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A global analysis of COVID-19 infection fatality rate and its associated factors during the Delta and Omicron variant periods: an ecological study

BACKGROUND: The Omicron variant of SARS-CoV-2 is more highly infectious and transmissible than prior variants of concern. It was unclear which factors might have contributed to the alteration of COVID-19 cases and deaths during the Delta and Omicron variant periods. This study aimed to compare the C...

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Autores principales: Thi Hong Nguyen, Nhi, Ou, Tsong-Yih, Huy, Le Duc, Shih, Chung-Liang, Chang, Yao-Mao, Phan, Thanh-Phuc, Huang, Chung-Chien
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10274323/
https://www.ncbi.nlm.nih.gov/pubmed/37333556
http://dx.doi.org/10.3389/fpubh.2023.1145138
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author Thi Hong Nguyen, Nhi
Ou, Tsong-Yih
Huy, Le Duc
Shih, Chung-Liang
Chang, Yao-Mao
Phan, Thanh-Phuc
Huang, Chung-Chien
author_facet Thi Hong Nguyen, Nhi
Ou, Tsong-Yih
Huy, Le Duc
Shih, Chung-Liang
Chang, Yao-Mao
Phan, Thanh-Phuc
Huang, Chung-Chien
author_sort Thi Hong Nguyen, Nhi
collection PubMed
description BACKGROUND: The Omicron variant of SARS-CoV-2 is more highly infectious and transmissible than prior variants of concern. It was unclear which factors might have contributed to the alteration of COVID-19 cases and deaths during the Delta and Omicron variant periods. This study aimed to compare the COVID-19 average weekly infection fatality rate (AWIFR), investigate factors associated with COVID-19 AWIFR, and explore the factors linked to the increase in COVID-19 AWIFR between two periods of Delta and Omicron variants. MATERIALS AND METHODS: An ecological study has been conducted among 110 countries over the first 12 weeks during two periods of Delta and Omicron variant dominance using open publicly available datasets. Our analysis included 102 countries in the Delta period and 107 countries in the Omicron period. Linear mixed-effects models and linear regression models were used to explore factors associated with the variation of AWIFR over Delta and Omicron periods. FINDINGS: During the Delta period, the lower AWIFR was witnessed in countries with better government effectiveness index [β = −0.762, 95% CI (−1.238)–(−0.287)] and higher proportion of the people fully vaccinated [β = −0.385, 95% CI (−0.629)–(−0.141)]. In contrast, a higher burden of cardiovascular diseases was positively associated with AWIFR (β = 0.517, 95% CI 0.102–0.932). Over the Omicron period, while years lived with disability (YLD) caused by metabolism disorders (β = 0.843, 95% CI 0.486–1.2), the proportion of the population aged older than 65 years (β = 0.737, 95% CI 0.237–1.238) was positively associated with poorer AWIFR, and the high proportion of the population vaccinated with a booster dose [β = −0.321, 95% CI (−0.624)–(−0.018)] was linked with the better outcome. Over two periods of Delta and Omicron, the increase in government effectiveness index was associated with a decrease in AWIFR [β = −0.438, 95% CI (−0.750)–(−0.126)]; whereas, higher death rates caused by diabetes and kidney (β = 0.472, 95% CI 0.089–0.855) and percentage of population aged older than 65 years (β = 0.407, 95% CI 0.013–0.802) were associated with a significant increase in AWIFR. CONCLUSION: The COVID-19 infection fatality rates were strongly linked with the coverage of vaccination rate, effectiveness of government, and health burden related to chronic diseases. Therefore, proper policies for the improvement of vaccination coverage and support of vulnerable groups could substantially mitigate the burden of COVID-19.
