tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2022 Mar 3;9(4)
fac101.
doi: 10.1093/ofid/ofac101. eCollection 2022 Apr.
Characteristics and Risk Factors for Mortality by Coronavirus Disease 2019 Pandemic Waves in Fulton County, Georgia: A Cohort Study March 2020-February 2021
Nathaniel Chishinga[SUP] 1 2 [/SUP], Sasha Smith[SUP] 1 [/SUP], Neel R Gandhi[SUP] 3 4 [/SUP], Udodirim N Onwubiko[SUP] 1 [/SUP], Carson Telford[SUP] 1 [/SUP], Juliana Prieto[SUP] 1 [/SUP], Allison T Chamberlain[SUP] 1 3 [/SUP], Shamimul Khan[SUP] 1 [/SUP], Steve Williams[SUP] 2 [/SUP], Fazle Khan[SUP] 1 [/SUP], N Sarita Shah[SUP] 3 4 [/SUP]
Affiliations
Abstract
Background: We examined differences in mortality among coronavirus disease 2019 (COVID-19) cases in the first, second, and third waves of the COVID-19 pandemic.
Methods: A retrospective cohort study of COVID-19 cases in Fulton County, Georgia, USA, reported to a public health surveillance from March 2020 through February 2021. We estimated case-fatality rates (CFR) by wave and used Cox proportional hazards random-effects models in each wave, with random effects at individual and long-term-care-facility level, to determine risk factors associated with rates of mortality.
Results: Of 75 289 confirmed cases, 4490 (6%) were diagnosed in wave 1 (CFR 31 deaths/100 000 person days [pd]), 24 293 (32%) in wave 2 (CFR 7 deaths/100 000 pd), and 46 506 (62%) in wave 3 (CFR 9 deaths/100 000 pd). Compared with females, males were more likely to die in each wave: wave 1 (adjusted hazard ratio [aHR], 1.5; 95% confidence interval [CI], 1.2-1.8), wave 2 (aHR 1.5, 95% CI, 1.2-1.8), and wave 3 (aHR 1.7, 95% CI, 1.5-2.0). Compared with non-Hispanic whites, non-Hispanic blacks were more likely to die in each wave: wave 1 (aHR, 1.4; 95% CI, 1.1-1.8), wave 2 (aHR, 1.5; 95% CI, 1.2-1.9), and wave 3 (aHR, 1.7; 95% CI, 1.4-2.0). Cases with any disability, chronic renal disease, and cardiovascular disease were more likely to die in each wave compared with those without these comorbidities.
Conclusions: Our study found gender and racial/ethnic disparities in COVID-19 mortality and certain comorbidities associated with COVID-19 mortality. These factors have persisted throughout the COVID-19 pandemic waves, despite improvements in diagnosis and treatment.
Keywords: COVID-19; case fatality rate; cohort; mortality; risk factors.
. 2022 Mar 3;9(4)
fac101.doi: 10.1093/ofid/ofac101. eCollection 2022 Apr.
Characteristics and Risk Factors for Mortality by Coronavirus Disease 2019 Pandemic Waves in Fulton County, Georgia: A Cohort Study March 2020-February 2021
Nathaniel Chishinga[SUP] 1 2 [/SUP], Sasha Smith[SUP] 1 [/SUP], Neel R Gandhi[SUP] 3 4 [/SUP], Udodirim N Onwubiko[SUP] 1 [/SUP], Carson Telford[SUP] 1 [/SUP], Juliana Prieto[SUP] 1 [/SUP], Allison T Chamberlain[SUP] 1 3 [/SUP], Shamimul Khan[SUP] 1 [/SUP], Steve Williams[SUP] 2 [/SUP], Fazle Khan[SUP] 1 [/SUP], N Sarita Shah[SUP] 3 4 [/SUP]
Affiliations
- PMID: 35360195
- PMCID: PMC8903476
- DOI: 10.1093/ofid/ofac101
Abstract
Background: We examined differences in mortality among coronavirus disease 2019 (COVID-19) cases in the first, second, and third waves of the COVID-19 pandemic.
Methods: A retrospective cohort study of COVID-19 cases in Fulton County, Georgia, USA, reported to a public health surveillance from March 2020 through February 2021. We estimated case-fatality rates (CFR) by wave and used Cox proportional hazards random-effects models in each wave, with random effects at individual and long-term-care-facility level, to determine risk factors associated with rates of mortality.
Results: Of 75 289 confirmed cases, 4490 (6%) were diagnosed in wave 1 (CFR 31 deaths/100 000 person days [pd]), 24 293 (32%) in wave 2 (CFR 7 deaths/100 000 pd), and 46 506 (62%) in wave 3 (CFR 9 deaths/100 000 pd). Compared with females, males were more likely to die in each wave: wave 1 (adjusted hazard ratio [aHR], 1.5; 95% confidence interval [CI], 1.2-1.8), wave 2 (aHR 1.5, 95% CI, 1.2-1.8), and wave 3 (aHR 1.7, 95% CI, 1.5-2.0). Compared with non-Hispanic whites, non-Hispanic blacks were more likely to die in each wave: wave 1 (aHR, 1.4; 95% CI, 1.1-1.8), wave 2 (aHR, 1.5; 95% CI, 1.2-1.9), and wave 3 (aHR, 1.7; 95% CI, 1.4-2.0). Cases with any disability, chronic renal disease, and cardiovascular disease were more likely to die in each wave compared with those without these comorbidities.
Conclusions: Our study found gender and racial/ethnic disparities in COVID-19 mortality and certain comorbidities associated with COVID-19 mortality. These factors have persisted throughout the COVID-19 pandemic waves, despite improvements in diagnosis and treatment.
Keywords: COVID-19; case fatality rate; cohort; mortality; risk factors.