Epidemiology of fatal cases associated with pandemic influenza reported in Yemen

Objectives: This study describes the incidence of all fatal cases associated with Pandemic Influenza A (H1N1) in Yemen. It sets out to highlight the factors associated with poor prognosis *The authors declare that they have no competing interests. to enhance the implementation of prevention and control programs. Methods: The study is based on retrospective analysis of available data until 14 March 2010, as compiled by the disease control and surveillance team in Yemen. Results: Between 16 June 2009 and 14 March 2010, a total of 33 laboratory-confirmed death cases associated with pandemic influenza A (H1N1) were reported to the Diseases Control and Surveillance in the Ministry of Public Health and Population. During this period, a total of 6049 suspected influenza A (H1N1) cases were recorded. With this denominator, the case fatality rate (CFR) was 0.54%. During June through August, H1N1 confirmed cases were infrequently detected, including only 30;however, from September through December, over 200 confirmed cases were reported each month. Of the 33 cases recorded, 25 were male (76%) and 8 were female (24%), male to female ratio being 3:1. Overall median age of the death cases was 30.8 years (range 1 - 55). The most common diagnosis upon admission was pneumonia. Out of the deaths, twenty five (75.8%) had no documented underlying diseases. Chronic cardiovascular disease (9.1%) was the most commonly reported disease and 2 deaths (6.1%) were recorded as pregnant women. Conclusions: The most common diagnosis upon admission was pneumonia. Chronic cardiovascular diseases were the most commonly reported underlying conditions, while the most identified risk factor was pregnancy. These findings should be taken into consideration, when vaccination strategies are employed.

Country-based modelling of COVID-19 case fatality rate:A multiple regression analysis

BACKGROUND The spread of the severe acute respiratory syndrome coronavirus 2 outbreak worldwide has caused concern regarding the mortality rate caused by the infection.The determinants of mortality on a global scale cannot be fully understood due to lack of information.AIM To identify key factors that may explain the variability in case lethality across countries.METHODS We identified 21 Potential risk factors for coronavirus disease 2019(COVID-19)case fatality rate for all the countries with available data.We examined univariate relationships of each variable with case fatality rate(CFR),and all independent variables to identify candidate variables for our final multiple model.Multiple regression analysis technique was used to assess the strength of relationship.RESULTS The mean of COVID-19 mortality was 1.52±1.72%.There was a statistically significant inverse correlation between health expenditure,and number of computed tomography scanners per 1 million with CFR,and significant direct correlation was found between literacy,and air pollution with CFR.This final model can predict approximately 97%of the changes in CFR.CONCLUSION The current study recommends some new predictors explaining affect mortality rate.Thus,it could help decision-makers develop health policies to fight COVID-19.

Clinical features of 162 fatal cases of COVID-19:a multi-center retrospective study

Background:The coronavirus disease 2019(COVID-19)has affected approximately 2 million individuals worldwide;however,data regarding fatal cases have been limited.Objective:To report the clinical features of 162 fatal cases of COVID-19 from 5 hospitals in Wuhan between December 30,2019 and March 12,2020.Methods:The demographic data,signs and symptoms,clinical course,comorbidities,laboratory findings,computed tomographic(CT)scans,treatments,and complications of the patients with fatal cases were retrieved from electronic medical records.Results:The median patient age was 69.5(interquartile range:63.0–77.25)years,and 80%of the patients were over 61 years.A total of 112(69.1%)patients were men.Hypertension(45.1%)was the most common comorbidity,while 59(36.4%)patients had no comorbidity.At admission,131(81.9%)patients had severe or critical COVID-19,whereas 39(18.1%)patients with hypertension or chronic lung disease had moderate COVID-19.In total,126(77.8%)patients received antiviral treatment,while 132(81.5%)patients received glucocorticoid treatment.A total of 116(71.6%)patients were admitted to the intensive care unit(ICU),and 137(85.1%)patients received mechanical ventilation.Most patients received mechanical ventilation before ICU admission.Approximately 93.2%of the patients developed respiratory failure or acute respiratory distress syndrome.There were no significant differences in the inhospital survival time among the hospitals(P=0.14).Conclusion:Young patients with moderate COVID-19 without comorbidity at admission could also develop fatal outcomes.The in-hospital survival time of the fatal cases was similar among the hospitals of different levels in Wuhan.

