Department of Medicine, Federal Medical Center Azare, Bauchi State, Nigeria.
Int J Infect Dis. 2021 Jan;102:118-122. doi: 10.1016/j.ijid.2020.10.038. Epub 2020 Oct 16.
COVID-19 continues to spread worldwide, with high numbers of fatalities reported first in China, followed by even higher numbers in Italy, Spain, the UK, the USA, and other advanced countries. Most African countries, even with their less advanced healthcare systems, continue to experience lower COVID-19 mortality rates. This was the case as the pandemic reached its first peak, plateaued, and declined. It is currently rising again in some countries, though not as rapidly as before. This study aimed to determine the predictors of COVID-19 mortality rate. This may help explain why Africa's COVID-19 mortality rate is, ironically, lower than that of more advanced countries with better health systems. This will also assist various governments in balancing their COVID-19 restrictive and socioeconomic measures.
This was an analytical review, which used pre-COVID-19 era population data and current COVID-19 mortality figures to determine predictors of COVID-19 mortality rates. Pearson's correlation was used to test the association between some population variables and COVID-19 mortality rates. Next, stepwise multiple regression analysis was used to determine significant predictors of COVID-19 mortality rates.
Significant positive predictors of COVID-19 mortality rate included pre-COVID-19 era '65-yr+ mortality %' (R = 0.574, B = 2.86, p < 0.001), population mean age (R = 0.570, B = 4.77, p = 0.001), and life expectancy (R = 0.524, B = 1.67, p = 0.008). Pre-COVID-19 era CVD death rate was a negative predictor of COVID-19 mortality rate (R = 0.524, B = -0.584, p = 0.012).
Africa's lower COVID-19 mortality rate is due to the lower population mean age, lower life expectancy, lower pre-COVID-19 era '65yr+ mortality rate', and smaller pool of people surviving and living with cardiovascular diseases.
COVID-19 继续在全球范围内传播，中国首先报告了大量死亡病例，随后意大利、西班牙、英国、美国和其他发达国家的死亡病例甚至更高。大多数非洲国家，即使其医疗保健系统不太先进，COVID-19 的死亡率继续保持较低水平。在大流行达到第一个高峰、稳定和下降时，情况就是如此。目前，一些国家的 COVID-19 死亡率再次上升，尽管没有以前那么快。本研究旨在确定 COVID-19 死亡率的预测因素。这可以帮助解释为什么具有更好卫生系统的更先进国家的 COVID-19 死亡率反而较低。这也将帮助各国政府在平衡 COVID-19 限制和社会经济措施方面发挥作用。
这是一项分析性综述，使用 COVID-19 前时代的人口数据和当前 COVID-19 死亡率数据来确定 COVID-19 死亡率的预测因素。使用 Pearson 相关系数来检验一些人口变量与 COVID-19 死亡率之间的关联。然后，使用逐步多元回归分析来确定 COVID-19 死亡率的显著预测因素。
COVID-19 死亡率的显著正预测因素包括 COVID-19 前时代的“65 岁以上死亡率%”（R=0.574，B=2.86，p<0.001）、人口平均年龄（R=0.570，B=4.77，p=0.001）和预期寿命（R=0.524，B=1.67，p=0.008）。COVID-19 前时代的 CVD 死亡率是 COVID-19 死亡率的负预测因素（R=0.524，B=-0.584，p=0.012）。
非洲 COVID-19 死亡率较低是由于人口平均年龄较低、预期寿命较低、COVID-19 前时代“65 岁以上死亡率”较低，以及患有心血管疾病并幸存下来的人群较小。
