An Analysis of The Trend of Incidences and Fatality of Pulmonary Tuberculosis in East Java from 2015-2020: A Lesson From COVID-19

Background: Pulmonary tuberculosis is still a public health problem, and surveillance data analysis has not been done much. Recently a global pandemic of COVID-19 has the potential in disturbing TB elimination programs and treatment. This study aims to comprehensively analyse the incidence rate (IR) and Case Fatality Rate (CFR) of pulmonary tuberculosis in East Java from 2015–2020 and during COVID-19 and the strategies for optimizing tuberculosis disease control. Methodology: The study analyzed annual surveillance data using an analytical descriptive design. The Variables were analyzed with Spearman correlation with a level of evidence of 95% (p<0.05). Results: The prevalence of pulmonary tuberculosis in East Java fluctuated from 2015–2020. In 2020 and during the COVID-19 pandemic, the number of cases and morbidity rates increased. Statistic results confirm the presence of a significant correlation between the values of Incidence rate (IR) and Case Fatality rate (CFR) (p = 0.032), IR and Treatment Success Rate (TSR) (p = 0.020), and CFR and TSR (p = 0.002). Population density is not correlated with the number of new cases (p = 0.667). Treatment rates have increased to 51%;cure and treatment rates have decreased to 76% and 89%, respectively, and there was a 4% increase in mortality during COVID-19. Conclusions: COVID-19 has tremendously affected the treatment of pulmonary TB cases in East Java, Indonesia by increasing the incidence rate and decreasing the fatality rate. The pandemic promotes fear in the community to check their medical status and improve the quality of their health in East Java. © The Authors retain the copyrights of this article, with first publication rights granted to Medsci Publications.

The Rise of SARS-CoV-2 (COVID-19) Omicron Subvariant Pathogenicity.

During the COVID-19 pandemic, variants of the Betacoronavirus SARS-CoV-2, the etiologic agent of COVID-19 disease, progressively decreased in pathogenicity up to the Omicron strain. However, the case fatality rate has increased from Omicron through each major Omicron subvariant (BA.2/BA.4, BA.5, XBB.1.5) in the United States of America. World data also mirror this trend. We show that the rise of Omicron pathogenicity is exponential, and we have modeled the case fatality rate of the next major subvariant as 0.0413, 2.5 times that of the Alpha strain and 60% of the original Wuhan strain which caused the greatest morbidity and mortality during the pandemic. Small-molecule therapeutics have been developed, and some of these, such as chlorpheniramine maleate, may be useful in the event of an Omicron subvariant of higher risk.

The value of discharged case fatality rate in estimating the severity and epidemic trend of COVID-19 in China: a novel epidemiological study.

Aim: The main objective of this study was to explore the value of the discharged case fatality rate (DCFR) in estimating the severity and epidemic trend of COVID-19 in China. Subjects and methods: Epidemiological data on COVID-19 in China and Hubei Province were obtained from the National Health Commission of the People's Republic of China from January 20, 2020, to March 31, 2020. The number of daily new confirmed cases, daily confirmed deaths, daily recovered cases, the proportion of daily deaths and total deaths of discharged cases were collected, and the total discharge case fatality rate (tDCFR), daily discharge case fatality rate (dDCFR), and stage-discharge case fatality rate (sDCFR) were calculated. We used the R software (version 3.6.3, R core team) to apply a trimmed exact linear time method to search for changes in the mean and variance of dDCFR in order to estimate the pandemic phase from dDCFR. Results: The tDCFR of COVID-19 in China was 4.16% until March 31, 2020. According to the pattern of dDCFR, the pandemic was divided into four phases: the transmission phase (from January 20 to February 2), the epidemic phase (from February 3 to February 14), the decline phase (from February 15 to February 22), and the sporadic phase (from February 23 to March 31). The sDCFR for these four phases was 43.18% (CI 39.82-46.54%), 13.23% (CI 12.52-13.94%), 5.86% (CI 5.49-6.22%), and 1.61% (CI 1.50-1.72%), respectively. Conclusion: DCFR has great value in assessing the severity and epidemic trend of COVID-19. Supplementary Information: The online version contains supplementary material available at 10.1007/s10389-023-01895-4.