SEIHCRD Model for COVID-19 Spread Scenarios,Disease Predictions and Estimates the Basic Reproduction Number,Case Fatality Rate,Hospital,and ICU Beds Requirement

We have proposed a new mathematical method,the SEIHCRD model,which has an excellent potential to predict the incidence of COVID-19 diseases.Our proposed SEIHCRD model is an extension of the SEIR model.Three-compartments have added death,hospitalized,and critical,which improves the basic understanding of disease spread and results.We have studiedCOVID-19 cases of six countries,where the impact of this disease in the highest are Brazil,India,Italy,Spain,the United Kingdom,and the United States.After estimating model parameters based on available clinical data,the modelwill propagate and forecast dynamic evolution.Themodel calculates the Basic reproduction number over time using logistic regression and the Case fatality rate based on the selected countries’age-category scenario.Themodel calculates two types of Case fatality rate one is CFR daily,and the other is total CFR.The proposed model estimates the approximate time when the disease is at its peak and the approximate time when death cases rarely occur and calculate how much hospital beds and ICU beds will be needed in the peak days of infection.The SEIHCRD model outperforms the classic ARXmodel and the ARIMA model.RMSE,MAPE,andRsquaredmatrices are used to evaluate results and are graphically represented using Taylor and Target diagrams.The result shows RMSE has improved by 56%–74%,and MAPE has a 53%–89%improvement in prediction accuracy.

Case Fatality Rate of Severe Acute Respiratory Syndromes in Beijing

To describe the case fatality rate of SARS in Beijing. Methods Data of SARS cases notified from Beijing Center for Disease Control and Prevention （BCDC） and supplemented by other channels were collected. The data were analyzed by rate calculation. Results The case fatality rate of SARS in Beijing was 7.66%, and had an ascending trend while the age of cases was getting older, and a descending trend while the epidemic developmem. The case fatality rate in Beijing was lower than that in other main epidemic countries or regions. Conclusions The risk of death increases with the increment of age of SARS patients. Beijing is successful in controlling and treating SARS.

A Study on the Global Scenario of COVID-19 Related Case Fatality Rate, Recovery Rate and Prevalence Rate and Its Implications for India—A Record Based Retrospective Cohort Study

Importance: Corona virus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pandemic claiming millions of lives since the first outbreak was reported in Wuhan, China during December 2019. It is thus important to make cross-country comparison of the relevant rates and understand the socio-demographic risk factors. Methods: This is a record based retrospective cohort study. Table 1 was extracted from https://www.worldometers.info/coronavirus/ and from the Corona virus resource center (Table 2, Figures 1-3), Johns Hopkins University. Data for Table 1 includes all countries which reported >1000 cases and Table 2 includes 20 countries reporting the largest number of deaths. The estimation of CFR, RR and PR of the infection, and disease pattern across geographical clusters in the world is presented. Results: From Table 1, we could infer that as on 4th May 2020, COVID-19 has rapidly spread world-wide with total infections of 3,566,423 and mortality of 248,291. The maximum morbidity is in USA with 1,188,122 cases and 68,598 deaths (CFR 5.77%, RR 15% and PR 16.51%), while Spain is at the second position with 247,122 cases and 25,264 deaths (CFR 13.71%, RR 38.75%, PR 9.78%). Table 2 depicts the scenario as on 8th October 2020, where-in the highest number of confirmed cases occurred in US followed by India and Brazil (cases per million population: 23,080, 5007 & 23,872 respectively). For deaths per million population: US recorded 647, while India and Brazil recorded 77 and 708 respectively. Conclusion: Studying the distribution of relevant rates across different geographical clusters plays a major role for measuring the disease burden, which in-turn enables implementation of appropriate public healthcare measures.

Crizotinib-induced acute fatal liver failure in an Asian ALK-positive lung adenocarcinoma patient with liver metastasis: A case report

BACKGROUND Crizotinib-induce hepatotoxicity is rare and non-specific, and severe hepatotoxicity can develop into fatal liver failure. Herein, we report a case of fatal crizotinib-induced liver failure in a 37-year-old Asian patient.CASE SUMMARY The patient complained of dyspnea and upper abdominal pain for a week in August 2017. He was diagnosed with anaplastic lymphoma kinase-rearranged lung adenocarcinoma combined with multiple distant metastases. Crizotinib was initiated as a first-line treatment at a dosage of 250 mg twice daily. No adverse effects were seen until day 46. On day 55, he was admitted to the hospital with elevated liver enzymes aspartate aminotransferase(AST)(402 IU/L), alanine aminotransferase(ALT)(215 IU/L) and total bilirubin(145 μmol/L) and was diagnosed with crizotinib-induced fulminant liver failure. Despite crizotinib discontinuation and intensive supportive therapy, the level of AST(1075 IU/L),ALT(240 IU/L) and total bilirubin(233 μmol/L) continued to rapidly increase,and he died on day 60.CONCLUSION Physicians should be aware of the potential fatal adverse effects of crizotinib.

