Epidemiological trends in COVID-19 pandemic: prospective critical appraisal of observations from six countries in Europe and the USA

Abstract

IntroductionEurope was the epicentre of the COVID-19 pandemic in March 2020, with the highest number of cases and deaths between March and April. In May, the infection numbers registered a fall followed by a second new rise, not proportionally reflected by an increase in the number of deaths. We aimed to investigate the relationship between disease prevalence and infection fatality rate (IFR), and the number of intensive care unit (ICU) and hospital admissions over time, to develop a predictive model, as well as appraising the potential contributing factors underpinning this complex relationship.MethodsA prospective epidemiological study using data from six countries collected between 10 March and 4 September 2020. Data on the number of daily hospital and ICU admissions with COVID-19 were gathered, and the IFR and the prevalence were calculated. Trends over time were analysed. A linear regression model was used to determine the association between the fatality rates and the number of admissions.FindingsThe prediction model confirmed the linear association between the fatality rates and the numbers of ICU and hospital admissions. The exception was during the peak of the COVID-19 pandemic when the model underestimated the fatalities indicating that a substantial number of deaths occurred outside of the hospitals. The fatality rates decreased in all countries from May until September regardless of the trends in prevalence, differences in healthcare systems or strategic variations in handling the pandemic.InterpretationThe observed gradual reduction in COVID-19 fatality rates over time despite varying disease prevalence and public health measures across multiple countries warrants search for a biological explanation. While our understanding of this novel virus grows, hospital and ICU admission rates remain effective predictors of patient outcomes which can be used as early warning signs for escalation of public health measures.

Aumento de solicitações de dímero–D na primeira onda de COVID-19 em um hospital universitário da região metropolitana do Estado do Rio de Janeiro

“…Ademais, os amplos e generalizados impactos ocasionados pela pandemia notoriamente tiveram desdobramentos sem precedentes nas políticas de saúde públicas, não apenas pelo Brasil mas também mundo afora. (Chen et al, 2020;Velicu et al, 2021) O esgotamento da oferta desses reagentes ocorreu de forma difusa, não apenas em um, como em outros hospitais, o que eleva as considerações de atendimento das demandas gerenciais a um prisma multifatorial e complexo.…”

“…No entanto, a despeito do caráter multifatorial (Chen et al, 2020;Velicu et al, 2021) que teria culminado em interrupção do fornecimento de reagentes licitados, obrigando a administração pública a ações sanadoras a fim de garantir a continuidade na prestação dos serviços, a necessidade de importação de insumos somada à diminuição do tráfego aéreo parece ter tido maior peso de contribuição no desabastecimento momentâneo destes insumos no laboratório em estudo, motivo pelo qual uma revisão dos protocolos de ações em situações de calamidade seriam oportunos como medida de prevenção no caso de uma próxima eventualidade.…”

“…(BRASIL, 2020) Desde então, a política de saúde pública no Brasil e no mundo, precisa lidar com inúmeros desafios, sobretudo no aspecto da gestão de riscos e de calamidades, fator indispensável na contenção de maiores desdobramentos pelo atual momento pandêmico. (Quacken et al, 2021;Velicu et al, 2021;WHO, 2010) O mundo ainda está tentando compreender a fisiopatologia da doença e seus diversos biomarcadores de gravidade.…”

COVID-19 infections among Iraqi school students: Severity, types, and symptoms

“…Additionally, some individuals may remain asymptomatic, showing no signs of illness. It is crucial to recognize and monitor these variations to better understand and manage the impacts of the pandemic and to protect vulnerable populations [6][7][8][9][10]. Asymptomatic infection is defined as an individual who tested positive for a laboratory-confirmed SARS-CoV-2 infection but did not exhibit any clinical symptoms associated with COVID-19 throughout the course of their illness.…”