesiologists (ASA) class, the presence of cancer, diseases of the central nervous system, kidney disease, and diagnosed obesity had good discrimination, both internally (AUC = 0.78, 95% confidence interval (CI) 0.75 to 0.81) and externally (AUC = 0.75, 95% CI 0.73 to 0.76). This model was superior to traditional models based on the Charlson (AUC = 0.66, 95% CI 0.62 to 0.70) and Elixhauser (AUC = 0.64, 95% CI 0.59 to 0.68) comorbidity indices. The model was well calibrated for predicted probabilities up to 5%. CONCLUSION: We developed a parsimonious model that may facilitate individualized risk assessment prior to one of the most common surgical interventions. We have published a web calculator to aid clinical decision-making. Cite this article: Bone Joint J 2021;103-B(3):469-478.


Asunto(s)
Artroplastia de Reemplazo de Cadera/mortalidad , Modelos Estadísticos , Mortalidad/tendencias , Osteoartritis de la Cadera/cirugía , Complicaciones Posoperatorias/mortalidad , Medición de Riesgo/métodos , Factores de Edad , Toma de Decisiones Conjunta , Inglaterra/epidemiología , Femenino , Humanos , Internet , Irlanda/epidemiología , Masculino , Valor Predictivo de las Pruebas , Sistema de Registros , Factores de Riesgo , Factores Sexuales , Suecia/epidemiología , Gales/epidemiología
8.
Health Aff (Millwood) ; 40(2): 307-316, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33523748

RESUMEN

The impact of the coronavirus disease 2019 (COVID-19) pandemic has been starkly unequal across race and ethnicity. We examined the geographic variation in excess all-cause mortality by race and ethnicity to better understand the impact of the pandemic. We used individual-level administrative data on the US population between January 2011 and April 2020 to estimate the geographic variation in excess all-cause mortality by race and Hispanic origin. All-cause mortality allows a better understanding of the overall impact of the pandemic than mortality attributable to COVID-19 directly. Nationwide, adjusted excess all-cause mortality during that period was 6.8 per 10,000 for Black people, 4.3 for Hispanic people, 2.7 for Asian people, and 1.5 for White people. Nationwide averages mask substantial geographic variation. For example, despite similar excess White mortality, Michigan and Louisiana had markedly different excess Black mortality, as did Pennsylvania compared with Rhode Island. Wisconsin experienced no significant White excess mortality but had significant Black excess mortality. Further work understanding the causes of geographic variation in racial and ethnic disparities-the relevant roles of social and environmental factors relative to comorbidities and of the direct and indirect health effects of the pandemic-is crucial for effective policy making.


Asunto(s)
/epidemiología , Grupos de Población Continentales , Geografía , Disparidades en el Estado de Salud , Mortalidad/etnología , Adulto , Afroamericanos/estadística & datos numéricos , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Hispanoamericanos/estadística & datos numéricos , Humanos , Masculino , Mortalidad/tendencias , Estados Unidos
9.
Lancet Public Health ; 6(4): e240-e248, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33636104

