The COVID-19 pandemic has claimed numerous lives worldwide. Malaysia documented about 118 mortalities during the second wave of the outbreak. This study aims to assess associated risk factors of the COVID-19 mortalities from 18 March until 22 May 2020. The majority of patients were above 60 years old (69.0%), male (78.0%), and Malaysian citizens (98.0%). The mean age of the mortalities was 64.01 years old (±SD 14.91 years). The major risk factors consist of hypertension (52.0%), diabetes mellitus (43.0%), cardiovascular diseases (21.0%), extra-pulmonary solid malignancies (5.0%), cerebrovascular diseases (3.0%), pulmonary diseases (1.0%) and pulmonary malignancies (1.0%). About 23.0% of mortalities were related to established clusters while 5.0% had a history of travelling overseas. The mean survival time was 11.87 days (±SD 9.32 days). Approximately 50.0% of the patients survived until day 10 post-admission. The probability of the patients surviving beyond 30 days post-admission was less than 10.0%. There is a significant difference between groups for having a shorter duration to death for risk factors including age group, history of travelling overseas, attending mass gatherings, and having pulmonary malignancies. The hazard ratio (HR) for pulmonary malignancy is 5.512 (95% CI 0.662, 45.899), mass gathering; 3.434 (95% CI 1.375, 8.579), pulmonary disease is 2.442 (95% CI 0.314, 18.983), travelling overseas; 2.251 (95% CI 0.657, 7.711), extra-pulmonary solid malignancy; 2.165 (95% CI 0.767, 6.112), and despite the significant result only applied for mass gathering (p-value = 0.008). COVID-19 screening should be mandatory for those who attend mass gatherings as they are the main source of COVID-19 spread in the community during the second wave outbreak in Malaysia.

Introduction The current global pandemic of the virus that emerged from Hubei province in China has caused coronavirus disease in 2019 (COVID-19), which has affected a total number of 900 036 people globally, involving 206 countries and resulted in a cumulative of 45 693 deaths worldwide as of 3 April 2020. The mode of transmission is identified through airdrops from patients’ body fluids such as during sneezing, coughing and talking. However, the relative importance of environmental effects in the transmission of the virus has not been vastly studied. In addition, the role of temperature and humidity in air-borne transmission of infection is presently still unclear. This study aims to identify the effect of temperature, humidity and air quality in the transmission of SARS-CoV-2. Methods and analysis We will systematically conduct a comprehensive literature search using various databases including PubMed, EMBASE, Scopus, CENTRAL and Google Scholar to identify potential studies. The search will be performed for any eligible articles from the earliest published articles up to latest available studies in 2020. We will include all the observational studies such as cohort case–control and cross-sectional studies that explains or measures the effects of temperature and/or humidity and/or air quality and/or anthropic activities that is associated with SARS-CoV-2. Study selection and reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Meta-Analysis of Observational Studies in Epidemiology guideline. All data will be extracted using a standardised data extraction form and quality of the studies will be assessed using the Newcastle-Ottawa Scale guideline. Descriptive and meta-analysis will be performed using a random effect model in Review Manager File. Ethics and dissemination No primary data will be collected, and thus no formal ethical approval is required. The results will be disseminated through a peer-reviewed publication and conference presentation. PROSPERO registration number CRD42020176756.

Serious injury due to motor vehicle accidents (MVAs) significantly contributes to the adolescents’ health status. The objective of this study was to estimate the prevalence of nonfatal injury due to MVAs and its associated factors among Malaysian school-going adolescents. Nationally representative samples were selected via 2-stage stratified cluster sampling. Data was collected using a validated self-administered questionnaire. Logistic regression analysis was conducted to examine the associations between the variables. A total of 1088 out of 27 497 adolescents reported that they had sustained serious injury due to MVAs with a prevalence of 4.1% (95% confidence interval [CI] = 3.7-4.5). Serious injury due to MVAs among adolescents was positively associated with being current cigarette smokers (adjusted odds ratio [aOR] = 2.5; 95% CI = 2.2-2.9), followed by Malay ethnicity (aOR = 2.4; 95% CI = 1.9-3.0), current drug users (aOR = 2.3; 95% CI = 1.9-3.0), boys (aOR = 2.1; 95% CI = 1.8-2.4), Indian ethnicity (aOR = 1.8; 95% CI = 1.2-2.5), and those who were in upper secondary school (aOR = 1.3; 95% CI = 1.2-1.5). Targeted intervention and curbing substance use among boys may reduce the morbidities from MVAs and its resulting complications.