Impacts of air pollution on COVID-19 case fatality rate: a global analysis

Li, Chao; Managi, Shunsuke

doi:10.1007/s11356-021-18442-x

Cited by 6 publications

(3 citation statements)

References 68 publications

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“…Thus, COVID-19 CFRs are widely considered to be influenced by multidimensional factors. Previous studies have tried to explain cross-country variation in COVID-19 CFR using a variety of unidimensional factors such as population age structure[ 7 , 8 ], comorbidities [ 9 , 10 ], medical resources [ 11 ], environment [ 12 ], culture, and so on [ 13 ]. While these studies have found some associations, they have also ignored the important interaction effects of these factors on the risk of COVID-19 death within a single country.…”

Section: Introductionmentioning

confidence: 99%

Country-specific determinants for COVID-19 case fatality rate and response strategies from a global perspective: an interpretable machine learning framework

Zhou,

Wheelock,

Zhang

et al. 2024

Popul Health Metrics

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Background There are significant geographic inequities in COVID-19 case fatality rates (CFRs), and comprehensive understanding its country-level determinants in a global perspective is necessary. This study aims to quantify the country-specific risk of COVID-19 CFR and propose tailored response strategies, including vaccination strategies, in 156 countries. Methods Cross-temporal and cross-country variations in COVID-19 CFR was identified using extreme gradient boosting (XGBoost) including 35 factors from seven dimensions in 156 countries from 28 January, 2020 to 31 January, 2022. SHapley Additive exPlanations (SHAP) was used to further clarify the clustering of countries by the key factors driving CFR and the effect of concurrent risk factors for each country. Increases in vaccination rates was simulated to illustrate the reduction of CFR in different classes of countries. Findings Overall COVID-19 CFRs varied across countries from 28 Jan 2020 to 31 Jan 31 2022, ranging from 68 to 6373 per 100,000 population. During the COVID-19 pandemic, the determinants of CFRs first changed from health conditions to universal health coverage, and then to a multifactorial mixed effect dominated by vaccination. In the Omicron period, countries were divided into five classes according to risk determinants. Low vaccination-driven class (70 countries) mainly distributed in sub-Saharan Africa and Latin America, and include the majority of low-income countries (95.7%) with many concurrent risk factors. Aging-driven class (26 countries) mainly distributed in high-income European countries. High disease burden-driven class (32 countries) mainly distributed in Asia and North America. Low GDP-driven class (14 countries) are scattered across continents. Simulating a 5% increase in vaccination rate resulted in CFR reductions of 31.2% and 15.0% for the low vaccination-driven class and the high disease burden-driven class, respectively, with greater CFR reductions for countries with high overall risk (SHAP value > 0.1), but only 3.1% for the ageing-driven class. Conclusions Evidence from this study suggests that geographic inequities in COVID-19 CFR is jointly determined by key and concurrent risks, and achieving a decreasing COVID-19 CFR requires more than increasing vaccination coverage, but rather targeted intervention strategies based on country-specific risks.

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Section: Introductionmentioning

confidence: 99%

Country-specific determinants for COVID-19 case fatality rate and response strategies from a global perspective: an interpretable machine learning framework

Zhou,

Wheelock,

Zhang

et al. 2024

Popul Health Metrics

View full text Add to dashboard Cite

show abstract

“…The risk of death from COVID-19 varies between countries, and case fatality rate (CFR) is an important indicator used to assess it. It is widely considered that the COVID-19 CFRs are affected by multidimensional factors, such as the SARS-CoV-2 variant infected ( 3 ), vaccination coverage ( 4 ), population age structure ( 5 , 6 ), health service ( 7 ), disease burden ( 8 , 9 ), environment ( 10 ), and so on ( 11 ). Of these, as the COVID-19 CFR is strongly associated with age, considering age structure when comparing CFR differences across countries is more helpful in minimizing potential bias ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

