Estimation of risk factors for COVID-19 mortality - preliminary results

  1. F Caramelo
  2. N Ferreira
  3. B Oliveiros

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Abstract

Since late December 2019 a new epidemic outbreak has emerged from Whuhan, China. Rapidly the new coronavirus has spread worldwide. China CDC has reported results of a descriptive exploratory analysis of all cases diagnosed until the 11th February 2020, presenting the epidemiologic curves and geo-temporal spread of COVID-19 along with case fatality rate according to some baseline characteristics, such as age, gender and several well-established high prevalence comorbidities. Despite this, we intend to increase even further the predictive value of that manuscript by presenting the odds ratio for mortality due to COVID-19 adjusted for the presence of those comorbidities and baseline characteristics such as age and gender. Besides, we present a way to determine the risk of each particular patient, given his characteristics.

We found that age is the variable that presents higher risk of COVID-19 mortality, where 60 or older patients have an OR = 18.8161 (CI95%[7.1997; 41.5517]). Regarding comorbidities, cardiovascular disease appears to be the riskiest (OR= 12.8328 CI95%[10.2736; 15.8643], along with chronic respiratory disease (OR=7.7925 CI95%[5.5446; 10.4319]). Males are more likely to die from COVID-19 (OR=1.8518 (CI95%[1.5996; 2.1270]). Some limitations such as the lack of information about the correct prevalence of gender per age or about comorbidities per age and gender or the assumption of independence between risk factors are expected to have a small impact on results. A final point of paramount importance is that the equation presented here can be used to determine the probability of dying from COVID-19 for a particular patient, given its age interval, gender and comorbidities associated.

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    SciScore for 10.1101/2020.02.24.20027268: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The approach adopted in this work has several limitations that must be referred to put into perspective the results. The first aspect, is that case fatality rate (CFR) is a feeble measure as it highly depends on the correct number of diagnosed cases and also on the final outcome of the current cases. Since this is an in-progress situation, CFR value is naturally uncertain, which undermines all parameters computed from this value, and naturally, the results obtained herein suffer from this fact. Regarding the CFR value, another question that arose was that the China CDC report enables two ways to compute it. All the observations may be used (1023 deaths in 44672 confirmed cases) or the ones with comorbidities information may be used instead (504 deaths in 20812 confirmed cases). We opted for the latter. Another aspect is the fact that there is neither information about the correct prevalence of gender per age nor about comorbidities per age and gender. To overcome this issue, we assumed homogeneous prevalence, which will increase ORs in some classes while decreasing in others. This approximation has a non-linear impact difficult to foresee, albeit departures from the real case are expected to be small. Moreover, the R routine is prepared to work with complete prevalence information and any user can test it. We have also assumed independence between risk factors but the logistic regression assumes the same. Therefore, the impact is not expected to be significant. Concerning the...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

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  2. Version published to 10.1101/2020.02.24.20027268 on medRxiv