PREDICTIVE FACTORS FOR MORTALITY FROM DELTA VARIANT OF SARS-COV-2 IN REPUBLIC OF NORTH MACEDONIA
Abstract
In 2019, Wuhan registered an epidemic of a severe form of pneumonia. On January 7, 2020, the pathogen was identified as SARS-CoV-2. COVID-19 causes acute and fatal disease with an average mortality rate of 2%. Based on evidences, risk factors include age, underlying health conditions, vaccination status, and immune response. Five variants of concern have been identified by WHO. The Delta variant was first reported in India in late 2020. The research aimed to analyze the predictive role of gender, number and type of comorbidities, hospitalization and vaccination status for mortality from Delta variant of SARS-CoV-2 in the Republic of North Macedonia. The research was a analitical cross-sectional study that included 56,030 cases and 2,292 deaths and elaborated the mortality from Delta variant of SARS-CoV-2 in the Republic of North Macedonia during the period June-November 2021. The analysis showed that the male gender (OR=1.30; 95% CI=1.20-1.42), the age ≥60 (OR=14.13; 95% CI=12.71-15.72), the positive comorbidity status (OR=13.69; 95% CI=12.25-15.29), and hospitalization (OR=208.1; 95% CI=178.6-242.5) significantly positively associated with death from Delta variant. Complete vaccination and/or booster dose had significant protective role reducing the probability for hospitalization and death from Delta variant for 38% and 47% respectively. Male patients, older age and comorbidities positively associated with death from the Delta variant of SARS-CoV-2. The findings of this study can be utilized to compare mortality rates among different variants of SARS-CoV-2.
Keywords: Delta SARS-CoV-2, mortality, hospitalization, vaccination, comorbidity, age
References
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2. Phelan AL, Katz R, Gostin LO. The novel coronavirus originating in Wuhan, China: challenges for global health governance. JAMA. 2020 Jan;323:709–10.
3. Seyed Hosseini E, Riahi Kashani N, Nikzad H, Azadbakht J, Hassani Bafrani H, Haddad Kashani H. The novel coronavirus Disease-2019 (COVID-19): Mechanism of action, detection and recent therapeutic strategies. Virology. 2020 Dec;551:1-9. doi: 10.1016/j.virol.2020.08.011.
4. Tian H, Liu Y, Li Y, Wu CH, Chen B, Kraemer MUG, Li B, Cai J, Xu B, Yang Q, Wang B, Yang P, Cui Y, Song Y, Zheng P, Wang Q, Bjornstad ON, Yang R, Grenfell BT, Pybus OG, Dye C. An investigation of transmission control measures during the first 50 days of the COVID-19 epidemic in China. Science. 2020 May 8;368(6491):638-642. doi: 10.1126/science.abb6105.
5. World Health Organization. Listings of WHO’s response to COVID-19. Available from: https://www.who.int/news/item/29-06-2020-covidtimeline. Accessed 21 Dec 2020.
6. Matta S, Chopra KK, Arora VK. Morbidity and mortality trends of Covid 19 in top 10 countries. Indian J Tuberc. 2020 Dec;67(4S):S167-S172. doi: 10.1016/j.ijtb.2020.09.031.
7. Samieefar N, Rashedi R, Akhlaghdoust M, Mashhadi M, Darzi P, Rezaei N. Delta Variant: The New Challenge of COVID-19 Pandemic, an Overview of Epidemiological, Clinical, and Immune Characteristics. Acta Biomed. 2022 Mar 14;93(1):e2022179. doi: 10.23750/abm.v93i1.12210. PMID: 35315394; PMCID: PMC8972886.
8. Saatci D, Ranger TA, Garriga C, et al. Association between race and COVID-19 outcomes among 2.6 million children in England. JAMA Pediatr. 2021;175:928–938. doi: 10.1001/jamapediatrics.2021.1685.
9. Lopez Bernal J, Andrews N, Gower C, Gallagher E, Simmons R, Thelwall S, Stowe J, Tessier E, Groves N, Dabrera G, Myers R, Campbell CNJ, Amirthalingam G, Edmunds M, Zambon M, Brown KE, Hopkins S, Chand M, Ramsay M. Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant. N Engl J Med. 2021 Aug 12;385(7):585-594. doi: 10.1056/NEJMoa2108891. Epub 2021 Jul 21. Erratum in: N Engl J Med. 2023 Feb 16;388(7):672. PMID: 34289274; PMCID: PMC8314739.
10. Docherty AB, Harrison EM, Green CA, Hardwick HE, Pius R, Norman L, Holden KA, Read JM, Dondelinger F, Carson G, Merson L, Lee J, Plotkin D, Sigfrid L, Halpin S, Jackson C, Gamble C, Horby PW, Nguyen-Van-Tam JS, Ho A, Russell CD, Dunning J, Openshaw PJ, Baillie JK, Semple MG; ISARIC4C investigators. Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. BMJ. 2020 May 22;369:m1985. doi: 10.1136/bmj.m1985.
11. Petrilli CM, Jones SA, Yang J, Rajagopalan H, O'Donnell L, Chernyak Y, Tobin KA, Cerfolio RJ, Francois F, Horwitz LI. Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study. BMJ. 2020 May 22;369:m1966. doi: 10.1136/bmj.m1966. PMID: 32444366; PMCID: PMC7243801.