儿童急性坏死性脑病26例临床特征及预后分析

目的总结儿童急性坏死性脑病(ANEC)的临床特征、治疗过程和预后。方法回顾性分析2016年6月至2022年12月确诊ANEC患儿的临床资料。对存活患儿进行电话随访,应用儿童整体表现分类量表(POPC)评估患儿生存质量。结果共纳入26例ANEC患儿,男女比例为1.6∶1,中位年龄36.0(23.0~69.0)个月。发病季节以夏季常见(42.3%),其次为冬季(34.6%);前驱感染以流感病毒感染多见(34.6%),其次为人类疱疹病毒6B型及新型冠状病毒。所有患儿均有发热伴不同程度意识障碍,24例出现惊厥。神经影像学以对称性丘脑受累(100%)为典型改变,多伴有基底节区(50.0%)、脑干(61.5%)、小脑(26.9%)等部位受累。23例患儿接受甲基泼尼松龙激素冲击治疗,住院病死率为23.1%(6/26),出院6个月后累积病死率为30.7%(8/26)。6个月后随访到14例存活患儿,11例接受康复治疗,其中POPC评估2分1例,3分4例,4分6例,5分1例,6分2例。3例新型冠状病毒感染后ANEC患儿3个月随访POPC评估结果为2分2例,6分1例。结论华南地区ANEC于夏季和冬季高发,新型冠状病毒感染可诱发ANEC;临床表现为发热、抽搐、意识障碍三联征,典型影像学改变为双侧丘脑受累。早期免疫治疗及综合康复训练有助于减少神经系统后遗症的严重程度。

全球COVID-19疫情主要预测模型比较分析

目的新冠感染病死率预测对于深入理解新冠病毒严重性、合理配置医疗资源及开展针对性防疫策略有重大意义。方法本研究依据新冠病毒变异优势株,将疫情发展划分四个时期,选取美国、印度、巴西、墨西哥、秘鲁、中国六个国家以及全球平均水平的病死率为研究对象。运用灰色模型、指数平滑模型、ARIMA模型、支持向量机、Prophet和LSTM模型六个模型进行拟合预测,探讨各模型的优缺点和适用性,选取效果最优的模型对全球和重点国家的病死率进行预测。结果模型比较显示多种模型各有优缺点,经预测,多数国家的累计确诊人数和累计死亡人数增长速度减缓,发展趋势逐渐平稳。结论传统时间序列模型适于发展趋势平稳、有限样本的预测;而机器学习模型更适用于波动型变化数据,可进行大样本预测,进一步外推,运用到其他卫生领域的研究。

2018—2022年某综合性三甲医院住院死亡病例分析

目的 分析2018—2022年某综合性三甲医院住院患者死亡病例特征,为科学合理配置医疗资源,加强医疗质量管理提供参考。方法 从该院病案信息系统中提取2018年1月1日至2022年12月31日的所有出院患者信息,对出院患者和死亡病例总数、年龄、性别分布以及疾病诊断等,采用Excel 2007和SPSS 18.0软件进行数据整理和统计分析。结果 675例死亡病例中,男性病例443例(65.63%),女性232例(34.37%),住院患者病死率0.64%;死亡原因居前3位的疾病为循环系统疾病、呼吸系统疾病、肿瘤,分别占总死亡病例数的28.44%、28.30%和27.56%;死亡病例男女性别比1.91∶1,病死率男性高于女性,差异有统计学意义(χ2=46.068,P<0.001)。年龄越大,病死率越高,50岁以上病死率迅速上升。结论 医院住院患者病死率总体较低,老年人是该院的死亡高危人群,循环系统疾病、恶性肿瘤和呼吸系统疾病是最主要的死亡原因。在医疗工作中,应根据患者年龄、性别、死亡高发病种等特点,科学合理配置医疗资源,降低住院患者病死率。

