Do pre-existing medical conditions affect COVID-19 incidence and fatality in Nigeria? A Geographical Perspective

Osayomi, Tolulope; Adeleke, Richard; Yaya, Sanni; Ayanda, Joy Temitope; Akpoterai, Lawrence Enejeta; Fatayo, Opeyemi Caleb

doi:10.1515/openhe-2022-0007

Cited by 2 publications

(1 citation statement)

References 36 publications

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“…In most cases, treatment benefits are offset by their preferential use in patients with a poorer prognosis. A multivariate analysis separates the independent effects of treatment and associated comorbidities (eg, obesity 6 ), removing bias and revealing beneficial factors. The challenge is that hundreds of conditions may serve as confounders.…”

Section: Methodsmentioning

confidence: 99%

Effect of vaccination on the case fatality rate for COVID-19 infections 2020–2021: multivariate modelling of data from the US Department of Veterans Affairs

Murata

Murata²,

Perkins

et al. 2022

BMJ Open

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ObjectivesTo evaluate the benefits of vaccination on the case fatality rate (CFR) for COVID-19 infections.Design, setting and participantsThe US Department of Veterans Affairs has 130 medical centres. We created multivariate models from these data—339 772 patients with COVID-19—as of 30 September 2021.Outcome measuresThe primary outcome for all models was death within 60 days of the diagnosis. Logistic regression was used to derive adjusted ORs for vaccination and infection with Delta versus earlier variants. Models were adjusted for confounding factors, including demographics, comorbidity indices and novel parameters representing prior diagnoses, vital signs/baseline laboratory tests and outpatient treatments. Patients with a Delta infection were divided into eight cohorts based on the time from vaccination to diagnosis. A common model was used to estimate the odds of death associated with vaccination for each cohort relative to that of unvaccinated patients.Results9.1% of subjects were vaccinated. 21.5% had the Delta variant. 18 120 patients (5.33%) died within 60 days of their diagnoses. The adjusted OR for a Delta infection was 1.87±0.05, which corresponds to a relative risk (RR) of 1.78. The overall adjusted OR for prior vaccination was 0.280±0.011 corresponding to an RR of 0.291. Raw CFR rose steadily after 10–14 weeks. The OR for vaccination remained stable for 10–34 weeks.ConclusionsOur CFR model controls for the severity of confounding factors and priority of vaccination, rather than solely using the presence of comorbidities. Our results confirm that Delta was more lethal than earlier variants and that vaccination is an effective means of preventing death. After adjusting for major selection biases, we found no evidence that the benefits of vaccination on CFR declined over 34 weeks. We suggest that this model can be used to evaluate vaccines designed for emerging variants.

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Section: Methodsmentioning

confidence: 99%