A Note on Estimating the Case Fatality Ratio for Novel Corona Virus Disease (COVID-19)

Background: In this paper, an attempt has been made to estimate the Case Fatality Ratio (CFR) for coronavirus disease of India and a few selected countries. And also, it highlighted the pros and cons of obtaining crude and adjusted CFR of COVID-19 pandemic. Material(s) and Method(s): Data extracted from the WHO situation report and the University of Oxford website have been used for this analysis. The CFR and its 95% confidence interval were computed, trend and bar plot was used for graphical representation. Result(s): The worldwide crude CFR stands 6.73% (95% CI 6.69 to 6.76) based on 21, 83, 877 confirmed and 1,46,872 death cases(as on 17th April, 2020). Belgium was the highest CFR at 13.95% as compared to others. However, India's CFR was found to be around 3.26% (as on 17th April, 2020). Conclusion(s): In conclusion, the estimation and interpretation of CFR are critical in response to ongoing COVID-19. The initial CFR estimates are subject to change, still, it is useful for healthcare planning over the coming months. Moreover, the precise and robust estimates of CFR will be available only at the end of the epidemic.Copyright © 2021 Bentham Science Publishers.

Predictive Model for National Minimal CFR during Spontaneous Initial Outbreak of Emerging Infectious Disease: Lessons from COVID-19 Pandemic in 214 Nations and Regions.

The minimal case fatality rate (CFR) is one of the essential fundaments for the establishment of a diverse national response strategy against the COVID-19 epidemic, but cannot be quantitatively predicted. The aim of the present study was to explore the applicable quantitative parameters labeling integrating responding capacity from national daily CFR curves, and whether the minimal CFR during initial emerging epidemic outbreaks can be predicted. We analyzed data from 214 nations and regions during the initial 2020 COVID-19 epidemic and found similar falling zones marked with two turning points within a fitting three-day-moving CFR curve which occurred for many nations and regions. The turning points can be quantified with parameters for the day duration (T1, T2, and ΔT) and for the three-day moving arithmetic average CFRs (CFR1, CFR2, and ΔCFR) under wave theory for 71 nations and regions after screening. Two prediction models of minimal CFR were established with multiple linear regressions (M1) and multi-order curve regressions (M2) after internal and external evaluation. Three kinds of falling zones could be classified in the other 71 nations and regions. Only the minimal CFR showed significant correlations with nine independent national indicators in 65 nations and regions with CFRs less than 7%. Model M1 showed that logarithmic population, births per 1000 people, and household size made significant positive contributions, and logarithmic GDP, percentage of population aged 65+ years, domestic general government health expenditure, physicians per 1000 people, nurses per 1000 people, and body mass index made negative contributions to the minimal CFR against COVID-19 epidemics for most nations and regions. The spontaneous minimal CFR was predicted well with model M1 for 57 nations and regions based on the nine national indicators (R2 = 0.5074), or with model M2 for 59 nations and regions based on the nine national indicators (R2 = 0.8008) at internal evaluation. The study confirmed that national spontaneous minimal CFR could be predicted with models successfully for most nations and regions against COVID-19 epidemics, which provides a critical method to predict the essential early evidence to evaluate the integrating responding capacity and establish national responding strategies reasonably for other emerging infectious diseases in the future.

Differences in case-fatality-rate of emerging SARS-CoV-2 variants.

Objects: Variants of Severe-Acute-Respiratory-Syndrome Coronavirus-2 (SARS-CoV-2) has caused tremendous impact globally. It has been widely reported that the Omicron (B.1.1.529) variant is less deadly than the Delta (B.1.617.2) variant, presumably due to immunity from vaccination and previous infection. When measuring the severity of a variant, Case-Fatality-Rate (CFR) is often estimated. The purpose of this work is to calculate the change in CFR of different variants over time from a large number of countries/regions since the start of the pandemic in 2020. Study design: A Cross-sectional study. Methods: We extend the comparison to all previous VOCs in 58 counties/regions. We use reported death divided by reported cases in 30-day sliding window with a two-week shift between reported death and reported cases. Results: The drop from Delta variant to Omicron variant is substantial and the difference between subvariants of Omicron is not evident. Conclusion: We showed that the CFR dropped over time, presumably due to vaccine-induced immune and infection induced immune. Population age structure and prevalence of comorbidity influence CFR.

Screening and identification of potential MERS-CoV papain-like protease (PLpro) inhibitors; Steady-state kinetic and Molecular dynamic studies.