影响热射病患者90 d预后的危险因素分析

目的探讨热射病患者90 d预后的危险因素。方法回顾性分析2018年6月至2022年8月该院重症医学科收治的热射病患者89例,根据90 d死亡情况分为存活组(62例)和死亡组(27例),比较2组患者年龄、入院时体温及心率、降温时间、炎症及器官功能障碍的实验室数据、急性生理和慢性健康状况Ⅱ评分、序贯器官衰竭估计(SOFA)评分、格拉斯哥昏迷评分法评分等。结果89例患者中90 d内死亡27例(30.3%)。降温时间、入院时心率、SOFA评分是影响患者生存的独立危险因素(风险比=6.230、1.738、1.042,95%可信区间:2.561~14.521、1.026~2.114、1.011~1.427,P=0.004、0.002、0.023)。降温时间、入院时心率、SOFA评分联合预测热射病患者90 d病死率的受试者工作特征曲线下面积为0.993(95%可信区间:0.976~1.000,P<0.001),灵敏度为1.000,特异度为0.933。结论降温时间、入院时心率、SOFA评分是影响热射病患者90 d生存的因素,3个指标可联合使用预测患者90 d病死率和不良预后。

Subgroup comparison of COVID-19 case and mortality with associated factors in Mississippi: findings from analysis of the first four months of public data

We compared subgroup differences in COVID-19 case and mortality and investigated factors associated with case and mortality rate(MR)measured at the county level in Mississippi.Findings were based on data published by the Mississippi State Department of Health between March 11 and July 16,2020.The COVID-19 case rate and case fatality rate(CFR)differed by gender and race,while MR only differed by race.Residents aged 80 years or older and those who live in a non-metro area had a higher case rate,CFR,and MR.After controlling for selected factors,researchers found that the percent of residents who are obese,low income,or with certain chronic conditions were associated with the county COVID-19 case rate,CFR,and/or MR,though some were negatively related.The findings may help the state to identify counties with higher COVID-19 case rate,CFR,and MR based on county demographics and the degree of its chronic conditions.

Tuberculosis septic shock, an elusive pathophysiology and hurdles in management: A case report and review of literature

BACKGROUND Tuberculosis (TB) is a rare etiology of the septic shock. Timely administration of the anti-microbial agents has shown mortality benefit. Prompt diagnosis and a high index of suspicion are crucial to the management. We present three cases of TBSS with poor outcome in the majority despite timely and susceptible antibiotic administration. CASE SUMMARY Sixty-seven-year-old woman with latent TB presented with fever, cough, and shortness of breath. She was promptly diagnosed with active TB and started on the appropriate anti-microbial regimen;she had a worsening clinical course with septic shock and multi-organ failure after initiation of antibiotics. Thirty-threeyear- old man immunocompromised with acquired immune deficiency syndrome presented with fever, anorexia and weight loss. He had no respiratory symptoms, and first chest X-ray was normal. He had enlarged liver, spleen and lymph nodes suspicious for lymphoma. Despite broad-spectrum antibiotics, he succumbed to refractory septic shock and multi-organ failure. It was shortly before his death that anti-TB antimicrobials were initiated based on pathology reports of bone marrow and lymph node biopsies. Forty-nine-year-old woman with asthma and latent TB admitted with cough and shortness of breath. Although Initial sputum analysis was negative, a subsequent broncho-alveolar lavage turned out to be positive for acid fast bacilli followed by initiation of susceptible ant-TB regimen. She had a downward spiral clinical course with shock, multi-organ failure and finally death. CONCLUSION Worse outcome despite timely initiation of appropriate antibiotics raises suspicion of TB immune reconstitution as a possible pathogenesis for TB septic shock.