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spelling pubmed-102743232023-06-17 A global analysis of COVID-19 infection fatality rate and its associated factors during the Delta and Omicron variant periods: an ecological study Thi Hong Nguyen, Nhi Ou, Tsong-Yih Huy, Le Duc Shih, Chung-Liang Chang, Yao-Mao Phan, Thanh-Phuc Huang, Chung-Chien Front Public Health Public Health BACKGROUND: The Omicron variant of SARS-CoV-2 is more highly infectious and transmissible than prior variants of concern. It was unclear which factors might have contributed to the alteration of COVID-19 cases and deaths during the Delta and Omicron variant periods. This study aimed to compare the COVID-19 average weekly infection fatality rate (AWIFR), investigate factors associated with COVID-19 AWIFR, and explore the factors linked to the increase in COVID-19 AWIFR between two periods of Delta and Omicron variants. MATERIALS AND METHODS: An ecological study has been conducted among 110 countries over the first 12 weeks during two periods of Delta and Omicron variant dominance using open publicly available datasets. Our analysis included 102 countries in the Delta period and 107 countries in the Omicron period. Linear mixed-effects models and linear regression models were used to explore factors associated with the variation of AWIFR over Delta and Omicron periods. FINDINGS: During the Delta period, the lower AWIFR was witnessed in countries with better government effectiveness index [β = −0.762, 95% CI (−1.238)–(−0.287)] and higher proportion of the people fully vaccinated [β = −0.385, 95% CI (−0.629)–(−0.141)]. In contrast, a higher burden of cardiovascular diseases was positively associated with AWIFR (β = 0.517, 95% CI 0.102–0.932). Over the Omicron period, while years lived with disability (YLD) caused by metabolism disorders (β = 0.843, 95% CI 0.486–1.2), the proportion of the population aged older than 65 years (β = 0.737, 95% CI 0.237–1.238) was positively associated with poorer AWIFR, and the high proportion of the population vaccinated with a booster dose [β = −0.321, 95% CI (−0.624)–(−0.018)] was linked with the better outcome. Over two periods of Delta and Omicron, the increase in government effectiveness index was associated with a decrease in AWIFR [β = −0.438, 95% CI (−0.750)–(−0.126)]; whereas, higher death rates caused by diabetes and kidney (β = 0.472, 95% CI 0.089–0.855) and percentage of population aged older than 65 years (β = 0.407, 95% CI 0.013–0.802) were associated with a significant increase in AWIFR. CONCLUSION: The COVID-19 infection fatality rates were strongly linked with the coverage of vaccination rate, effectiveness of government, and health burden related to chronic diseases. Therefore, proper policies for the improvement of vaccination coverage and support of vulnerable groups could substantially mitigate the burden of COVID-19. Frontiers Media S.A. 2023-06-02 /pmc/articles/PMC10274323/ /pubmed/37333556 http://dx.doi.org/10.3389/fpubh.2023.1145138 Text en Copyright © 2023 Thi Hong Nguyen, Ou, Huy, Shih, Chang, Phan and Huang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Thi Hong Nguyen, Nhi
Ou, Tsong-Yih
Huy, Le Duc
Shih, Chung-Liang
Chang, Yao-Mao
Phan, Thanh-Phuc
Huang, Chung-Chien
A global analysis of COVID-19 infection fatality rate and its associated factors during the Delta and Omicron variant periods: an ecological study
title A global analysis of COVID-19 infection fatality rate and its associated factors during the Delta and Omicron variant periods: an ecological study
title_full A global analysis of COVID-19 infection fatality rate and its associated factors during the Delta and Omicron variant periods: an ecological study
title_fullStr A global analysis of COVID-19 infection fatality rate and its associated factors during the Delta and Omicron variant periods: an ecological study
title_full_unstemmed A global analysis of COVID-19 infection fatality rate and its associated factors during the Delta and Omicron variant periods: an ecological study
title_short A global analysis of COVID-19 infection fatality rate and its associated factors during the Delta and Omicron variant periods: an ecological study
title_sort global analysis of covid-19 infection fatality rate and its associated factors during the delta and omicron variant periods: an ecological study
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10274323/
https://www.ncbi.nlm.nih.gov/pubmed/37333556
http://dx.doi.org/10.3389/fpubh.2023.1145138
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