RESUMEN

BACKGROUND: Mass incarceration has collateral consequences for community health, which are reflected in county-level health indicators, including county mortality rates. County jail incarceration rates are associated with all-cause mortality rates in the USA. We assessed the causes of death that drive the relationship between county-level jail incarceration and mortality. METHODS: In this retrospective, longitudinal study, we assessed the association between county-level jail incarceration rates and county-level cause-specific mortality using county jail incarceration data (1987-2017) for 1094 counties in the USA obtained from the Vera Institute of Justice and cause-specific mortality data for individuals younger than 75 years in the total county population (1988-2018) obtained from the US National Vital Statistics System. We fitted quasi-Poisson models for nine common causes of death (cerebrovascular disease, chronic lower respiratory disease, diabetes, heart disease, infectious disease, malignant neoplasm, substance use, suicide, and unintentional injury) with county fixed effects, controlling for all unmeasured stable county characteristics and measured time-varying confounders (county median age, county poverty rate, county percentage of Black residents, county crime rate, county unemployment rate, and state incarceration rate). We lagged county jail incarceration rates by 1 year to assess the short-term, by 5 years to assess the medium-term, and by 10 years to assess the long-term associations of jail incarceration with premature mortality. FINDINGS: A 1 per 1000 within-county increase in jail incarceration rate was associated with a 6·5% increase in mortality from infectious diseases (risk ratio 1·065, 95% CI 1·061-1·070), a 4·9% increase in mortality from chronic lower respiratory disease (1·049, 1·045-1·052), a 2·6% increase in mortality induced from substance use (1·026, 1·020-1·032), a 2·5% increase in suicide mortality (1·025, 1·020-1·029), and smaller increases in mortality from heart disease (1·021, 1·019-1·023), unintentional injury (1·015, 1·011-1·018), malignant neoplasm (1·014, 1·013-1·016), diabetes (1·013, 1·009-1·018), and cerebrovascular disease (1·010, 1·007-1·013) after 1 year. Associations between jail incarceration and cause-specific mortality rates weakened as time lags increased, but to a greater extent for causes of death with generally shorter latency periods (infectious disease and suicide) than for those with generally longer latency periods (heart disease, malignant neoplasm, and cerebrovascular disease). INTERPRETATION: Jail incarceration rates are potential drivers of many causes of death in US counties. Jail incarceration can be harmful not only to the health of individuals who are incarcerated, but also to public health more broadly. Our findings suggest important points of intervention, including disinvestment from carceral systems and investment in social and public health services, such as community-based treatment of substance-use disorders. FUNDING: US National Institute on Drug Abuse (National Institutes of Health).


Asunto(s)
Mortalidad/tendencias , Prisioneros/estadística & datos numéricos , Prisiones/estadística & datos numéricos , Causas de Muerte/tendencias , Humanos , Estudios Longitudinales , Estudios Retrospectivos , Estados Unidos/epidemiología
11.
Eur Rev Med Pharmacol Sci ; 25(3): 1684-1707, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33629339

RESUMEN

The mortality of COVID-19 patients is increasing in logarithmic fashion and is mostly observed in older age people and patients having history of chronic ailments like chronic obstructive pulmonary disease (COPD), hypertension, diabetes, cardiovascular & cerebrovascular dysfunction, compromised immunity, renal comorbidities, hepatic, obesity problems etc., and recently investigated thrombotic complications. The molecular underpinnings linking the chronic human diseases with COVID-19 related morbidity and mortality are evolving and poorly understood. The aim of the present review is to discuss the mortality and morbidity in COVID-19 in relation to preexisting comorbidities across the globe, upcoming molecular mechanisms associated with expression profile of ACE2 and viral load, evolving pathophysiology of COVID-19 with special reference to thrombotic complication ('Storm of Blood Clots') and related predictive markers. The levels of plasminogen/plasmin in comorbid diseases of COVID-19 have been elaborated in the framework of risk and benefits of fibrinolysis in COVID-19. We have also attempted to discuss the puzzle of prescribing ARBs and ACEI drugs in COVID-19 management which are routinely prescribed for the management of hypertension in COVID-19 patients. A focused discourse on risk of cardiovascular complications and diabetes in concert with COVID-19 pathogenesis has been presented along with dynamics of SARS-CoV-2 induced immune dysfunctions in COVID-19 patients.


Asunto(s)
/biosíntesis , Trombosis/mortalidad , /sangre , Comorbilidad , Humanos , Morbilidad/tendencias , Mortalidad/tendencias , Glicoproteína de la Espiga del Coronavirus/metabolismo , Trombosis/sangre , Trombosis/etiología , Carga Viral
12.
BMC Infect Dis ; 21(1): 149, 2021 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-33546623

