- CDC's Morbidity and Mortality Weekly Report

References for Case-Fatality Among COVID-19 Patients in the United States by Age Organized by Source

References for Case-Fatality by Among COVID-19 Patients in the United States Organized by Journal 

- 0-19 (n=123): 0%
- 20-44 (n=705): 0.1–0.2%
- 45-54 (n=429): 0.5–0.8%
- 55-64 (n=429): 1.4–2.6%
- 65-74 (n=409): 2.7–4.9%
- 75-84 (n=210): 4.3–10.5%
- greater than or equal to 85 (n=144): 10.4–27.3%
- Total (n=2,449): 1.8–3.4%

University of Michigan - Ann Arbor

Smith College

- Hospitalization
- ICU admission
- Case-fatality

Severe Outcomes Among COVID-19 Patients in the United States

COVID-19 Case Fatality Rate Categorized by Age Group

- Case Demographics of Patients
- Categorized by Geographic Location
- Communicable Period
- Control Strategies
- Disparate COVID-19 Outcomes
- Fatality
- Interventions
- Patient Comorbidities
- Patient Laboratory Results
- Psychological effects
- Recovery & Rehabilitation
- Re-opening of Childcare/ Educational Environments
- Secondary Infections
- Signs
- Symptomology
- Time from Onset to Reporting
- Telehealth (telemedicine)
- Transmission
- Risk Factors
- COVID-19 Vaccination Uptake

Focuses of Epidemiological studies on COVID-19

Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United States, February 12–March 16, 2020. MMWR Morb Mortal Wkly Rep 2020;69:343-346. DOI: http://dx.doi.org/10.15585/mmwr.mm6912e2

Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United States, February 12–March 16, 2020

- 0-19 (n=123): 1.6–2.5%
- 20-44 (n=705): 14.3–20.8%
- 45-54 (n=429): 21.2–28.3%
- 55-64 (n=429): 20.5–30.1%
- 65-74 (n=409): 28.6–43.5%
- 75-84 (n=210): 30.5–58.7%
- >=85 (n=144): 31.3–70.3%
- Total (n=2,449): 20.7–31.4%

Hospitalization Among COVID-19 Patients in the United States by Age

- 0-19 (n=123): 0%
- 20-44 (n=705): 2.0–4.2%
- 45-54 (n=429): 5.4–10.4%
- 55-64 (n=429): 4.7–11.2%
- 65-74 (n=409): 8.1–18.8%
- 75-84 (n=210): 10.5–31.0%
- >=85 (n=144): 6.3–29.0%
- Total (n=2,449): 4.9–11.5%

ICU Admission Among COVID-19 Patients in the United States by Age

Case-Fatality Among COVID-19 Patients in the United States by Age

Researchers analyzed the amount of hospitalizations by race/ethnicity in 12 states. 
- White Patients: in all 12 states, the percentage of hospitalizations among White patients was significantly less than their representative proportion of their states' populations.  
-	Black Patients: in all 12 states, the percentage of hospitalizations among Black patients was significantly higher than their representative proportion of their states' populations.  (For example, in Indiana, the hospitalizations of Black patients was 28.1%, but their representative proportion of the state population is only 9.8%.)  
-	Hispanic Patients: in 10 states, the percentage of hospitalizations among Hispanic patients was also significantly more than their representative proportion of their states' populations.  
-	Asian Patients: in 6 states, the percentage of hospitalizations for Asians was less than their representative proportion of their states' populations. 
-	American Indian and Alaskan Native (AIAN) Patients: in 8 states, the percentage of hospitalizations for American Indian and Alaskan Native populations (AIAN) was higher than their representative proportion of their states' populations.  

Hospitalization Among COVID-19 Patients in the United States by Race/Ethnicity

As of April 2020, the case fatality rate for COVID-19 among children (<18 years old)  is estimated to be small due to low detection of pediatric COVID-19 cases. 

COVID-19 Case Fatality Rate Among Children

In one study the case fatality rates of the following age groups were as follows:
"Older than 80 years":  18.8% (3 of 16 patients)
Patients 65 or older (including the 16 patients above 80 years old): 8.3% (5 of 60 patients)

Case-Fatality Rate of COVID-19 in the Elderly Transferred by Beijing Emergency Medical Service

- among those who are elderly, deaths are concentrated even further among those living in long term care facilities
- 2.1 million people live in nursing homes or residential care facilities, representing 0.6% of the U.S. population
- residents in such facilities account for 45 percent of all deaths from COVID-19, for states that report such statistics
- nationally the share of fatalities from nursing home and residential care facilities is 45%, and 52% outside of New York State
- US not an outlier in nursing home fatalities with Ireland and Canada each with 85% of deaths occurring in care homes

Fatalities in Nursing Homes and Long Term Care Facilities

Due to differences in testing and case definitions, as well as how new COVID-19 is, the fatality of the virus is not well-defined yet.

Fatality of COVID-19

Countries have implemented multiple control strategies for reducing the spread of COVID-19, such as closing schools and businesses to enforce social distancing.

