ArticleScientific reports2021
County-level longitudinal clustering of COVID-19 mortality to incidence ratio in the United States.
Article in Scientific reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 35 citations in OpenAlex.
- A national growth mixture modeling analysis of county-level COVID-19 incidence rate trajectories and health inequities during three successive pandemic waves in 2020.Scientific reports · 2025Article
- Clustering-based methodology for comparing multi-characteristic epidemiological dynamics with application to COVID-19 epidemiology in Europe.Royal Society open science · 2025Article
- The spatiotemporal dynamics of COVID-19 in Europe: time-series clustering maps 5 distinct trajectories to spatial patterns.Population health metrics · 2025Article
- Geographic Variation, Economic Activity, and Labor Market Characteristics in Trajectories of Suicide in the United States, 2008-2020.American journal of epidemiology · 2024Article
- Nonpharmaceutical Interventions in Georgia: Public Health Implications.Southern medical journal · 2023Article
- Mortality rates from asbestos-related diseases in Italy during the first year of the COVID-19 pandemic.Frontiers in public health · 2023Article
- Estimates from 31 countries show the significant impact of COVID-19 excess mortality on the incidence of family bereavement.Proceedings of the National Academy of Sciences of the United States of America · 2022Article
- Longwise Cluster Analysis for the Prediction of COVID-19 Severity within 72 h of Admission: COVID-DATA-SAVE-LIFES Cohort.Journal of clinical medicine · 2022Article
- Artificial Intelligence for COVID-19 Detection in Medical Imaging-Diagnostic Measures and Wasting-A Systematic Umbrella Review.Journal of clinical medicine · 2022Review
- Static Socio-Ecological COVID-19 Vulnerability Index and Vaccine Hesitancy Index for England.The Lancet regional health. Europe · 2022Article
- Compound impact of drought and COVID-19 on agriculture yield in the USA.The Science of the total environment · 2022Article
- Risk factors for territorial spreading of SARS-CoV-2 in North-eastern Italy.Scientific reports · 2022Article
- Association between county-level risk groups and COVID-19 outcomes in the United States: a socioecological study.BMC public health · 2022Article
- Long-term exposure to PMEnvironment international · 2022Observational
- Estimation of COVID-19 generated medical waste in the Kingdom of Bahrain.The Science of the total environment · 2021Article
- New confinement index and new perspective for comparing countries - COVID-19.Computer methods and programs in biomedicine · 2021Article
- County-level demographic, social, economic, and lifestyle correlates of COVID-19 infection and death trajectories during the first wave of the pandemic in the United States.The Science of the total environment · 2021Article
- Spatial Modeling of COVID-19 Vaccine Hesitancy in the United States.International journal of environmental research and public health · 2021Article
- Epidemiological challenges in pandemic coronavirus disease (COVID-19): Role of artificial intelligence.Wiley interdisciplinary reviews. Data mining and knowledge discoveryReview
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
As of November 12, 2020, the mortality to incidence ratio (MIR) of COVID-19 was 5.8% in the US. A longitudinal model-based clustering system on the disease trajectories over time was used to identify "vulnerable" clusters of counties that would benefit from allocating additional resources by federal, state and county policymakers. County-level COVID-19 cases and deaths, together with a set of potential risk factors were collected for 3050 U.S. counties during the 1st wave of COVID-19 (Mar25-Jun3, 2020), followed by similar data for 1344 counties (in the "sunbelt" region of the country) during the 2nd wave (Jun4-Sep2, 2020), and finally for 1055 counties located broadly in the great plains region of the country during the 3rd wave (Sep3-Nov12, 2020). We used growth mixture models to identify clusters of counties exhibiting similar COVID-19 MIR growth trajectories and risk-factors over time. The analysis identifies "more vulnerable" clusters during the 1st, 2nd and 3rd waves of COVID-19. Further, tuberculosis (OR 1.3-2.1-3.2), drug use disorder (OR 1.1), hepatitis (OR 13.1), HIV/AIDS (OR 2.3), cardiomyopathy and myocarditis (OR 1.3), diabetes (OR 1.2), mesothelioma (OR 9.3) were significantly associated with increased odds of being in a more vulnerable cluster. Heart complications and cancer were the main risk factors increasing the COVID-19 MIR (range 0.08-0.52% MIR↑). We identified "more vulnerable" county-clusters exhibiting the highest COVID-19 MIR trajectories, indicating that enhancing the capacity and access to healthcare resources would be key to successfully manage COVID-19 in these clusters. These findings provide insights for public health policymakers on the groups of people and locations they need to pay particular attention while managing the COVID-19 epidemic.
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