RESUMEN

BACKGROUND: Lassa fever (LF) is a zoonotic infectious disease of public concern in Nigeria. The infection dynamics of the disease is not well elucidated in Nigeria. This study was carried out to describe the pattern of infection, case fatality rate and spread of lassa virus (LASV) from 2017 to 2020. METHODS: Weekly epidemiological data on LF from December, 2016 to September, 2020 were obtained from Nigeria Centre for Disease Control. The number of confirmed cases and deaths were computed according to months and states. Descriptive statistics was performed and case fatality rate was calculated. Distribution and spread maps of LF over the four years period was performed on ArcMap 10.7. RESULTS: A total of 2787 confirmed cases and 516 deaths were reported in Nigeria from December, 2016 to September, 2020. Increase in number of cases and deaths were observed with 298, 528, 796 and 1165 confirmed cases and 79, 125, 158 and 158 deaths in 2017, 2018, 2019 and 2020 respectively. Over 60% of the cases were reported in two states, Edo and Ondo states. The LF cases spread from 19 states in 2017 to 32 states and Federal Capital Territory (FCT) in 2020. Ondo state (25.39%) had the highest of deaths rate from LF over the four years. Case fatality rate (CFR) of LF was highest in 2017 (26.5%) with CFR of 23.7, 19.6 and 13.4% in 2018, 2019 and 2020 respectively. The peak of infection was in the month of February for the four years. Infections increases at the onset of dry season in November and decline till April when the wet season sets-in. CONCLUSION: There is an annual increase in the number of LASV infection across the states in Nigeria. There is need to heighten control strategies through the use of integrated approach, ranging from vector control, health education and early diagnosis.


Asunto(s)
Fiebre de Lassa/mortalidad , Fiebre de Lassa/transmisión , Animales , Geografía , Humanos , Fiebre de Lassa/epidemiología , Virus Lassa , Mortalidad/tendencias , Nigeria/epidemiología , Estaciones del Año , Zoonosis/epidemiología , Zoonosis/mortalidad , Zoonosis/transmisión
13.
Sci Rep ; 11(1): 3735, 2021 02 12.
Artículo en Inglés | MEDLINE | ID: mdl-33580190

RESUMEN

Underlying chronic respiratory disease may be associated with the severity of coronavirus disease 2019 (COVID-19). This study investigated the impact of chronic obstructive pulmonary disease (COPD) on the risk for respiratory failure and mortality in COVID-19 patients. A nationwide retrospective cohort study was conducted in 4610 patients (≥ 40 years old) infected with COVID-19 between January 20 and May 27, 2020, using data from the Ministry of Health and Welfare and Health Insurance Review and Assessment Service in Korea. The clinical course and various clinical features were compared between COPD and non-COPD patients, and the risks of respiratory failure and all-cause mortality in COPD patients were analyzed using a multivariate logistic regression model. Among 4610 COVID-19 patients, 4469 (96.9%) and 141 (3.1%) were categorized into the non-COPD and COPD groups, respectively. The COPD group had greater proportions of older (≥ 60 years old) (78.0% vs. 45.2%, P < 0.001) and male (52.5% vs. 36.6%, P < 0.001) patients than the non-COPD group. Relatively greater proportions of patients with COPD received intensive critical care (7.1% vs. 3.7%, P = 0.041) and mechanical ventilation (5.7% vs. 2.4%, P = 0.015). Multivariate analyses showed that COPD was not a risk factor for respiratory failure but was a significant independent risk factor for all-cause mortality (OR = 1.80, 95% CI 1.11-2.93) after adjustment for age, sex, and Charlson Comorbidity Index score. Among COVID-19 patients, relatively greater proportions of patients with COPD received mechanical ventilation and intensive critical care. COPD is an independent risk factor for all-cause mortality in COVID-19 patients in Korea.


Asunto(s)
/complicaciones , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Adulto , /terapia , Femenino , Humanos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Mortalidad/tendencias , Enfermedad Pulmonar Obstructiva Crónica/mortalidad , Enfermedad Pulmonar Obstructiva Crónica/terapia , República de Corea , Respiración Artificial/estadística & datos numéricos , Resultado del Tratamiento
14.
PLoS One ; 16(2): e0246190, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33592019