MERS-CoV belongs to the coronavirus group. Recent years have seen a rash of coronavirus epidemics. In June 2012, MERS-CoV was discovered in the Kingdom of Saudi Arabia, with 2,591 MERSA cases confirmed by lab tests by the end of August 2022 and 894 deaths at a case-fatality ratio (CFR) of 34.5% documented worldwide. Saudi Arabia reported the majority of these cases, with 2,184 cases and 813 deaths (CFR: 37.2%), necessitating a thorough understanding of the molecular machinery of MERS-CoV. To develop antiviral medicines, illustrative investigation of the protein in coronavirus subunits are required to increase our understanding of the subject. In this study, recombinant expression and purification of MERS-CoV (PLpro), a primary goal for the development of 22 new inhibitors, were completed using a high throughput screening methodology that employed fragment-based libraries in conjunction with structure-based virtual screening. Compounds 2, 7, and 20, showed significant biological activity. Moreover, a docking analysis revealed that the three compounds had favorable binding mood and binding free energy. Molecular dynamic simulation demonstrated the stability of compound 2 (2-((Benzimidazol-2-yl) thio)-1-arylethan-1-ones) the strongest inhibitory activity against the PLpro enzyme. In addition, disubstitutions at the meta and para locations are the only substitutions that may boost the inhibitory action against PLpro. Compound 2 was chosen as a MERS-CoV PLpro inhibitor after passing absorption, distribution, metabolism, and excretion studies; however, further investigations are required.

Trends in managing COVID-19 from an emerging infectious disease to a common respiratory infectious disease: What are the subsequent impacts on and new challenges for healthcare systems?

Targeting the 9 countries with the highest cumulative number of newly confirmed cases in the past year, we analyzed the case fatality ratio (CFR) among newly confirmed cases and the vaccination rate (two or more doses of vaccine per 100 people) in the United States of America (USA), India, France, Germany, Brazil, the Republic of Korea, Japan, Italy, and the United Kingdom (UK) for the period of 2020-2022. Data reveal a decrease in the CFR among newly confirmed cases since the beginning of 2022, when transmission of the Omicron variant predominates, and an increase in vaccination rates. The Republic of Korea had the lowest CFR among newly confirmed cases (0.093%) in 2022 and the highest vaccination rate (86.27%). Japan had the second highest vaccination rate (83.12%) and a decrease in the CFR among newly confirmed cases of 1.478% in 2020, 1.000% in 2021, and 0.148% in 2022; while the average estimated fatality ratio for seasonal influenza from 2015-2020 was 0.020%. Currently, most countries are now easing COVID-19-related restrictions and are exploring a shift in management of COVID-19 from an emerging infectious disease to a common respiratory infectious disease that can be treated as the equivalent of seasonal or regional influenza. However, compared to influenza, infection with the Omicron variant still has a higher fatality ratio, is more transmissible, and the size of future outbreaks cannot be accurately predicted due to the uncertainty of viral mutation. More importantly, as countries shift their response strategies to COVID-19, there is an urgent need at this time to clarify what the subsequent impacts on healthcare systems and new challenges will be, including the clinical response, the dissemination of scientific information, vaccination campaigns, the creation of future surveillance and response systems, the cost of treatments and vaccinations, and the flexible use of big data in healthcare systems.

The role of selenium in severe fever with thrombocytopenia syndrome: an integrative analysis of surveillance data and clinical data.

OBJECTIVES: Selenium deficiency can be associated with increased susceptibility to some viral infections and even more severe diseases. In this study, we aimed to examine whether this association applies to severe fever with thrombocytopenia syndrome (SFTS). METHOD: An observational study was conducted based on the data of 13,305 human SFTS cases reported in mainland China from 2010 to 2020. The associations among incidence, case fatality rate of SFTS, and crop selenium concentration at the county level were explored. The selenium level in a cohort of patients with SFTS was tested, and its relationship with clinical outcomes was evaluated. RESULTS: The association between selenium-deficient crops and the incidence rate of SFTS was confirmed by multivariate Poisson analysis, with an estimated incidence rate ratio (IRR, 95% confidence interval [CI]) of 4.549 (4.215-4.916) for moderate selenium-deficient counties and 16.002 (14.706-17.431) for severe selenium-deficient counties. In addition, a higher mortality rate was also observed in severe selenium-deficient counties with an IRR of 1.409 (95% CI: 1.061-1.909). A clinical study on 120 patients with SFTS showed an association between serum selenium deficiency and severe SFTS (odds ratio, OR: 2.94; 95% CI: 1.00-8.67) or fatal SFTS (OR: 7.55; 95% CI: 1.14-50.16). CONCLUSION: Selenium deficiency is associated with increased susceptibility to SFTS and poor clinical outcomes.

Fatality assessment and variant risk monitoring for COVID-19 using three new hospital occupancy related metrics.

