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1.
Managerial Finance ; 49(5):789-807, 2023.
Article in English | ProQuest Central | ID: covidwho-2299024

ABSTRACT

PurposeThe unemployment rate (UR) is the leading macroeconomic indicator used in the credit card loss forecasting. COVID-19 pandemic has caused an unprecedented level of volatility in the labor market variables, leading to new challenges to use UR in the credit risk modeling framework. This paper examines the dynamic relationship between the credit card charge-off rate and the unemployment rate over time.Design/methodology/approachThis study uses quarterly observations of charge-off rates on credit card loans of all commercial banks from Q1 1990 to Q4 2020. Univariate, multivariable, machine learning, and regime-switching time series modeling are employed in this research.FindingsThe authors decompose UR into two components – temporary and permanent UR. The authors find the spike in UR during COVID-19 is mainly attributed to the surge in temporary layoffs. More importantly, the authors find that the credit card charge-off rate is primarily driven by permanent UR while temporary UR has little predictive power. During recessions, permanent UR seems to be a stronger indicator than total UR. This research highlights the importance of using permanent UR for credit risk modeling.Originality/valueThe findings in the research can be applied to the credit card loss forecasting and CECL reserve models. In addition, this research also has implications for banks, macroeconomic data vendors, regulators, and policymakers.

2.
Managerial Finance ; 2022.
Article in English | Web of Science | ID: covidwho-2121464

ABSTRACT

Purpose - The unemployment rate (UR) is the leading macroeconomic indicator used in the credit card loss forecasting. COVID-19 pandemic has caused an unprecedented level of volatility in the labor market variables, leading to new challenges to use UR in the credit risk modeling framework. This paper examines the dynamic relationship between the credit card charge-off rate and the unemployment rate over time. Design/methodology/approach - This study uses quarterly observations of charge-off rates on credit card loans of all commercial banks from Q1 1990 to Q4 2020. Univariate, multivariable, machine learning, and regime-switching time series modeling are employed in this research. Findings - The authors decompose UR into two components - temporary and permanent UR. The authors find the spike in UR during COVID-19 is mainly attributed to the surge in temporary layoffs. More importantly, the authors find that the credit card charge-off rate is primarily driven by permanent UR while temporary UR has little predictive power. During recessions, permanent UR seems to be a stronger indicator than total UR. This research highlights the importance of using permanent UR for credit risk modeling. Originality/value - The findings in the research can be applied to the credit card loss forecasting and CECL reserve models. In addition, this research also has implications for banks, macroeconomic data vendors, regulators, and policymakers.

3.
J Thorac Dis ; 13(6): 3628-3642, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1296313

ABSTRACT

BACKGROUND: To analyze the clinical characteristics and predictors for mortality of adult younger than 60 years old with severe coronavirus disease 2019 (COVID-19). METHODS: We retrospectively retrieved data for 152 severe inpatients with COVID-19 including 60 young patients in the Eastern Campus of Wuhan University affiliated Renmin Hospital in Wuhan, China, from January 31, 2020 to February 20, 2020. We recorded and analyzed patients' demographic, clinical, laboratory, and chest CT findings, treatment and outcomes data. RESULTS: Of those 60 severe young patients, 15 (25%) were died. Male was more predominant in deceased young patients (12, 80%) than that in recovered young patients (22, 49%). Hypertension was more common among deceased young patients (8, 53%) than that in recovered young patients (7, 16%). Compared with the recovered young patients, more deceased young patients presented with sputum (11, 73%), dyspnea (12, 80%) and fatigue (13, 87%). Only sputum, PSI and neutrophil counts were remained as independent predictors of death in a multivariate logistic regression model. Among ARDS patients, the recovered were administrated with corticosteroid earlier and anticoagulation. The addition of neutrophil counts >6.3×109/L to the SMART-COP score resulted in improved area under the curves. CONCLUSIONS: Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection in young deceased patients appears to cause exuberant inflammatory responses, leading to compromised oxygen exchange, coagulation and multi-organ dysfunction. In addition, young patients with ARDS could benefit from adjuvant early corticosteroid and anticoagulation therapy. The expanded SMART-COP could predict the fatal outcomes with optimal efficiency.

