SARS-CoV 2 (Covid-19) Heterogeneous Mortality Rates across Countries May Be Partly Explained by Life Expectancy, Calorie Intake, and Prevalence of Diabetes.

Nkhata, Smith G.; Ngoma, Theresa N.; Chilenga, Praise M

doi:10.1007/s10745-020-00191-z

Cited by 7 publications

(7 citation statements)

References 19 publications

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“…Regarding the clinical factors, our data confirmed that the prevalence of diabetes independently predicted the risk of death. This observation has been widely documented also at the individual level ( 59 , 60 ). This has been attributed to the fact that the patients with diabetes have delayed viral clearance, decreased immunity, and increased angiotensin-converting enzyme 2 (ACE2) expression, leading to an inappropriate response to COVID-19 infection and other secondary infections ( 41 , 61 , 62 ).…”

Section: Discussionsupporting

confidence: 58%

The Determinants of the Low COVID-19 Transmission and Mortality Rates in Africa: A Cross-Country Analysis

Bouba

Tsinda

Fonkou

et al. 2021

Front. Public Health

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Background: More than 1 year after the beginning of the international spread of coronavirus 2019 (COVID-19), the reasons explaining its apparently lower reported burden in Africa are still to be fully elucidated. Few studies previously investigated the potential reasons explaining this epidemiological observation using data at the level of a few African countries. However, an updated analysis considering the various epidemiological waves and variables across an array of categories, with a focus on African countries might help to better understand the COVID-19 pandemic on the continent. Thus, we investigated the potential reasons for the persistently lower transmission and mortality rates of COVID-19 in Africa.Methods: Data were collected from publicly available and well-known online sources. The cumulative numbers of COVID-19 cases and deaths per 1 million population reported by the African countries up to February 2021 were used to estimate the transmission and mortality rates of COVID-19, respectively. The covariates were collected across several data sources: clinical/diseases data, health system performance, demographic parameters, economic indicators, climatic, pollution, and radiation variables, and use of social media. The collinearities were corrected using variance inflation factor (VIF) and selected variables were fitted to a multiple regression model using the R statistical package.Results: Our model (adjusted R-squared: 0.7) found that the number of COVID-19 tests per 1 million population, GINI index, global health security (GHS) index, and mean body mass index (BMI) were significantly associated (P < 0.05) with COVID-19 cases per 1 million population. No association was found between the median life expectancy, the proportion of the rural population, and Bacillus Calmette–Guérin (BCG) coverage rate. On the other hand, diabetes prevalence, number of nurses, and GHS index were found to be significantly associated with COVID-19 deaths per 1 million population (adjusted R-squared of 0.5). Moreover, the median life expectancy and lower respiratory infections rate showed a trend towards significance. No association was found with the BCG coverage or communicable disease burden.Conclusions: Low health system capacity, together with some clinical and socio-economic factors were the predictors of the reported burden of COVID-19 in Africa. Our results emphasize the need for Africa to strengthen its overall health system capacity to efficiently detect and respond to public health crises.

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Section: Discussionsupporting

confidence: 58%

The Determinants of the Low COVID-19 Transmission and Mortality Rates in Africa: A Cross-Country Analysis

Bouba

Tsinda

Fonkou

et al. 2021

Front. Public Health

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“…Interestingly, treatment under real world conditions resulted in similar outcomes compared with a treatment strategy in which none of the patients had received ECMO. This finding might be explained by factors related to patient selection for ECMO and by influences related to country specific and temporal heterogeneity in decision making and treatment capacity 2728. For example, clinicians might have been hesitant to use ECMO early in the pandemic after reports of poor survival rates in the initial case series of patients with covid-19 associated acute respiratory failure.…”

Section: Discussionmentioning

confidence: 99%

Venovenous extracorporeal membrane oxygenation in patients with acute covid-19 associated respiratory failure: comparative effectiveness study