The role of booster vaccination in decreasing COVID-19 age-adjusted case fatality rate: Evidence from 32 countries

Zhou

Wheelock

Zhang

et al. 2023

Front. Public Health

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BackgroundThe global COVID-19 pandemic is still ongoing, and cross-country and cross-period variation in COVID-19 age-adjusted case fatality rates (CFRs) has not been clarified. Here, we aimed to identify the country-specific effects of booster vaccination and other features that may affect heterogeneity in age-adjusted CFRs with a worldwide scope, and to predict the benefit of increasing booster vaccination rate on future CFR.MethodCross-temporal and cross-country variations in CFR were identified in 32 countries using the latest available database, with multi-feature (vaccination coverage, demographic characteristics, disease burden, behavioral risks, environmental risks, health services and trust) using Extreme Gradient Boosting (XGBoost) algorithm and SHapley Additive exPlanations (SHAP). After that, country-specific risk features that affect age-adjusted CFRs were identified. The benefit of booster on age-adjusted CFR was simulated by increasing booster vaccination by 1–30% in each country.ResultsOverall COVID-19 age-adjusted CFRs across 32 countries ranged from 110 deaths per 100,000 cases to 5,112 deaths per 100,000 cases from February 4, 2020 to Jan 31, 2022, which were divided into countries with age-adjusted CFRs higher than the crude CFRs and countries with age-adjusted CFRs lower than the crude CFRs (n = 9 and n = 23) when compared with the crude CFR. The effect of booster vaccination on age-adjusted CFRs becomes more important from Alpha to Omicron period (importance scores: 0.03–0.23). The Omicron period model showed that the key risk factors for countries with higher age-adjusted CFR than crude CFR are low GDP per capita and low booster vaccination rates, while the key risk factors for countries with higher age-adjusted CFR than crude CFR were high dietary risks and low physical activity. Increasing booster vaccination rates by 7% would reduce CFRs in all countries with age-adjusted CFRs higher than the crude CFRs.ConclusionBooster vaccination still plays an important role in reducing age-adjusted CFRs, while there are multidimensional concurrent risk factors and precise joint intervention strategies and preparations based on country-specific risks are also essential.

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“…Studies using statistical and computational techniques have shown that air pollution threatens human health and affects the spread of communicable diseases [ 4 , 5 ]. A large number of research results have also offered accumulated proof of the influence of pollutants in the air on the transmission of communicable diseases such as influenza, measles, COVID-19, and so on [ 6 – 9 ]. Therefore, it has been one of the most fun and significant topics to investigate the impact of pollutants in the air on the burst of communicable diseases [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Dynamics and calculation of the basic reproduction number for a nonlocal dispersal epidemic model with air pollution

Zhou

Zhang

2023

J. Appl. Math. Comput.

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In order to reflect the dispersal of pollutants in non-adjacent areas and the large-scale movement of individuals, this paper proposes an epidemic model of nonlocal dispersal with air pollution, where the transmission rate is related to the concentration of pollutants. This paper checks the uniqueness and existence of the global positive solution and defines the basic reproduction number, . We simultaneously explore the global dynamics: when , the disease-free stable point is global asymptotic stability; when , the disease is uniformly persistent. Additionally, in order to approximate , a numerical method has been introduced. Illustrative examples are used to verify the theoretical outcomes and show the effect of the dispersal rate on the basic reproduction number .

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Impacts of air pollution on COVID-19 case fatality rate: a global analysis

Cited by 6 publications

References 68 publications

Country-specific determinants for COVID-19 case fatality rate and response strategies from a global perspective: an interpretable machine learning framework

Country-specific determinants for COVID-19 case fatality rate and response strategies from a global perspective: an interpretable machine learning framework

The role of booster vaccination in decreasing COVID-19 age-adjusted case fatality rate: Evidence from 32 countries

Dynamics and calculation of the basic reproduction number for a nonlocal dispersal epidemic model with air pollution

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