Age-specific SARS-CoV-2 infection fatality ratio and associated risk factors, Italy, February to April 2020

Poletti, Piero; Tirani, Marcello; Cereda, Danilo; Trentini, Filippo; Guzzetta, Giorgio; Marziano, Valentina; Buoro, Sabrina; Riboli, Simona; Crottogini, Lucia; Piccarreta, Raffaella; Piatti, Alessandra; Grasselli, Giacomo; Melegaro, Alessia; Gramegna, Maria; Ajelli, Marco; Merler, Stefano

doi:10.2807/1560-7917.es.2020.25.31.2001383

Cited by 69 publications

(76 citation statements)

References 15 publications

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“…Of interest, the high mortality risk of elderly adults was consistently observed in China, European regions, and North America ( Figure 2 ). Indeed, similar findings have been consistently reported by single-country studies of COVID-19 patients in many countries such as America [ 12 ], Belgium [ 13 ], Canada [ 14 ], France [ 15 ], Germany [ 16 ], Italy [ 17 ], Mexico [ 18 ], Poland [ 19 ], Romania [ 20 ], Russia [ 21 ], Spain [ 22 ], and the United Kingdom [ 23 ]. Of note, age, gender, and chronic comorbidities are key factors that determine hospitalization rather than outpatient care [ 10 ].…”

Section: Discussionsupporting

confidence: 78%

Mortality risk of COVID-19 in elderly males with comorbidities: a multi-country study

Liu

Jing

et al. 2020

Aging

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The COVID-19 pandemic causes severe morbidity and mortality. This multi-country study aimed to explore risk factors that drive mortality in COVID-19 patients who received neither dexamethasone nor remdesivir. We analyzed a cohort of 568 survivors and 507 non-survivors from China, European regions, and North America. Elderly males ≥70 years accounted for only 25% of survivors, but this rate was significantly higher in non-survivors from China (55%), European regions (63%), and North America (47%). Compared with survivors, non-survivors had more incidences of comorbidities such as cerebrovascular disease and chronic obstructive pulmonary disease (COPD, p-values<0.05). Survival analyses revealed age, male gender, shortness of breath, cerebrovascular disease, and COPD as mortality-associated factors. Survival time from symptom onset was significantly shorter in elderly versus young patients (median: 29 versus 62 days), males versus females (median: 46 versus 59 days), and patients with versus without comorbidities (mean: 41 versus 61 days). Mortality risk was higher in elderly males with comorbidities than in young females without comorbidities (p-value<0.01). Elderly male survivors with comorbidities also had longer hospital stays than other survivors (25 versus 18.5 days, p-value<0.01). Overall, the high mortality risk in elderly males with COVID-19-associated comorbidities supports early prevention and critical care for elderly populations.

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Section: Discussionsupporting

confidence: 78%

Mortality risk of COVID-19 in elderly males with comorbidities: a multi-country study

Liu

Jing

et al. 2020

Aging

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“…We further found that countries with higher median age had higher CFR value. Older age has been recognized as one of the most common risk factors for a severe outcome of COVID-19 [99][100][101]. A study conducted with 5,484 patients in Italy found the CFR of COVID-19 was 0.43% for people below 70 years and 10.5% for people above 70 years and above [101].…”

Section: Discussionmentioning

confidence: 99%

“…Older age has been recognized as one of the most common risk factors for a severe outcome of COVID-19 [99][100][101]. A study conducted with 5,484 patients in Italy found the CFR of COVID-19 was 0.43% for people below 70 years and 10.5% for people above 70 years and above [101]. Another study showed that an increase of 1% population aged 65 years and above increased the risk of death due to COVID-19 by 10% [100].…”

Section: Discussionmentioning

confidence: 99%

Estimation of novel coronavirus (covid-19) reproduction number and case fatality rate: a systematic review and meta-analysis

Ahammed

Anjum

Rahman

et al. 2020

Preprint

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Understanding the transmission dynamics and the severity of the novel coronavirus disease 2019 (COVID-19) informs public health interventions, surveillance, and planning. Two important parameters, the basic reproduction number (R0) and case fatality rate (CFR) of COVID-19, help in this understanding process. The objective of this study was to estimate the R0 and CFR of COVID-19 and assess whether the parameters vary in different regions of the world. We carried out a systematic review to retrieve the published estimates of the R0 and the CFR in articles from international databases between 1st January and 31st August 2020. Random-effect models and Forest plots were implemented to evaluate the mean effect size of the R0 and the CFR. Furthermore, the R0 and CFR of the studies were quantified based on geographic location, the tests/thousand population, and the median population age of the countries where studies were conducted. The I2 statistic and the Cochran's Q test were applied to assess statistical heterogeneity among the selected studies. Forty-five studies involving R0 and thirty-four studies involving CFR were included. The pooled estimation of the R0 was 2.69 (95% CI: 2.40, 2.98), and that of the CFR was 2.67 (2.25, 3.13). The CFR in different regions of the world varied significantly, from 2.51 (2.12, 2.95) in Asia to 7.11 (6.38, 7.91) in Africa. We observed higher mean CFR values for the countries with lower tests (3.15 vs. 2.16) and greater median population age (3.13 vs. 2.27). However, the R0 did not vary significantly in different regions of the world. An R0 of 2.69 and CFR of 2.67 indicate the severity of the COVID-19. Although R0 and CFR may vary over time, space, and demographics, we recommend considering these figures in control and prevention measures.

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“…Lombardy, Italy [99] This study used a database of 62881 contacts of COVID-19 cases and conducted RT-PCR tests and antibody screening on 5484 individuals. The study reported that 2824 individuals had positive tests (51•5% of the sample), of which 62 individuals subsequently died with a COVID-19 diagnosis.…”

Section: H35 Close Contacts Of Positive Cases Location Descriptionmentioning

confidence: 99%

Assessing the Age Specificity of Infection Fatality Rates for COVID-19: Systematic Review, Meta-analysis, & Public Policy Implications

Levin¹,

Hanage²,

Owusu‐Boaitey³

et al. 2020

104

129

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To assess age-specific infection fatality rates (IFRs) for COVID-19, we have conducted a systematic review of seroprevalence studies as well as countries with comprehensive tracing programs. Age-specific IFRs were computed using the prevalence data in conjunction with reported fatalities four weeks after the midpoint date of each study, reflecting typical lags in fatalities and reporting. Using metaregression procedures, we find a highly significant log-linear relationship between age and IFR for COVID-19. The estimated age-specific IFRs are very low for children and younger adults but increase progressively to 0.4% at age 55, 1.3% at age 65, 4.2% at age 75, and 14% at age 85. About 90% of the geographical variation in population IFR is explained by differences in age composition of the population and age-specific prevalence. These results indicate that COVID-19 is hazardous not only for the elderly but also for middle-aged adults. Moreover, the population IFR for COVID-19 should not be viewed as a fixed parameter but as intrinsically linked to the age-specific pattern of infections. Consequently, public health measures to protect vulnerable age groups could substantially decrease total deaths.

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Age-specific SARS-CoV-2 infection fatality ratio and associated risk factors, Italy, February to April 2020

Cited by 69 publications

References 15 publications

Mortality risk of COVID-19 in elderly males with comorbidities: a multi-country study

Mortality risk of COVID-19 in elderly males with comorbidities: a multi-country study

Estimation of novel coronavirus (covid-19) reproduction number and case fatality rate: a systematic review and meta-analysis

Assessing the Age Specificity of Infection Fatality Rates for COVID-19: Systematic Review, Meta-analysis, & Public Policy Implications

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