2007-2021年某院住院患儿死亡疾病谱分析

目的了解某院住院患儿死亡疾病谱的特点和变化规律,为优化医疗资源配置、制定相关政策提供科学依据。方法收集2007-2021年某三甲儿童医院0~18岁住院患儿的病案首页信息,共纳入出院病案1003170份,其中死亡病案为1969份。对不同时间段、年龄段住院死亡患儿疾病谱进行分析。结果2007-2021年住院患儿病死率呈逐年递减趋势。不同时间段住院患儿病死率比较,差异有统计学意义(P<0.001)。不同时间段住院死亡患儿性别分布情况比较,差异无统计学意义(P>0.05)。不同时间段住院死亡患儿年龄分布情况比较,差异有统计学意义(P<0.001)。肿瘤构成比由2007-2011年的6.18%上升至2017-2021年的17.79%。起源于围生期的疾病构成比由2007-2011年的8.20%下降至2017-2021年的2.90%。新生儿期、婴儿期、幼儿期排名第一的疾病分别为起源于围生期的疾病、先天性畸形/变形和染色体异常、传染病和寄生虫病;学龄前期、学龄期和青春期排名第一的疾病均为肿瘤。结论该院2007-2021年住院患儿死亡疾病谱变化较大,呼吸系统疾病如肺炎仍是儿童疾病防治的重点,同时还应加强对儿童恶性肿瘤、意外伤害的防控,降低儿童病死率。

肌少症对老年骨质疏松性胸腰段脊柱压缩性骨折的影响

目的探讨肌少症对老年患者骨质疏松性胸腰段脊柱压缩性骨折的影响。方法回顾性分析昆山市锦溪人民医院2021年2月—2022年1月收治的老年患者骨质疏松性胸腰段脊柱压缩性骨折患者88例的临床资料。全部患者均采用电子握力器对优势手握力测量,由此提示肌少症可能,诊断标准:女性<18 kg,男性<28 kg,采用生物电阻测量法(bio-impedance analysis,BIA)测量人体四肢肌肉量,后根据身高平方的比例获取骨骼肌指数(skeletal muscle mass index,SMI),男性<7.0 kg/m^(2)、女性<5.7kg/m^(2),将握力及SMI值同时小于诊断界值时诊断为肌少症。将该组患者分为肌少症组(n=43)及非肌少症组(n=45),对比两组患者预后结局指标、视觉模拟评分法(visual analogue scale,VAS)评分及Oswestry功能障碍指数(Oswestrydisabilityindex,ODI),同时对比两组患者术后1年的再骨折发生率及死亡率。结果肌少症组与非肌少症组相比,住院天数较长,下床时间更长,术后1个月VAS评分较高,术后1个月内ODI较高,术后1年内死亡率较高,差异有统计学意义(P<0.05)。肌少症组与非肌少症组相比,手术时间、出血量、随访1年内的再骨折发生率比较,差异无统计学意义(P>0.05)。结论肌少症可增加老年患者骨质疏松性胸腰段脊柱压缩性骨折的住院时间,术后疼痛程度及功能障碍较为严重。

99例维持性血液透析死亡患者的流行病学分析:一项单中心调查研究

目的回顾性分析2020年~2022年维持性血液透析(MHD)死亡患者流行病学,以期为当地血液透析质量改进提供关键指导。方法以2020年1月初至2022年末经本院在全国血液净化病例登记系统(CNRDS)上报的99例资料详实MHD死亡病例作回顾性流行病学分析,且按原发病、透析通路等进行分层后分析透析生存情况。结果2020~2022年MHD患者平均病死率为6.88%,2020年、2021年、2022年病死率依次为7.59%、7.17%、6.27%,呈下降趋势,但差异无统计学意义(χ^(2)=0.656,P=0.720),男性高于女性,差异有统计学意义【59.60%(59/99)VS 40.40%(40/99)】(χ^(2)=7.293,P=0.007);老年(≥60岁)高于青中年(<60岁),差异有统计学意义【61.62%(61/99)VS 38.38%(38/99)】(χ^(2)=10.687,P=0.001);2020~2022年MHD患者整体原发病位居首位的是DKD(34.34%),死亡原因首位为心血管事件(33.33%),其次为感染(18.18%),透析龄范围4~185个月,中位透析龄57个月,MHD死亡高峰为透析龄5~10年(33%);由Kaplan-Meier生存曲线显示:原发病中非DKD患者生存时间长于DKD患者,透析通路选择AVF患者生存时间长于非AVF患者,透析频次周均3次患者生存时间长于周均1~2次患者,Alb≥40g/L患者生存时间长于Alb<40g/L患者,血钙2.1~2.5mmol患者生存时间长于<2.1mmol或>2.5mmol患者,i PTH处于150~300ng/L患者生存时间长于<150ng/L或>300ng/L患者,差异均有统计学意义(P<0.05);经COX回归多因素分析:影响MHD生存危险因素为透析通路(非AVF)(HR=1.539)、透析频次(HR=1.543)、Alb(异常)(HR=2.610)、血钙(异常)(HR=1.941),保护因素为原发病(非DKD)(HR=0.506)。结论MHD患者死亡具有性别、年龄差异,原发病以DKD为首,主要死于心血管事件,以透析龄5~10年为死亡高峰,DKD患者透析生存情况较差,应用AVF,周均3次,且Alb、血钙正常患者具有较长透析生存期。