BACKGROUND: Though case fatality rate (CFR) is widely used to reflect COVID-19 fatality risk, its use is limited by large temporal and spatial variation. Hospital mortality rate (HMR) is also used to assess the severity of COVID-19, but HMR data is not directly available globally. Alternative metrics are needed for COVID-19 severity and fatality assessment. METHODS: We introduce new metrics for COVID-19 fatality risk measurements/monitoring and a new mathematical model to estimate average hospital length of stay for deaths (Ldead) and discharges (Ldis). Multiple data sources were used for our analyses. FINDINGS: We propose three, new metrics: hospital occupancy mortality rate (HOMR), ratio of total deaths to hospital occupancy (TDHOR), and ratio of hospital occupancy to cases (HOCR), for dynamic assessment of COVID-19 fatality risk. Estimated Ldead and Ldis for 501,079 COVID-19 hospitalizations in 34 US states between 7 August 2020 and 1 March 2021 were 18·2(95%CI:17·9-18·5) and 14·0(95%CI:13·9-14·0) days, respectively. We found the dramatic changes in COVID-19 CFR observed in 27 countries during early stages of the pandemic were mostly caused by undiagnosed cases. Compared to the first week of November 2021, the week mean HOCRs (mimics hospitalization-to-case ratio) for Omicron variant (58·6% of US new cases as of 25 December 2021) decreased 65·16% in the US as of 16 January 2022. INTERPRETATION: The new and reliable measurements described here could be useful for COVID-19 fatality risk and variant-associated risk monitoring. FUNDING: No specific funding was associated with the present study.

Analysis of the renewed European Medical Device Regulations in the frame of the non - EU regulatory landscape during the COVID facilitated change.

The term "Medical devices" includes technology-based devices or articles, both basic and complex. Due to these types of variations, a strict, robust, transparent, and sustainable regulatory framework is required. In recent clinical practice, incidents including the breast implant and the hip replacement crisis have made it necessary to improve the regulatory and compliance approaches for the industry to ensure the manufacturing and distribution of safe and innovative MDs within the EU. In response to this, the EU revised the laws governing medical devices and in vitro diagnostics to align with the developments of the sector, address critical safety issues and support innovation. The new regulation (EU) 2017/745 on Medical Devices (MDR) is now applicable from May 26 2021 and the In Vitro Diagnostic Medical Devices Regulation (EU) 2017/746 will take effect from May 2022.In this review, we aim to provide an update on the new Medical Device Regulations in the context of the current medical needs of the world, and also to give a glimpse at the non-EU regulatory landscape. Finally, we take a look at the closed-system transfer devices (CSTD) and COVID facilitated changes promoting demand for continuous improvement and trends in the pharmaceutical and medical industry related areas.

The Trend of COVID-19 Pandemic in India: A Methodical Comparison with Italy, UK, and the US

Introduction: To statistically compare the trends of epidemiological indicators of COVID-19 in India with Italy, the UK, and the US. Methodology: In this descriptive analysis, epidemiological indicators were calculated and their trends were plotted and compared statistically. Regression analysis was done to predict the fatalities. Results: The trends of total and active cases per million populations are rising in India and US, while Italy has achieved the plateau in the total cases per million populations, and active cases have been sharply declining with time. The UK is about to achieve the same. India has remained far behind the other three countries in the number of tests per million populations (p<0.05). In the initial phase, the test positivity rate of India was quite lower but has overtaken Italy and UK. India has always reported a higher recovery rate than US and lower than Italy. CFRs have achieved a plateau in Italy and UK, in US it is declining, while it remained almost constant in India throughout the pandemic. Testing was a significant covariate in predicting the fatalities. Conclusions: India was able to manage the initial phase of this pandemic due to early and strict government interventions and strong public health responses. @ 2022 The Journal retains the copyrights of this article.

Evolution of the pandemic: Analysis of demographic characteristics of COVID-19-infected patients during its two waves in Gwalior district of central India.

