tetano
Editor, Senior Moderator
Clin Infect Dis
. 2020 Oct 1;ciaa1187.
doi: 10.1093/cid/ciaa1187. Online ahead of print.
Significantly Lower Case-fatality Ratio of Coronavirus Disease 2019 (COVID-19) than Severe Acute Respiratory Syndrome (SARS) in Hong Kong-A Territory-Wide Cohort Study
Grace Chung-Yan Lui[SUP] 1 2 3 [/SUP], Terry Cheuk-Fung Yip[SUP] 1 2 4 [/SUP], Vincent Wai-Sun Wong[SUP] 1 2 4 [/SUP], Viola Chi-Ying Chow[SUP] 5 [/SUP], Tracy Hang-Yee Ho[SUP] 1 [/SUP], Timothy Chun-Man Li[SUP] 1 [/SUP], Yee-Kit Tse[SUP] 1 2 4 [/SUP], Henry Lik-Yuen Chan[SUP] 1 2 4 [/SUP], David Shu-Cheong Hui[SUP] 1 2 3 [/SUP], Grace Lai-Hung Wong[SUP] 1 2 4 [/SUP]
Affiliations
Abstract
Background: The case-fatality ratios (CFR) of coronavirus disease 2019 (COVID-19) and severe acute respiratory syndrome (SARS) appeared to differ substantially. We aimed to compare the CFR and its predictors of COVID-19 and SARS patients using a territory-wide cohort in Hong Kong.
Methods: This was a territory-wide retrospective cohort study using data captured from all public hospitals in Hong Kong. Laboratory-confirmed COVID-19 and SARS patients were identified. The primary endpoint was a composite endpoint of intensive care unit admission, use of mechanical ventilation, and/or death.
Results: We identified 1013 COVID-19 patients (mean age, 38.4 years; 53.9% male) diagnosed from 23 January to 14 April 2020 and 1670 SARS patients (mean age, 44.4 years; 44.0% male) from March to June 2003. Fifty-five (5.4%) COVID-19 patients and 432 (25.9%) SARS patients had reached the primary endpoint in 30 days. By 30 June 2003, 286 SARS patients had died (CFR, 17.1%). By 7 June 2020, 4 COVID-19 patients had died (CFR, 0.4%). After adjusting for demographic and clinical parameters, COVID-19 was associated with a 71% lower risk of primary endpoint compared with SARS (adjusted hazard ratio, 0.29; 95% confidence interval, .21-.40; P < .0001). Age, diabetes mellitus, and laboratory parameters (high lactate dehydrogenase, high C-reactive protein, and low platelet count) were independent predictors of the primary endpoint in COVID-19 patients, whereas use of antiviral treatments was not associated with primary endpoint.
Conclusions: The CFR of COVID-19 was 0.4%. Age and diabetes were associated with worse outcomes, whereas antiviral treatments were not.
Keywords: SARS-CoV-2; COVID-19; death; nCoV; pneumonia.
. 2020 Oct 1;ciaa1187.
doi: 10.1093/cid/ciaa1187. Online ahead of print.
Significantly Lower Case-fatality Ratio of Coronavirus Disease 2019 (COVID-19) than Severe Acute Respiratory Syndrome (SARS) in Hong Kong-A Territory-Wide Cohort Study
Grace Chung-Yan Lui[SUP] 1 2 3 [/SUP], Terry Cheuk-Fung Yip[SUP] 1 2 4 [/SUP], Vincent Wai-Sun Wong[SUP] 1 2 4 [/SUP], Viola Chi-Ying Chow[SUP] 5 [/SUP], Tracy Hang-Yee Ho[SUP] 1 [/SUP], Timothy Chun-Man Li[SUP] 1 [/SUP], Yee-Kit Tse[SUP] 1 2 4 [/SUP], Henry Lik-Yuen Chan[SUP] 1 2 4 [/SUP], David Shu-Cheong Hui[SUP] 1 2 3 [/SUP], Grace Lai-Hung Wong[SUP] 1 2 4 [/SUP]
Affiliations
- PMID: 33005933
- DOI: 10.1093/cid/ciaa1187
Abstract
Background: The case-fatality ratios (CFR) of coronavirus disease 2019 (COVID-19) and severe acute respiratory syndrome (SARS) appeared to differ substantially. We aimed to compare the CFR and its predictors of COVID-19 and SARS patients using a territory-wide cohort in Hong Kong.
Methods: This was a territory-wide retrospective cohort study using data captured from all public hospitals in Hong Kong. Laboratory-confirmed COVID-19 and SARS patients were identified. The primary endpoint was a composite endpoint of intensive care unit admission, use of mechanical ventilation, and/or death.
Results: We identified 1013 COVID-19 patients (mean age, 38.4 years; 53.9% male) diagnosed from 23 January to 14 April 2020 and 1670 SARS patients (mean age, 44.4 years; 44.0% male) from March to June 2003. Fifty-five (5.4%) COVID-19 patients and 432 (25.9%) SARS patients had reached the primary endpoint in 30 days. By 30 June 2003, 286 SARS patients had died (CFR, 17.1%). By 7 June 2020, 4 COVID-19 patients had died (CFR, 0.4%). After adjusting for demographic and clinical parameters, COVID-19 was associated with a 71% lower risk of primary endpoint compared with SARS (adjusted hazard ratio, 0.29; 95% confidence interval, .21-.40; P < .0001). Age, diabetes mellitus, and laboratory parameters (high lactate dehydrogenase, high C-reactive protein, and low platelet count) were independent predictors of the primary endpoint in COVID-19 patients, whereas use of antiviral treatments was not associated with primary endpoint.
Conclusions: The CFR of COVID-19 was 0.4%. Age and diabetes were associated with worse outcomes, whereas antiviral treatments were not.
Keywords: SARS-CoV-2; COVID-19; death; nCoV; pneumonia.