2012-2021年石河子大学第一附属医院儿科住院死亡病例临床分析

目的:回顾性分析2012年1月-2021年12月石河子大学第一附属医院儿科住院死亡病例临床特点,为降低儿童死亡率及进一步消除儿童可预防死亡提供参考。方法:收集2012年1月-2021年12月我院儿科死亡病例资料,包括年龄、性别、住院天数、死亡疾病等,分析病死率及主要死因。结果:各年龄组死亡儿童中,新生儿组构成比最高;死亡病例主要集中在入院24小时内;2012-2021年总病死率为0.27%,2017-2021年病死率较2012-2016年下降;死因系统顺位中,前3位是:围生期疾病、呼吸系统疾病、心血管系统疾病及血液系统疾病;不同年龄组首位死因不同,早期新生儿是新生儿呼吸窘迫综合征,晚期新生儿是新生儿败血症,婴儿组是重症肺炎,1~5岁组是重症脑炎和意外伤害,5~14岁组是急性白血病;意外伤害所致的死亡中,交通事故排首位死因。结论:围生期疾病在住院儿童死因系统顺位中排首位,加强围生期保健,减少早产儿及低出生体重儿出生;重点关注高危新生儿,积极预防呼吸系统感染,减少交通意外等事故发生进一步降低死亡率。

不同液体复苏对脓毒症休克患者血流动力学状态的影响研究

为研究不同液体复苏对脓毒症休克患者血流动力学状态的影响,选取2020年1月—2022年12月在贵州省罗甸县中医医院进行治疗的84例脓毒症休克患者作为观察对象,采用计算机编号随机分组法将其分为4组(每组21例),分别予以差异化的复苏液进行治疗。其中,甲组选用羟乙基淀粉溶液,乙组选用生理盐水,丙组选用乳酸林格液,丁组选用醋酸钠钾镁钙葡萄糖注射液。比较4组患者复苏6h后达标率、危重病情评价(APACHEⅡ)评分、血流动力学、病死率。结果显示,甲、乙、丙、丁4组患者复苏6h后达标率差异无统计学意义(P>0.05)。复苏后14d,丁组的病死率明显低于甲、乙组(P<0.05)。丙丁两组复苏后的APACHEⅡ评分与复苏前相比明显降低,且丁组低于丙组(P<0.05)。丁组复苏后的HR水平低于甲、乙、丙三组,CI、MAP水平高于甲、乙、丙三组(P<0.05)。研究发现,醋酸钠钾镁钙葡萄糖注射液能够降低脓毒症休克患者病死率及病情危重程度,改善其血流动力学状态。

A new method for accurate calculation of case fatality rates during a pandemic:Mathematical deduction based on population-level big data

Background:During the course of an epidemic of a potentially fatal disease,it is difficult to accurately estimate the case fatality rate(CFR)because many calculation methods do not account for the delay between case confirmation and disease outcome.Taking the coronavirus disease-2019(COVID-19)as an example,this study aimed to develop a new method for CFR calculation while the pandemic was ongoing.Methods:We developed a new method for CFR calculation based on the following formula:number of deaths divided by the number of cases T days before,where T is the average delay between case confirmation and disease outcome.An objective law was found using simulated data that states if the hypothesized T is equal to the true T,the calculated real-time CFR remains constant;whereas if the hypothesized T is greater(or smaller)than the true T,the real-time CFR will gradually decrease(or increase)as the days progress until it approaches the true CFR.Results:Based on the discovered law,it was estimated that the true CFR of COVID-19 at the initial stage of the pandemic in China,excluding Hubei Province,was 0.8%;and in Hubei Province,it was 6.6%.The calculated CFRs predicted the death count with almost complete accuracy.Conclusions:The method could be used for the accurate calculation of the true CFR during a pandemic,instead of waiting until the end of the pandemic,whether the pandemic is under control or not.It could provide those involved in outbreak control a clear view of the timeliness of case confirmations.