RESUMEN

BACKGROUND AND OBJECTIVES: With the increase in the number of COVID-19 infections, the global health apparatus is facing insufficient resources. The main objective of the current study is to provide additional data regarding the clinical characteristics of the patients diagnosed with COVID-19, and in particular to analyze the factors associated with disease severity, lack of improvement, and mortality. METHODS: 102 studies were included in the present meta-analysis, all of which were published before September 24, 2020. The studies were found by searching a number of databases, including Scopus, MEDLINE, Web of Science, and Embase. We performed a thorough search from early February until September 24. The selected papers were evaluated and analyzed using Stata software application version 14. RESULTS: Ultimately, 102 papers were selected for this meta- analysis, covering 121,437 infected patients. The mean age of the patients was 58.42 years. The results indicate a prevalence of 79.26% for fever (95% CI: 74.98-83.26; I2 = 97.35%), 60.70% for cough (95% CI: 56.91-64.43; I2 = 94.98%), 33.21% for fatigue or myalgia (95% CI: 28.86-37.70; I2 = 96.12%), 31.30% for dyspnea (95% CI: 26.14-36.69; I2 = 97.67%), and 10.65% for diarrhea (95% CI: 8.26-13.27; I2 = 94.20%). The prevalence for the most common comorbidities was 28.30% for hypertension (95% CI: 23.66-33.18; I2 = 99.58%), 14.29% for diabetes (95% CI: 11.88-16.87; I2 = 99.10%), 12.30% for cardiovascular diseases (95% CI: 9.59-15.27; I2 = 99.33%), and 5.19% for chronic kidney disease (95% CI: 3.95-6.58; I2 = 96.42%). CONCLUSIONS: We evaluated the prevalence of some of the most important comorbidities in COVID-19 patients, indicating that some underlying disorders, including hypertension, diabetes, cardiovascular diseases, and chronic kidney disease, can be considered as risk factors for patients with COVID-19 infection. Furthermore, the results show that an elderly male with underlying diseases is more likely to have severe COVID-19.


Asunto(s)
/epidemiología , Enfermedades Cardiovasculares/epidemiología , Tos/epidemiología , Diabetes Mellitus/epidemiología , Diarrea/epidemiología , Fiebre/epidemiología , Insuficiencia Renal Crónica/epidemiología , Adulto , Anciano , Comorbilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mortalidad/tendencias
15.
Natl Vital Stat Rep ; 69(13): 1-83, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33541516

RESUMEN

Objectives-This report presents final 2018 data on U.S. deaths, death rates, life expectancy, infant and maternal mortality, and trends by selected characteristics such as age, sex, Hispanic origin and race, state of residence, and cause of death. The race categories are consistent with 1997 Office of Management and Budget (OMB) standards, which are different from previous reports (1977 OMB standards). Methods-Information reported on death certificates is presented in descriptive tabulations. The original records are filed in state registration offices. Statistical information is compiled in a national database through the Vital Statistics Cooperative Program of the National Center for Health Statistics. Causes of death are processed according to the International Classification of Diseases, 10th Revision. As of 2018, all states and the District of Columbia were using the 2003 revised certificate of death, which includes the 1997 OMB revised standards for race. The 2018 data based on the revised standards are not completely comparable to previous years. Selected estimates are presented in this report for both the revised and previous race standards to provide some reference for interpretation of trends. Results-In 2018, a total of 2,839,205 deaths were reported in the United States. The age-adjusted death rate was 723.6 deaths per 100,000 U.S. standard population, a decrease of 1.1% from the 2017 rate. Life expectancy at birth was 78.7 years, an increase of 0.1 year from 2017. Age-specific death rates decreased in 2018 from 2017 for age groups 15-24, 25-34, 45-54, 65-74, 75-84, and 85 and over. The 15 leading causes of death in 2018 remained the same as in 2017. The infant mortality rate decreased 2.2% to a historically low figure of 5.66 infant deaths per 1,000 live births in 2018. Conclusions-The age-adjusted death rate for the total, male, and female populations decreased from 2017 to 2018, and life expectancy at birth increased in 2018 for the total, male, and female populations.


