Assessing the age specificity of infection fatality rates for COVID-19: systematic review, meta-analysis, and public policy implications

Abstract

Determine age-specific infection fatality rates for COVID-19 to inform public health policies and communications that help protect vulnerable age groups. Studies of COVID-19 prevalence were collected by conducting an online search of published articles, preprints, and government reports that were publicly disseminated prior to 18 September 2020. The systematic review encompassed 113 studies, of which 27 studies (covering 34 geographical locations) satisfied the inclusion criteria and were included in the meta-analysis. Age-specific IFRs were computed using the prevalence data in conjunction with reported fatalities 4 weeks after the midpoint date of the study, reflecting typical lags in fatalities and reporting. Meta-regression procedures in Stata were used to analyze the infection fatality rate (IFR) by age. Our analysis finds a exponential relationship between age and IFR for COVID-19. The estimated age-specific IFR is very low for children and younger adults (e.g., 0.002% at age 10 and 0.01% at age 25) but increases progressively to 0.4% at age 55, 1.4% at age 65, 4.6% at age 75, and 15% at age 85. Moreover, our results indicate that about 90% of the variation in population IFR across geographical locations reflects differences in the age composition of the population and the extent to which relatively vulnerable age groups were exposed to the virus. These results indicate that COVID-19 is hazardous not only for the elderly but also for middle-aged adults, for whom the infection fatality rate is two orders of magnitude greater than the annualized risk of a fatal automobile accident and far more dangerous than seasonal influenza. Moreover, the overall 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 mitigate infections in older adults could substantially decrease total deaths.

Dynamics of COVID-19 under social distancing measures are driven by transmission network structure

“…The important role of presymptomatic and asymptomatic individuals in transmitting infection makes symptom-based isolation less effective. Uncertainty about the case fatality risk from COVID-19 [ 1 ] and misguided comparisons to seasonal influenza contributed to sluggish responses in many regions, in contrast to previous outbreaks of SARS and MERS.…”

COVID-19 and Dentistry in 72 Questions: An Overview of the Literature

“…There are major differences between countries that depend on geographical and demographic factors, and on the political will to communicate the data transparently. Infection fatality rate for COVID-19 is below 1% under 50 years, with an exponential increase over 60 years, ranging from 2.5% in the age group 65–74 years, to around 28% over 80 years [ 25 ]. According to JHU reports, there was an initial epidemic peak in China on 13 February 2020, followed by three pandemic waves worldwide in April–May, August–September and November–December-January (still ongoing) [ 1 ].…”

COVID-19 Crisis Creates Opportunity towards Global Monitoring & Surveillance

“…However, based on the fact that the policies and decision-making are guided by the infection fatality rate (IFR), calculations based on sero-prevalence data may give a clue as to the total infected population [91]. This would certainly help in better coping with the influx of patients and would also lead to a significantly reduced number of healthcare providers and healthcare workers contracting infections and dying [92]. About 17 years ago, we witnessed the loss of $40-50 billion in the global economy and ~$20 billion in Asian countries due to SARS-CoV-1, which was later successfully eliminated by rigorous contact tracing and implementing strict case isolation measures; no further cases have been reported since 2004 [93,94].…”