Background: Studies of pandemics in past centuries have suggested that the second wave was always more lethal and devastating as compared to the first wave. Regarding coronavirus disease (COVID) pandemic also, various speculations were made that during the second wave virus changes its nature either for age structure, gender or rural-urban differential. Present study was aimed to compare the demographic and mortality profile of COVID-19 patients during the two waves. Materials and Methods: A total of 51,425 individuals with 16,538 cases from first wave and 34,887 cases from the second wave were included in the study. Frequency, percentage, case fatality rate (CFR) and OR (95% CI) were calculated. Level of significance was considered at 5%. Results: Maximum cases were observed in the age group 21-30 years (23.7%). During the first wave, 29.5% females were infected while during the second wave 38.5% females were infected. Infection in rural areas increased to 5.7% as compared to 4.8% in the first wave. Among the females, CFR increased to 37% in second wave which was 25.2% in the first wave. Disease load was at its peak in the month of April 2021. Conclusion: During the second wave, infection rate and mortality were higher in females and patients residing in rural areas showing extension of community spread. Patients with age above 50 years succumbed more. Occurrence of more than two-fifth of the cases in a single month (April 2021) shows a need for better planning for the supposed third wave to tackle any unwanted situation.

Incidence and outcomes of patients with COVID-19 associated pulmonary aspergillosis (CAPA) in intensive care units: a systematic review and meta-analysis of 31 cohort studies.

BACKGROUND: We aimed to identify studies systematically that describe the incidence and outcome of COVID-19-related pulmonary aspergillosis (CAPA). METHODS: We searched ScienceDirect, PubMed, CNKI, and MEDLINE (OVID) from December 31, 2019 to November 20, 2021 for all eligible studies. Random-model was used to reported the incidence, all-cause case fatality rate (CFR) and 95% confidence intervals (CIs). The meta-analysis was registered with PROSPERO (CRD42021242179). RESULTS: In all, thirty-one cohort studies were included in this study. A total of 3,441 patients with severe COVID-19 admitted to an intensive care unit (ICU) were investigated and 442 cases of CAPA were reported (30 studies). The pooled incidence rate of CAPA was 0.14 (95% CI: 0.11-0.17, I2=0.0%). Twenty-eight studies reported 287 deceased patients and 269 surviving patients. The pooled CFR of CAPA was 0.52 (95% CI: 0.47-0.56, I2=3.9%). Interestingly, patients with COVID19 would develop CAPA at 7.28 days after mechanical ventilation (range, 5.48-9.08 days). No significant publication bias was detected in this meta-analysis. DISCUSSION: Patients with COVID-19 admitted to an ICU might develop CAPA and have high all-cause CFR. We recommend conducting prospective screening for CAPA among patients with severe COVID-19, especially for those who receive mechanical ventilation over 7 days.

Analysis of the COVID-19 pandemic data across different states and union territories of India and effectiveness of the lockdown

With the onset of March 2020, India has stared witnessing the pandemic caused by COVID-19. However, the effect of this pandemic is not the same across different states of India. In this paper, the authors have carried out detailed analysis to get the complete view of the severity of COVID-19 disease in various states of India and have tried to find out the impact of various preventive measures like lockdown on its containment. The analysis will help various agencies to take appropriate, rigorous, and continuous measures to overcome this great health challenge. Copyright © 2021 Inderscience Enterprises Ltd.

A review on initiatives for the management of daily medical emergencies prior to the arrival of emergency medical services.

Emergency services worldwide face increasing cost pressure that potentially limits their existing resources. In many countries, emergency services also face the issues of staff shortage-creating extra challenges and constraints, especially during crisis times such as the COVID-19 pandemic-as well as long distances to sparsely populated areas resulting in longer response times. To overcome these issues and potentially reduce consequences of daily (medical) emergencies, several countries, such as Sweden, Germany, and the Netherlands, have started initiatives using new types of human resources as well as equipment, which have not been part of the existing emergency systems before. These resources are employed in response to medical emergency cases if they can arrive earlier than emergency medical services (EMS). A good number of studies have investigated the use of these new types of resources in EMS systems, from medical, technical, and logistical perspectives as their study domains. Several review papers in the literature exist that focus on one or several of these new types of resources. However, to the best of our knowledge, no review paper that comprehensively considers all new types of resources in emergency medical response systems exists. We try to fill this gap by presenting a broad literature review of the studies focused on the different new types of resources, which are used prior to the arrival of EMS. Our objective is to present an application-based and methodological overview of these papers, to provide insights to this important field and to bring it to the attention of researchers as well as emergency managers and administrators.

COVID-19 associated pulmonary aspergillosis (CAPA): An added potential burden on India's pre-existing fungal superinfection.

The ongoing pandemic that initiated in Wuhan, China, has been an international public health emergency since January 2020. India has been battling a brutal COVID-19's second wave since April 2021. The healthcare system was struggling with a substantial increase in COVID-19 cases when the lack of necessary resources further aroused a major setback. Opportunistic fungal infections, specifically mucormycosis and candidiasis have become a pressing matter of concern. Recent cases of aspergillosis have also heightened public alarm. Hence, call for an immediate response to this public health crisis is the need of the hour by establishing countrywide surveillance, diagnostic, and management system, as well as public awareness to alleviate the burden of COVID-19 and fungal infections in India.