Asunto(s)
Mortalidad/tendencias , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Causas de Muerte/tendencias , Niño , Preescolar , Grupos Étnicos/estadística & datos numéricos , Femenino , Hispanoamericanos/estadística & datos numéricos , Humanos , Lactante , Recién Nacido , Esperanza de Vida/tendencias , Masculino , Persona de Mediana Edad , Características de la Residencia/estadística & datos numéricos , Distribución por Sexo , Estados Unidos/epidemiología , Estadísticas Vitales , Adulto Joven
16.
Medicine (Baltimore) ; 100(6): e24671, 2021 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-33578598

RESUMEN

ABSTRACT: The mortality rate of patients diagnosed with sepsis is high. To date, many markers in sepsis patients have been studied to diagnose, determine their prognosis, and contribute to treatment. These studies were conducted in both experimental and clinical settings, but clinical trials remain limited. Therefore, more well-planned clinical studies are needed in patients with sepsis.The current study aimed to examine the prognostic role of signal peptide-CUB-epidermal growth factor-like domain-containing protein 1 (SCUBE-1) in sepsis and sepsis-related mortality. We also wanted to study its relationship with inflammatory markers and scoring systems.This prospective, cross-sectional, observational study included a total of 187 sepsis cases treated in the intensive care unit. Venous samples were obtained after diagnosis. The patients were separated into 2 groups: (1) the survivor group who were discharged or transferred within 28 days of the first diagnosis and (2) the nonsurvivor group who died within 28 days of the first diagnosis.The SCUBE-1, C-reactive protein, procalcitonin, creatinine, lactate values, acute physiology and chronic health evaluation 2, sequential organ failure assessment scores were significantly higher in the survivor group, and platelets were higher in the survivor group. In addition, SCUBE-1 positively correlated with the inflammatory markers C-reactive protein, lactate, sequential organ failure assessment, and acute physiology and chronic health evaluation 2. Additionally, the SCUBE-1 value predicts 28-day mortality, and the optimal cutoff value for predicting mortality is 4,73 pg/mL.Sepsis is a disease with high mortality. SCUBE-1 can be used as a new prognostic factor for sepsis patients.


Asunto(s)
Biomarcadores/metabolismo , Proteínas de Unión al Calcio/metabolismo , Unidades de Cuidados Intensivos/estadística & datos numéricos , Sepsis/metabolismo , Sobrevivientes/estadística & datos numéricos , APACHE , Anciano , Anciano de 80 o más Años , Proteína C-Reactiva/metabolismo , Estudios de Casos y Controles , Reglas de Decisión Clínica , Creatinina/sangre , Estudios Transversales , Femenino , Humanos , Ácido Láctico/análisis , Masculino , Mortalidad/tendencias , Puntuaciones en la Disfunción de Órganos , Polipéptido alfa Relacionado con Calcitonina/metabolismo , Pronóstico , Estudios Prospectivos , Sepsis/diagnóstico , Sepsis/mortalidad , Turquia/epidemiología
17.
Artículo en Ruso | MEDLINE | ID: mdl-33591650

RESUMEN

The statistical data on mortality due to COVID-19 has been studied. The weekly cycle of mortality was established. Presumably, the decreased mortality on particular days of the week related to optimized treatment protocols applied on the «favorable days¼. If the factors reducing mortality on particular days of the week could be identified, their positive effect should be applied to other days of the week to decrease mortality among patients with COVID-19.


Asunto(s)
Humanos , Mortalidad/tendencias
18.
MMWR Morb Mortal Wkly Rep ; 70(6): 202-207, 2021 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-33571180

