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      Elderly people and responses to COVID-19 in 27 Countries

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          Abstract

          Amongst the most robust consensus related to the COVID-19 disease is that the elderly are by far the most vulnerable population group. Hence, public authorities target older people in order to convince them to comply with preventive measures. However, we still know little about older people’s attitudes and compliance toward these measures. In this research, I aim to improve our understanding of elderly people’s responses to the pandemic using data from 27 countries. Results are surprising and quite troubling. Elderly people’s response is substantially similar to their fellow citizens in their 50’s and 60’s. This research (i) provides the first thorough description of the most vulnerable population’s attitudes and compliance in a comparative perspective (ii) suggest that governments’ strategies toward elderly people are far from successful and (iii) shows that methodologically, we should be more cautious in treating age as having a linear effect on COVID-19 related outcomes.

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          Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

          Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days. Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.
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            Covid-19: risk factors for severe disease and death

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              Demographic science aids in understanding the spread and fatality rates of COVID-19

              Governments around the world must rapidly mobilize and make difficult policy decisions to mitigate the coronavirus disease 2019 (COVID-19) pandemic. Because deaths have been concentrated at older ages, we highlight the important role of demography, particularly, how the age structure of a population may help explain differences in fatality rates across countries and how transmission unfolds. We examine the role of age structure in deaths thus far in Italy and South Korea and illustrate how the pandemic could unfold in populations with similar population sizes but different age structures, showing a dramatically higher burden of mortality in countries with older versus younger populations. This powerful interaction of demography and current age-specific mortality for COVID-19 suggests that social distancing and other policies to slow transmission should consider the age composition of local and national contexts as well as intergenerational interactions. We also call for countries to provide case and fatality data disaggregated by age and sex to improve real-time targeted forecasting of hospitalization and critical care needs.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SoftwareRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                2 July 2020
                2020
                2 July 2020
                : 15
                : 7
                : e0235590
                Affiliations
                [1 ] School of Social and Political Science, Politics and International Relations, University of Edinburgh, Edinburgh, Scotland, United Kingdom
                [2 ] Center for the Study of Democratic Citizenship, Montreal, Quebec, Canada
                Chinese Academy of Medical Sciences and Peking Union Medical College, CHINA
                Author notes

                Competing Interests: YouGov provided the datasets pro bono to Imperial College London and the Institute of Global Health Innovation. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

                Author information
                http://orcid.org/0000-0002-2736-7430
                Article
                PONE-D-20-14858
                10.1371/journal.pone.0235590
                7332014
                32614889
                a8935c05-09c3-4910-9304-42587cfdbda4
                © 2020 J. -F. Daoust

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 19 May 2020
                : 19 June 2020
                Page count
                Figures: 4, Tables: 0, Pages: 13
                Funding
                The author received no specific funding (or salary) for this work.
                Categories
                Research Article
                People and Places
                Population Groupings
                Age Groups
                Elderly
                Medicine and Health Sciences
                Geriatrics
                Medicine and Health Sciences
                Public and Occupational Health
                People and Places
                Population Groupings
                Age Groups
                Physical Sciences
                Mathematics
                Operator Theory
                Kernel Functions
                Social Sciences
                Sociology
                Social Research
                Biology and Life Sciences
                Population Biology
                Population Metrics
                Death Rates
                Research and Analysis Methods
                Research Design
                Survey Research
                Surveys
                Custom metadata
                The data were downloaded from the publicly accessible github of ICL and YouGov: https://github.com/YouGov-Data/covid-19-tracker. The replications files (datasets and code) are available on Harvard dataverse: https://doi.org/10.7910/DVN/8UTBVA.
                COVID-19

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                Uncategorized

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