4.
Clin Respir J ; 15(3): 293-309, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-916058

ABSTRACT

INTRODUCTION: COVID-19 has spread rapidly worldwide and has been declared a pandemic. OBJECTIVES: To delineate clinical features of COVID-19 patients with different severities and prognoses and clarify the risk factors for disease progression and death at an early stage. METHODS: Medical history, laboratory findings, treatment and outcome data from 214 hospitalised patients with COVID-19 pneumonia admitted to Eastern Campus of Renmin Hospital, Wuhan University in China were collected from 30 January 2020 to 20 February 2020, and risk factors associated with clinical deterioration and death were analysed. The final date of follow-up was 21 March 2020. RESULTS: Age, comorbidities, higher neutrophil cell counts, lower lymphocyte counts and subsets, impairment of liver, renal, heart, coagulation systems, systematic inflammation and clinical scores at admission were significantly associated with disease severity. Ten (16.1%) moderate and 45 (47.9%) severe patients experienced deterioration after admission, and median time from illness onset to clinical deterioration was 14.7 (IQR 11.3-18.5) and 14.5 days (IQR 11.8-20.0), respectively. Multivariate analysis showed increased Hazards Ratio of disease progression associated with older age, lymphocyte count <1.1 × 109/L, blood urea nitrogen (BUN)> 9.5 mmol/L, lactate dehydrogenase >250 U/L and procalcitonin >0.1 ng/mL at admission. These factors were also associated with the risk of death except for BUN. Prediction models in terms of nomogram for clinical deterioration and death were established to illustrate the probability. CONCLUSIONS: These findings provide insights for early detection and management of patients at risk of disease progression or even death, especially older patients and those with comorbidities.


Subject(s)
COVID-19/diagnosis , Hospitalization/trends , Pandemics , SARS-CoV-2 , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , China/epidemiology , Disease Progression , Female , Hospital Mortality/trends , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Risk Factors , Survival Rate/trends
5.
Theranostics ; 10(21): 9663-9673, 2020.
Article in English | MEDLINE | ID: covidwho-732688

ABSTRACT

Introduction: To explore the involvement of the cardiovascular system in coronavirus disease 2019 (COVID-19), we investigated whether myocardial injury occurred in COVID-19 patients and assessed the performance of serum high-sensitivity cardiac Troponin I (hs-cTnI) levels in predicting disease severity and 30-day in-hospital fatality. Methods: We included 244 COVID-19 patients, who were admitted to Renmin Hospital of Wuhan University with no preexisting cardiovascular disease or renal dysfunction. We analyzed the data including patients' clinical characteristics, cardiac biomarkers, severity of medical conditions, and 30-day in-hospital fatality. We performed multivariable Cox regressions and the receiver operating characteristic analysis to assess the association of cardiac biomarkers on admission with disease severity and prognosis. Results: In this retrospective observational study, 11% of COVID-19 patients had increased hs-cTnI levels (>40 ng/L) on admission. Of note, serum hs-cTnI levels were positively associated with the severity of medical conditions (median [interquartile range (IQR)]: 6.00 [6.00-6.00] ng/L in 91 patients with moderate conditions, 6.00 [6.00-18.00] ng/L in 107 patients with severe conditions, and 11.00 [6.00-56.75] ng/L in 46 patients with critical conditions, P for trend=0.001). Moreover, compared with those with normal cTnI levels, patients with increased hs-cTnI levels had higher in-hospital fatality (adjusted hazard ratio [95% CI]: 4.79 [1.46-15.69]). The receiver-operating characteristic curve analysis suggested that the inclusion of hs-cTnI levels into a panel of empirical prognostic factors substantially improved the prediction performance for severe or critical conditions (area under the curve (AUC): 0.71 (95% CI: 0.65-0.78) vs. 0.65 (0.58-0.72), P=0.01), as well as for 30-day fatality (AUC: 0.91 (0.85-0.96) vs. 0.77 (0.62-0.91), P=0.04). A cutoff value of 20 ng/L of hs-cTnI level led to the best prediction to 30-day fatality. Conclusions: In COVID-19 patients with no preexisting cardiovascular disease, 11% had increased hs-cTnI levels. Besides empirical prognostic factors, serum hs-cTnI levels upon admission provided independent prediction to both the severity of the medical condition and 30-day in-hospital fatality. These findings may shed important light on the clinical management of COVID-19.


Subject(s)
Cardiomyopathies/etiology , Coronavirus Infections/complications , Pneumonia, Viral/complications , Troponin I/blood , Aged , COVID-19 , Cardiomyopathies/blood , China , Cohort Studies , Coronavirus Infections/blood , Coronavirus Infections/mortality , Female , Hospitalization , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/blood , Pneumonia, Viral/mortality , Predictive Value of Tests , Prognosis , Retrospective Studies
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