RESUMEN

Deaths involving synthetic opioids other than methadone (synthetic opioids), which largely consist of illicitly manufactured fentanyl; psychostimulants with abuse potential (e.g., methamphetamine); and cocaine have increased in recent years, particularly since 2013 (1,2). In 2019, a total of 70,630 drug overdose deaths occurred, corresponding to an age-adjusted rate of 21.6 per 100,000 population and a 4.3% increase from the 2018 rate (20.7) (3). CDC analyzed trends in age-adjusted overdose death rates involving synthetic opioids, psychostimulants, cocaine, heroin, and prescription opioids during 2013-2019, as well as geographic patterns in synthetic opioid- and psychostimulant-involved deaths during 2018-2019. From 2013 to 2019, the synthetic opioid-involved death rate increased 1,040%, from 1.0 to 11.4 per 100,000 age-adjusted (3,105 to 36,359). The psychostimulant-involved death rate increased 317%, from 1.2 (3,627) in 2013 to 5.0 (16,167) in 2019. In the presence of synthetic opioid coinvolvement, death rates for prescription opioids, heroin, psychostimulants, and cocaine increased. In the absence of synthetic opioid coinvolvement, death rates increased only for psychostimulants and cocaine. From 2018 to 2019, the largest relative increase in the synthetic opioid-involved death rate occurred in the West (67.9%), and the largest relative increase in the psychostimulant-involved death rate occurred in the Northeast (43.8%); these increases represent important changes in the geographic distribution of drug overdose deaths. Evidence-based prevention and response strategies including substance use disorder treatment and overdose prevention and response efforts focused on polysubstance use must be adapted to address the evolving drug overdose epidemic.


Asunto(s)
Analgésicos Opioides/envenenamiento , Sobredosis de Droga/mortalidad , Drogas Sintéticas/envenenamiento , Geografía , Humanos , Mortalidad/tendencias , Estados Unidos/epidemiología
19.
Biomed Environ Sci ; 34(1): 1-8, 2021 Jan 20.
Artículo en Inglés | MEDLINE | ID: mdl-33531102

RESUMEN

Objective: To investigate the association between blood pressure and all-cause mortality in Shanxi, China. Methods: The '2002 China Nutrition and Health Survey' baseline data in Shanxi province was used. A retrospective investigation was performed in 2015. The effects of SBP and DBP on the all-cause mortality were analyzed using the Cox regression model. The hazard ratio ( HR) and 95% confidence interval ( CI) were estimated by the sex and age groups. Results: The follow-up rate was 76.52% over 13 years, while the cumulative mortality rate for all participants was 917.12/100,000 person-years. The mortality rose with an increasing SBP ( χ 2 trend = 270.537, P < 0.001) or DBP level ( χ 2 trend = 57.240, P < 0.001). After adjustment for the confounding factors, a significant association between mortality and high SBP (≥ 160 mmHg) and high DBP (≥ 100 mmHg), with adjusted HR ranging from 1.405- to 2.179-fold for SBP and 1.550- to 2.854-fold for DBP, was noted. Significant HRs for most DBP subgroups were found in > 60-year-old participants. Males with DBP ≥ 100 mmHg had a significantly higher mortality, with an HR (95% CI) of 2.715 (1.377-5.351). Conclusion: Adults with SBP > 160 mmHg and DBP > 100 mmHg had a higher mortality risk. Sex and age difference was noted in both DBP and mortality risk.


Asunto(s)
Hipertensión/mortalidad , Mortalidad/tendencias , Adolescente , Adulto , Anciano , Presión Sanguínea , China , Estudios de Cohortes , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Adulto Joven
20.
Epidemiol Serv Saude ; 30(1): e2020680, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33566896

RESUMEN

OBJECTIVE: To describe the Institute for Health Metrics and Evaluation (IHME) projections for the COVID-19 pandemic in Brazil and the Brazilian states, present their accuracy and discuss their implications. METHODS: The IHME projections from May to August 2020 for Brazil and selected states were compared with the ensuing reported number of cumulative deaths. RESULTS: The pandemic was projected to cause 182,809 deaths by December 1, 2020 in Brazil. An increase in mask use could reduce the projected death toll by ~17,000. The mean error in the cumulative number of deaths at 2, 4 and 6 weeks after the projections were made was 13%, 18% and 22%, respectively. CONCLUSION: Short and medium-term projections provide important and sufficiently accurate data to inform health managers, elected officials, and society at large. After following an arduous course up until August, the pandemic is projected to decline steadily although slowly, with ~400 deaths/day still occurring in early December.


Asunto(s)
/mortalidad , Predicción , Pandemias/estadística & datos numéricos , Brasil/epidemiología , /prevención & control , Humanos , Máscaras/estadística & datos numéricos , Modelos Teóricos , Mortalidad/tendencias , Factores de Tiempo
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