Mixture and Non-Mixture Cure Models for the survival analysis of SARS-CoV-2 patients in Khyber Pakhtunkhwa, Pakistan

  • Naseem Asghar Abdul Wali Khan University Mardan
  • Umair Khalil Abdul Wali Khan University Mardan, Pakistan
  • Iftikhar Uddin Bacha Khan Medical College Mardan, Pakistan
Keywords: Cox proportional hazards model, Kaplan-Meier curve, Mixture cure model, non-mixture cure model, SARS-CoV-2

Abstract

Objective: To examine the potential difference in survival and risk of death between asymptomatic and symptomatic SARS-CoV-2 patients, controlled by age and gender for all the attendance in hospitals of Khyber Pakhtunkhwa (KP), Pakistan.

Methods: In this retrospective study, the medical records of 6273 SARS-CoV-2 patients admitted to almost all hospitals in Khyber Pakhtunkhwa during the first wave of the coronavirus outbreak from March to June 2020 were analysed. The effects of gender, age, and being symptomatic on the survival of SARS-CoV-2 patients were assessed using cure-survival models as opposed to the conventional Cox proportional hazards model.

Results: The prevalence of initially symptomatic patients was 55.8%, and the overall mortality rate was 11.8%. The fitted cure-survival models suggest that age affects the probability of death (incidence) but not the short-term survival time of patients (latency); symptomatic patients have a higher risk of death than their asymptomatic counterparts, but the survival time of symptomatic patients is longer on average; gender has no significant effect on the probability of death and survival time.

Conclusion: The available data and statistical results suggest that asymptomatic and young patients are generally less susceptible to initial infection with SARS-CoV-2 and therefore have a lower risk of death. Our regression models show that uncured asymptomatic patients generally have poorer short-term survival than their uncured symptomatic counterparts. The association between gender and survival outcome was not significant.

doi: https://doi.org/10.12669/pjms.40.8.8931

How to cite this: Asghar N, Khalil U, Iftikhar Uddin. Mixture and Non-Mixture Cure Models for the survival analysis of SARS-CoV-2 patients in Khyber Pakhtunkhwa, Pakistan. Pak J Med Sci. 2024;40(8):---------. doi: https://doi.org/10.12669/pjms.40.8.8931

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Author Biographies

Naseem Asghar, Abdul Wali Khan University Mardan

Lecturer, Department of Mathematics and Statistics, University of Swat, Pakistan and PhD scholar, Abdul Wali Khan University Mardan, Pakistan

Umair Khalil, Abdul Wali Khan University Mardan, Pakistan

Associate Professor, Department of Statistics, Abdul Wali Khan University Mardan, Pakistan

Iftikhar Uddin, Bacha Khan Medical College Mardan, Pakistan

Assistant Professor, Department of Community Medicine, Bacha Khan Medical College Mardan, Pakistan

Published
2024-08-02
How to Cite
Asghar, N., Khalil, U., & Iftikhar Uddin. (2024). Mixture and Non-Mixture Cure Models for the survival analysis of SARS-CoV-2 patients in Khyber Pakhtunkhwa, Pakistan. Pakistan Journal of Medical Sciences, 40(8). https://doi.org/10.12669/pjms.40.8.8931
Section
Original Articles