Urner

Barnett

Bassi

et al. 2022

BMJ

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Objective To estimate the effect of extracorporeal membrane oxygenation (ECMO) compared with conventional mechanical ventilation on outcomes of patients with covid-19 associated respiratory failure. Design Observational study. Setting 30 countries across five continents, 3 January 2020 to 29 August 2021. Participants 7345 adults admitted to the intensive care unit with clinically suspected or laboratory confirmed SARS-CoV-2 infection. Interventions ECMO in patients with a partial pressure of arterial oxygen to fraction of inspired oxygen (PaO 2 /FiO 2 ) ratio <80 mm Hg compared with conventional mechanical ventilation without ECMO. Main outcome measure The primary outcome was hospital mortality within 60 days of admission to the intensive care unit. Adherence adjusted estimates were calculated using marginal structural models with inverse probability weighting, accounting for competing events and for baseline and time varying confounding. Results 844 of 7345 eligible patients (11.5%) received ECMO at any time point during follow-up. Adherence adjusted mortality was 26.0% (95% confidence interval 24.5% to 27.5%) for a treatment strategy that included ECMO if the PaO 2 /FiO 2 ratio decreased <80 mm Hg compared with 33.2% (31.8% to 34.6%) had patients received conventional treatment without ECMO (risk difference –7.1%, 95% confidence interval –8.2% to –6.1%; risk ratio 0.78, 95% confidence interval 0.75 to 0.82). In secondary analyses, ECMO was most effective in patients aged <65 years and with a PaO 2 /FiO 2 <80 mm Hg or with driving pressures >15 cmH 2 O during the first 10 days of mechanical ventilation. Conclusions ECMO was associated with a reduction in mortality in selected adults with covid-19 associated respiratory failure. Age, severity of hypoxaemia, and duration and intensity of mechanical ventilation were found to be modifiers of treatment effectiveness and should be considered when deciding to initiate ECMO in patients with covid-19.

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“…The primary endpoint was in‐hospital death. Because the mortality rates due to COVID‐19 are known to vary across countries, 22 the individual data points per country are shown in Supporting Information, Table S3 . The secondary endpoints were intensive care hospitalization and length of stay, the duration of hospitalization, and the need for and duration of non‐invasive mechanical ventilation.…”

Section: Methodsmentioning

confidence: 99%

Heart failure in COVID‐19: the multicentre, multinational PCHF‐COVICAV registry

et al. 2021

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Aims We assessed the outcome of hospitalized coronavirus disease 2019 (COVID‐19) patients with heart failure (HF) compared with patients with other cardiovascular disease and/or risk factors (arterial hypertension, diabetes, or dyslipidaemia). We further wanted to determine the incidence of HF events and its consequences in these patient populations. Methods and results International retrospective Postgraduate Course in Heart Failure registry for patients hospitalized with COVID‐19 and CArdioVascular disease and/or risk factors (arterial hypertension, diabetes, or dyslipidaemia) was performed in 28 centres from 15 countries (PCHF‐COVICAV). The primary endpoint was in‐hospital mortality. Of 1974 patients hospitalized with COVID‐19, 1282 had cardiovascular disease and/or risk factors (median age: 72 [interquartile range: 62–81] years, 58% male), with HF being present in 256 [20%] patients. Overall in‐hospital mortality was 25% ( n = 323/1282 deaths). In‐hospital mortality was higher in patients with a history of HF (36%, n = 92) compared with non‐HF patients (23%, n = 231, odds ratio [OR] 1.93 [95% confidence interval: 1.44–2.59], P < 0.001). After adjusting, HF remained associated with in‐hospital mortality (OR 1.45 [95% confidence interval: 1.01–2.06], P = 0.041). Importantly, 186 of 1282 [15%] patients had an acute HF event during hospitalization (76 [40%] with de novo HF), which was associated with higher in‐hospital mortality (89 [48%] vs. 220 [23%]) than in patients without HF event (OR 3.10 [2.24–4.29], P < 0.001). Conclusions Hospitalized COVID‐19 patients with HF are at increased risk for in‐hospital death. In‐hospital worsening of HF or acute HF de novo are common and associated with a further increase in in‐hospital mortality.

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SARS-CoV 2 (Covid-19) Heterogeneous Mortality Rates across Countries May Be Partly Explained by Life Expectancy, Calorie Intake, and Prevalence of Diabetes.

Abstract: z) contains supplementary material, which is available to authorized users.

Cited by 7 publications

References 19 publications

The Determinants of the Low COVID-19 Transmission and Mortality Rates in Africa: A Cross-Country Analysis

The Determinants of the Low COVID-19 Transmission and Mortality Rates in Africa: A Cross-Country Analysis

Venovenous extracorporeal membrane oxygenation in patients with acute covid-19 associated respiratory failure: comparative effectiveness study

Heart failure in COVID‐19: the multicentre, multinational PCHF‐COVICAV registry

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