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Mortality in Four Waves of COVID-19 Is Differently Associated with Healthcare Capacities Affected by Economic Disparities

Background: The greatest challenges are imposed on the overall capacity of disease management when the cases reach the maximum in each wave of the pandemic. Methods: The cases and deaths for the four waves of COVID-19 in 119 countries and regions (CRs) were collected. We compared the mortality acros...

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Autores principales: Yao, Lan, Graff, J. Carolyn, Aleya, Lotfi, Ma, Jiamin, Cao, Yanhong, Wei, Wei, Sun, Shuqiu, Wang, Congyi, Jiao, Yan, Gu, Weikuan, Wang, Gang, Sun, Dianjun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9506267/
https://www.ncbi.nlm.nih.gov/pubmed/36136652
http://dx.doi.org/10.3390/tropicalmed7090241
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author Yao, Lan
Graff, J. Carolyn
Aleya, Lotfi
Ma, Jiamin
Cao, Yanhong
Wei, Wei
Sun, Shuqiu
Wang, Congyi
Jiao, Yan
Gu, Weikuan
Wang, Gang
Sun, Dianjun
author_facet Yao, Lan
Graff, J. Carolyn
Aleya, Lotfi
Ma, Jiamin
Cao, Yanhong
Wei, Wei
Sun, Shuqiu
Wang, Congyi
Jiao, Yan
Gu, Weikuan
Wang, Gang
Sun, Dianjun
author_sort Yao, Lan
collection PubMed
description Background: The greatest challenges are imposed on the overall capacity of disease management when the cases reach the maximum in each wave of the pandemic. Methods: The cases and deaths for the four waves of COVID-19 in 119 countries and regions (CRs) were collected. We compared the mortality across CRs where populations experience different economic and healthcare disparities. Findings: Among 119 CRs, 117, 112, 111, and 55 have experienced 1, 2, 3, and 4 waves of COVID-19 disease, respectively. The average mortality rates at the disease turning point were 0.036, 0.019. 0.017, and 0.015 for the waves 1, 2, 3, and 4, respectively. Among 49 potential factors, income level, gross national income (GNI) per capita, and school enrollment are positively correlated with the mortality rates in the first wave, but negatively correlated with the rates of the rest of the waves. Their values for the first wave are 0.253, 0.346 and 0.385, respectively. The r value for waves 2, 3, and 4 are −0.310, −0.293, −0.234; −0.263, −0.284, −0.282; and −0.330, −0.394, −0.048, respectively. In high-income CRs, the mortality rates in waves 2 and 3 were 29% and 28% of that in wave 1; while in upper-middle-income CRs, the rates for waves 2 and 3 were 76% and 79% of that in wave 1. The rates in waves 2 and 3 for lower-middle-income countries were 88% and 89% of that in wave 1, and for low-income countries were 135% and 135%. Furthermore, comparison among the largest case numbers through all waves indicated that the mortalities in upper- and lower-middle-income countries is 65% more than that of the high-income countries. Interpretation: Conclusions from the first wave of the COVID-19 pandemic do not apply to the following waves. The clinical outcomes in developing countries become worse along with the expansion of the pandemic.
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spelling pubmed-95062672022-09-24 Mortality in Four Waves of COVID-19 Is Differently Associated with Healthcare Capacities Affected by Economic Disparities Yao, Lan Graff, J. Carolyn Aleya, Lotfi Ma, Jiamin Cao, Yanhong Wei, Wei Sun, Shuqiu Wang, Congyi Jiao, Yan Gu, Weikuan Wang, Gang Sun, Dianjun Trop Med Infect Dis Article Background: The greatest challenges are imposed on the overall capacity of disease management when the cases reach the maximum in each wave of the pandemic. Methods: The cases and deaths for the four waves of COVID-19 in 119 countries and regions (CRs) were collected. We compared the mortality across CRs where populations experience different economic and healthcare disparities. Findings: Among 119 CRs, 117, 112, 111, and 55 have experienced 1, 2, 3, and 4 waves of COVID-19 disease, respectively. The average mortality rates at the disease turning point were 0.036, 0.019. 0.017, and 0.015 for the waves 1, 2, 3, and 4, respectively. Among 49 potential factors, income level, gross national income (GNI) per capita, and school enrollment are positively correlated with the mortality rates in the first wave, but negatively correlated with the rates of the rest of the waves. Their values for the first wave are 0.253, 0.346 and 0.385, respectively. The r value for waves 2, 3, and 4 are −0.310, −0.293, −0.234; −0.263, −0.284, −0.282; and −0.330, −0.394, −0.048, respectively. In high-income CRs, the mortality rates in waves 2 and 3 were 29% and 28% of that in wave 1; while in upper-middle-income CRs, the rates for waves 2 and 3 were 76% and 79% of that in wave 1. The rates in waves 2 and 3 for lower-middle-income countries were 88% and 89% of that in wave 1, and for low-income countries were 135% and 135%. Furthermore, comparison among the largest case numbers through all waves indicated that the mortalities in upper- and lower-middle-income countries is 65% more than that of the high-income countries. Interpretation: Conclusions from the first wave of the COVID-19 pandemic do not apply to the following waves. The clinical outcomes in developing countries become worse along with the expansion of the pandemic. MDPI 2022-09-10 /pmc/articles/PMC9506267/ /pubmed/36136652 http://dx.doi.org/10.3390/tropicalmed7090241 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Yao, Lan
Graff, J. Carolyn
Aleya, Lotfi
Ma, Jiamin
Cao, Yanhong
Wei, Wei
Sun, Shuqiu
Wang, Congyi
Jiao, Yan
Gu, Weikuan
Wang, Gang
Sun, Dianjun
Mortality in Four Waves of COVID-19 Is Differently Associated with Healthcare Capacities Affected by Economic Disparities
title Mortality in Four Waves of COVID-19 Is Differently Associated with Healthcare Capacities Affected by Economic Disparities
title_full Mortality in Four Waves of COVID-19 Is Differently Associated with Healthcare Capacities Affected by Economic Disparities
title_fullStr Mortality in Four Waves of COVID-19 Is Differently Associated with Healthcare Capacities Affected by Economic Disparities
title_full_unstemmed Mortality in Four Waves of COVID-19 Is Differently Associated with Healthcare Capacities Affected by Economic Disparities
title_short Mortality in Four Waves of COVID-19 Is Differently Associated with Healthcare Capacities Affected by Economic Disparities
title_sort mortality in four waves of covid-19 is differently associated with healthcare capacities affected by economic disparities
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9506267/
https://www.ncbi.nlm.nih.gov/pubmed/36136652
http://dx.doi.org/10.3390/tropicalmed7090241
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