Time to recovery from Covid-19 and its associated factors among patients hospitalized to the treatment center in South Central Ethiopia.

Coronavirus outbreak was a public health emergency. The surge of new confirmed cases and deaths was observed in developing countries due to the occurrence of new variants. However, factors associated with the duration of recovery among admitted patients remained uncertain. Therefore, we assessed factors associated with time to recovery from Covid-19 among hospitalized patients at the treatment center in South Central, Ethiopia. We employed a retrospective cross-sectional study among 422 patients hospitalized at Bokoji Hospital treatment center with Covid-19 from July 1, 2020, through October 30, 2021. Data were entered, coded, and analyzed using SPSS 26 version. We computed the survival probability using the Kaplan Meier method and determined factors associated with time to recovery using Cox regression analysis. Finally, the interpretation of adjusted hazard ratio (AHR) with 95% Confidence Interval (CI) and P-values less than 0.05 were declared as statistically significant. Our study found that the median time to recovery from Covid-19 infection of 13 days, with an IQR of 9-17 days. In multivariate Cox regression, ≥ 60 years old (AHR = 0.66; 95% CI: 0.49, 0.895), chronic pulmonary disease (AHR = 0.67; 95% CI: 0.455, 0.978), Male (AHR = 0.77; 95% CI: 0.611, 0.979), and being on Intranasal oxygen care (AHR = 0.56; 95% CI: 0.427-0.717) were significantly associated with time to recovery. Thus, health providers in treatment centers should give strict follow-up and priority for elders, patients with underlying diseases, and under supportive treatment during case management.

Marburg virus disease outbreak amidst COVID-19 in the Republic of Guinea: A point of contention for the fragile health system?

In August 2021, the Marburg virus disease (MVD) outbreak was confirmed amid the coronavirus disease 2019 (COVID-19) pandemic in the Republic of Guinea. This is the first time it is detected in Guinea and West Africa. Marburg virus is one of the world's most threatening diseases, causing severe haemorrhagic fever, with a case fatality rate of 90%. Currently, there are no vaccines and specific antiviral drugs for MVD. Technical teams and community health care workers that were set up as part of the recent Ebola virus disease (EVD) outbreak that was declared over on June 19, 2021, are now redeployed to support governments response activities of the MVD outbreak in the country. The MVD is an added burden to the fragile healthcare systems that are already overburdened with multiple reoccurring epidemics and the COVID-19 pandemic. Previous epidermic strategies are needed to contain the spread of the disease, amid the COVID-19 pandemic, so the health care systems are not overwhelmed. This commentary discusses the available evidence regarding the epidemic of MVD in Guinea amid the COVID-19 pandemic, and highlights the efforts, challenges to be prioritized, and provides evidence-based recommendations.

Evaluate the Case Fatality Rate (CFR) and Basic Reproductive Rate (R-naught) of COVID-19.

INTRODUCTION: SARS-CoV-2 primarily affects a person's respiratory system and leads to the spread of pathogenicity in the person and therefore this study evaluated the Case Fatality Rate (CFR) and Basic Reproductive Rate (R-naught) of COVID-19. METHOD: This cross-sectional descriptive study was performed on all people with COVID-19 from the first date of admission of positive PCR patients with SARS-CoV-2 until September 21, 2020, in the area of Markazi Province in Khomein, Iran. Information on the records of definitively discharged and deceased patients due to COVID-19 (having positive PCR) was extracted from 20/2/2020 to 21/9/2020, and Case Fatality Rate (CFR) and Basic Reproductive Rate (R-naught) of COVID-19 were evaluated. The sample size was 691 people. RESULTS: The CFR of the COVID-19 in the current study is 6.65%, and the rate of disease transmission among the sensitive population of Khomein city at the beginning of the study (March) averaged BASIC REPRODUCTIVE RATE= 1.75, and in the last month (September) of the study This value was reduced to BASIC REPRODUCTIVE RATE= 1.306. CONCLUSION: According to our study on Case Fatality Rate (CFR) and Basic Reproductive Rate (R-naught) of COVID-19, showed that the prevalence of the disease was high in March, which due to lack of proper observance of health protocols, we saw this problem and in the months when people have more problems. Hygiene was reduced, and the rate of transmission and mortality was reduced.