Struggle pertaining to controlling the virus:
The epidemiology of the respiratory virus changes rapidly. Reponses have to be nimble. Given that everyone is susceptible to for which we lack effective biologic interventions, the response has required large-scale behavior change, including social distancing and public masking.

Control Strategies for COVID-19

- Age
- Education
- Employment
- Ethnicity
- Gender
- Income
- Marital status
- Race





Case Demographics of Patients with COVID-19

- Asia
- Africa 
- North America
- South America
- Europe
- Australia & Oceania 

Epidemiological studies on COVID-19 Categorized by Continents

The progression of COVID-19 varies greatly by individual and demographic, as do many of the factors related to the disease. Studies have been analyzing the disease progression timeline, or the time frames before patients feel symptoms, are admitted to the hospital, are admitted to the ICU, are put on a mechanical ventilator, experience acute respiratory distress syndrome, etc. Not every COVID-19 case will reach each of these events.

COVID-19 Clinical Disease Progression Timeline

Following a primary infection of SARS-CoV-2, some patients acquire a secondary infection of SARS-CoV-2, or a co-infection with a different bacteria or virus

Secondary/Co-Infections of COVID-19

COVID-19 patients have gone through laboratory testing to determine the impact and extent of SARS-CoV-2 on the body.

COVID-19 Laboratory Results

The spread of the SARS-CoV-2 virus has produced or highlighted disparate outcomes of different types between population groups all over the world. Health disparities can highlight inequitable access, treatment, etc. within a country or state and often indicate the need for public health intervention.

Disparate COVID-19 Outcomes

Due to the varying experiences for those with COVID-19, recovery and rehabilitation look different for many individuals. As a baseline, "for persons recovered from COVID-19 illness, CDC recommends that isolation be maintained for at least 10 days after illness onset and at least 3 days (72 hours) after recovery. Illness onset is defined as the date symptoms begin. Recovery is defined as resolution of fever without the use of fever-reducing medications with progressive improvement or resolution of other symptoms. Ideally, isolation should be maintained for this full period to the extent that it is practicable under rapidly changing circumstances."

COVID-19 Recovery & Rehabilitation

- Resuscitation
- Convalescent Plasma (CP) Transfusion

COVID-19 Patient Interventions

The seroprevalence of COVID-19 is the measurement of the level of the pathogen in a population. There have been difficulties with estimating the seroprevalence in large populations because of the unknown qualities of COVID-19, expense in widespread population collection, asymptomatic infection, etc.

Seroprevalence of SARS-CoV-2 (COVID-19) 

A communicable period is defined as the interval from the first day of positive ribonucleic acid test to the first day of continuous negative test. For COVID-19, the communicable period has been established as two days before onset of symptoms until three days of symptom relief and no fever. 

Communicable Period of COVID-19

- Fever (when high temperature is measured)
- Laboratory confirmation of illness via viral testing
- Radiological lung abnormalities such as ground-glass chest and stripe shadowing


Clinical Characteristics of Asymptomatic COVID-19 Patients

Telehealth are health-related services and information through electronic communication technologies to help patients with or people influenced by COVID-19. It allows long-distance patient and clinician care, education, and monitoring. Telemedicine is sometimes used as a synonym, or is used in a more limited sense to describe remote clinical services, such as diagnosis and monitoring. 

Telehealth (telemedicine) and COVID-19

Presence and severity of symptoms of COVID-19 depend largely on individual characteristics. COVID-19 produces both symptomatic and asymptomatic infection.

Symptomology of COVID-19 

The psychological effect COVID-19 is having on the populations affected by the pandemic

Psychological Effects of COVID-19 Pandemic

COVID-19 comorbidities are high risk conditions that put patients at greater risk for infection and negative outcomes. Some COVID-19 comorbidities have been found to be: 
- Cancer 
- Cardiovascular Disease
- Diabetes
- Digestive Diseases
- HIV
- Hypertension
- Immunological Disease
- Liver Injury
- Obesity
- Renal disease
- Respiratory System Disease

COVID-19 Patient Comorbidities

- Schools (K-12)

- Universities/Colleges

- Summer Camps

- Daycares

- Nurseries

Re-opening Childcare/ Educational Environments

COVID-19 is spread through person-to-person transmission. The virus spreads mainly through close personal contact (such as when people are within 6 feet of one another) and through the respiratory droplets of someone infected with COVID-19.  Aerosol transmission is also likely, but the relative contribution of these smaller respiratory particles is not completely understood. While less common, spreading can also occur when people touch contaminated objects or surfaces and then their faces, eyes, or mouth. 

Transmission of COVID-19

- smoking
- high BMI
- old age
- congregate housing
- environmental conditions
- Immune system conditions

Risk Factors For COVID-19

We can explore factors that affect the uptake of established adult vaccinations to inform efforts of COVID-19 vaccine acceptance. 

- Social Factors 
- Knowledge, Attitudes, and Beliefs
- Racial Factors
- Age

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