12. Mlcochova P., Kemp S. A., Dhar M. S., Papa G., Meng B., Ferreira I. A. T. M., et al.. (2021). SARS-CoV-2 B.1.617.2 Delta Variant Replication and Immune Evasion. Nature 599 (7883), 114–119. doi: 10.1038/s41586-021-03944-y
13. Sheikh A, McMenamin J, Taylor B, Robertson C; Public Health Scotland and the EAVE II Collaborators. SARS-CoV-2 Delta VOC in Scotland: demographics, risk of hospital admission, and vaccine effectiveness. Lancet. 2021 Jun 26;397(10293):2461-2462. doi: 10.1016/S0140-6736(21)01358-1. Epub 2021 Jun 14. PMID: 34139198; PMCID: PMC8201647.
14. Hussey H, Davies MA, Heekes A, Williamson C, Valley-Omar Z, Hardie D, Korsman S, Doolabh D, Preiser W, Maponga T, Iranzadeh A, Engelbrecht S, Wasserman S, Schrueder N, Boloko L, Symons G, Raubenheimer P, Viljoen A, Parker A, Cohen C, Jasat W, Lessells R, Wilkinson RJ, Boulle A, Hsiao M. Higher mortality associated with the SARS-CoV-2 Delta variant in the Western Cape, South Africa, using RdRp target delay as a proxy: a cross-sectional study. Gates Open Res. 2022 Aug 31;6:117. doi: 10.12688/gatesopenres.13654.1. PMID: 37994361; PMCID: PMC10663174.
15. Hodgson SH, Mansatta K, Mallett G, Harris V, Emary KRW, Pollard AJ. What defines an efficacious COVID-19 vaccine? A review of the challenges assessing the clinical efficacy of vaccines against SARS-CoV-2. Lancet Infect Dis. 2021;21:e26–e35. doi: 10.1016/S1473-3099(20)30773-8.
16. The WHO European Respiratory Surveillance Network: Meslé M, at all. Estimated number of lives directly saved by COVID-19 vaccination programs in the WHO European Region, December 2020 to March 2023. MedRxiv 2024 Jan. https://doi.org/10.1101/2024.01.12.24301206
17. Pijls BG, Jolani S, Atherley A et al (2021) Demographic risk factors for COVID-19 infection, severity, ICU admission and death: a meta-analysis of 59 studies. BMJ, (Open) 11:e044640. 10.1136/bmjopen-2020-044640.
18. Nyberg T, Ferguson NM, Nash SG, Webster HH, Flaxman S, Andrews N, Hinsley W, Bernal JL, Kall M, Bhatt S, Blomquist P, Zaidi A, Volz E, Aziz NA, Harman K, Funk S, Abbott S; COVID-19 Genomics UK (COG-UK) consortium; Hope R, Charlett A, Chand M, Ghani AC, Seaman SR, Dabrera G, De Angelis D, Presanis AM, Thelwall S. Comparative analysis of the risks of hospitalisation and death associated with SARS-CoV-2 omicron (B.1.1.529) and delta (B.1.617.2) variants in England: a cohort study. Lancet. 2022 Apr 2;399(10332):1303-1312. doi: 10.1016/S0140-6736(22)00462-7.
19. Australian Bureau of Statistics (2023). COVID-19 mortality by wave. Available at https://www.abs.gov.au/articles/covid-19-mortality-wave (accessed 25 February 2024).
20. Guan WJ, Liang WH, Zhao Y et al (2020) Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J 55. 10.1183/13993003.00547-2020.
21. Singh P., Bhaskar Y., Verma P., Rana S., Goel P., Kumar S., et al. Impact of comorbidity on patients with COVID-19 in India: a nationwide analysis. Front Public Health. 2023;10 doi: 10.3389/fpubh.2022.1027312.
22. Barron E., Bakhai C., Kar P., Weaver A., Bradley D., Ismail H., et al. Associations of Type 1 and Type 2 diabetes with COVID-19-related mortality in England: a whole-population study. Lancet Diabetes Endocrinol. 2020;8:813–822. doi: 10.1016/S2213-8587(20)30272-2.
23. Twohig KA, Nyberg T, Zaidi A, Thelwall S, Sinnathamby MA, Aliabadi S, Seaman SR, Harris RJ, Hope R, Lopez-Bernal J, Gallagher E, Charlett A, De Angelis D, Presanis AM, Dabrera G; COVID-19 Genomics UK (COG-UK) consortium. Hospital admission and emergency care attendance risk for SARS-CoV-2 delta (B.1.617.2) compared with alpha (B.1.1.7) variants of concern: a cohort study. Lancet Infect Dis. 2022 Jan;22(1):35-42. doi: 10.1016/S1473-3099(21)00475-8. Epub 2021 Aug 27. PMID: 34461056; PMCID: PMC8397301.
24. Mohammed I, Nauman A, Paul P, Ganesan S, Chen KH, Jalil SMS, Jaouni SH, Kawas H, Khan WA, Vattoth AL, Al-Hashimi YA, Fares A, Zeghlache R, Zakaria D. The efficacy and effectiveness of the COVID-19 vaccines in reducing infection, severity, hospitalization, and mortality: a systematic review. Hum Vaccin Immunother. 2022 Dec 31;18(1):2027160. doi: 10.1080/21645515.2022.2027160.
25. Le Page M. Vaccines vs variants. New Sci. 2021;250(3336):8–23. doi: 10.1016/S0262-4079(21)00895-2.
Published
2024-04-30
How to Cite
KOCHINSKI, Dragan et al.
PREDICTIVE FACTORS FOR MORTALITY FROM DELTA VARIANT OF SARS-COV-2 IN REPUBLIC OF NORTH MACEDONIA.
Journal of Morphological Sciences, [S.l.], v. 7, n. 1, p. 40-46, apr. 2024.
ISSN 2545-4706.
Available at: <https://www.jms.mk/jms/article/view/vol7no1-6>. Date accessed: 23 may 2024.
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