Predictors of the Aggregate of COVID-19 Cases and Its Case-Fatality: A Global Investigation Involving 120 Countries

Objective: Since the identification of COVID-19 in December 2019 as a pandemic, over 4500 research papers were published with the term “COVID-19” contained in its title. Many of these reports on the COVID-19 pandemic suggested that the coronavirus was associated with more serious chronic diseases and mortality particularly in patients with chronic diseases regardless of country and age. Therefore, there is a need to understand how common comorbidities and other factors are associated with the risk of death due to COVID-19 infection. Our investigation aims at exploring this relationship. Specifically, our analysis aimed to explore the relationship between the total number of COVID-19 cases and mortality associated with COVID-19 infection accounting for other risk factors. Methods: Due to the presence of over dispersion, the Negative Binomial Regression is used to model the aggregate number of COVID-19 cases. Case-fatality associated with this infection is modeled as an outcome variable using machine learning predictive multivariable regression. The data we used are the COVID-19 cases and associated deaths from the start of the pandemic up to December 02-2020, the day Pfizer was granted approval for their new COVID-19 vaccine. Results: Our analysis found significant regional variation in case fatality. Moreover, the aggregate number of cases had several risk factors including chronic kidney disease, population density and the percentage of gross domestic product spent on healthcare. The Conclusions: There are important regional variations in COVID-19 case fatality. We identified three factors to be significantly correlated with case fatality.