Background. Wide variation between countries has been noted in per-capita mortality from the disease (COVID-19) caused by the SARS-CoV-2 virus. Determinants of this variation are not fully understood. Methods. Potential predictors of per-capita coronavirus-related mortality in 198 countries were examined, including age, sex ratio, obesity prevalence, temperature, urbanization, smoking, duration of infection, lockdowns, viral testing, contact tracing policies, and public mask-wearing norms and policies. Multivariable linear regression analysis was performed. Results. In univariate analyses, the prevalence of smoking, per-capita gross domestic product, urbanization, and colder average country temperature were positively associated with coronavirus-related mortality. In a multivariable analysis of 194 countries, the duration of infection in the country, and the proportion of the population 60 years of age or older were positively associated with per-capita mortality, while duration of mask-wearing by the public was negatively associated with mortality (all p<0.001). The prevalence of obesity was independently associated with mortality in models which controlled for testing levels or policy. International travel restrictions were independently associated with lower per-capita mortality, but other containment measures and viral testing and tracing policies were not. In countries with cultural norms or government policies supporting public mask-wearing, per-capita coronavirus mortality increased on average by just 8.0% each week, as compared with 54% each week in remaining countries. On multivariable analysis, lockdowns tended to be associated with less mortality (p=0.43), and increased per-capita testing with higher reported mortality (p=0.70), though neither association was statistically significant. Conclusions. Societal norms and government policies supporting the wearing of masks by the public, as well as international travel controls, are independently associated with lower per-capita mortality from COVID-19.

Background Populations heavily exposed to the novel coronavirus provide an opportunity to estimate the mortality from COVID-19 in different age groups. Methods The mortality reported by May 13 from COVID-19 among Diamond Princess cruise ship passengers, and New York residents and Metropolitan Transit Authority (MTA) workers was estimated based on publicly available information. Results The mortality among children (age 0 to 17 yrs) in New York City was 1 in 172,692. The mortality in New York state was 1 in 322,217 for ages 10-19 yrs., and 1 in 36,725 for ages 20-29 yrs. The mortality among New York transit workers was estimated to be 1 in 7,329 for ages 30-39 years; 1 in 1,075 for ages 40-49 yrs.; 1 in 343 for ages 50-59 yrs.; and 1 in 178 for ages 60-69 yrs. Among Diamond Princess passengers, the mortality was estimated to be 1 in 145 for ages 70-79, and 1 in 54 for ages 80-89. Conclusions Mortality among populations exposed to the novel coronavirus increases with age, ranging from about 1 in 170,000 below the age of 18 years, to 1 in 54 above the age of 80 years.

We studied sources of variation between countries in per-capita mortality from COVID-19 (caused by the SARS-CoV-2 virus). Potential predictors of per-capita coronavirus-related mortality in 200 countries by May 9, 2020 were examined, including age, gender, obesity prevalence, temperature, urbanization, smoking, duration of the outbreak, lockdowns, viral testing, contact-tracing policies, and public mask-wearing norms and policies. Multivariable linear regression analysis was performed. In univariate analysis, the prevalence of smoking, per-capita gross domestic product, urbanization, and colder average country temperature were positively associated with coronavirus-related mortality. In a multivariable analysis of 196 countries, the duration of the outbreak in the country, and the proportion of the population aged 60 years or older were positively associated with per-capita mortality, whereas duration of mask-wearing by the public was negatively associated with mortality (all P < 0.001). Obesity and less stringent international travel restrictions were independently associated with mortality in a model which controlled for testing policy. Viral testing policies and levels were not associated with mortality. Internal lockdown was associated with a nonsignificant 2.4% reduction in mortality each week (P = 0.83). The association of contact-tracing policy with mortality was not statistically significant (P = 0.06). In countries with cultural norms or government policies supporting public mask-wearing, per-capita coronavirus mortality increased on average by just 16.2% each week, as compared with 61.9% each week in remaining countries. Societal norms and government policies supporting the wearing of masks by the public, as well as international travel controls, are independently associated with lower per-capita mortality from COVID-19.

The presence of KMT2A/AFF1 rearrangement in B-lymphoblastic leukemia (B-ALL) is an independent poor prognostic factor and has been associated with higher rate of treatment failure and higher risk of linage switch under therapy. Blinatumomab has shown promising therapeutic results in refractory or relapsed B-ALL; however, it has potential risk of inducing lineage switch, especially in KMT2A/AFF1 rearranged B-ALL into acute myeloid leukemia and/or myeloid sarcoma. We report a 40-year-old female with KMT2A/AFF1-rearranged B-ALL that was refractory to conventional chemotherapy. Following administration of blinatumomab, she developed a breast mass proven to be myeloid sarcoma, in addition to bone marrow involvement by AML. Approximately six weeks after cessation of blinatumomab, a repeat bone marrow examination revealed B/myeloid MPAL.