Increase in COVID‐19 cases and case‐fatality and case‐recovery rates in Europe: A cross‐temporal meta‐analysis

Abstract

The new coronavirus (COVID-19) infection reported in China in December 2019 has become a pandemic in a few weeks, affecting the entire world. In this respect, it is crucial to determine the case-increase, case-fatality, and case-recovery rates to control COVID-19. In this study, the case-increase, case-fatality, and case-recovery rates of COVID-19 in 36 European countries were analyzed with the meta-analysis method using data released by the health organizations and WHO. The data were obtained from the website of health organizations of 36 European countries and the website of WHO until 11 May 2020. The analyses were carried out on 1 744 704 COVID-19-diagnosed cases in 36 European countries. The case-increase, casefatality and case-recovery rates of COVID-19 were calculated using 95% confidence intervals (95% CI), single-arm meta-analysis, cross-temporal meta-analysis, and meta-regression random-effects model. The standardized case-increase rate of COVID-19 is 5% (95% CI [0.040, 0.063]) and the average case-increase rate in European countries has started to decline by around 3% (95% CI [0.047, 0.083])weekly. The countries with the highest rate of case increase are Belgium, Sweden, Russia, the Netherlands and the United Kingdom. Although the case-fatality rate of COVID-19 patients was 4.5% as of May 11 (95% CI [0.037-0.055]), this rate is 6.3% (95% CI [0.047, 0.083]) in standardized time (6th week). The case-recovery rates of patients are 46% (95% ). This study presents important results regarding the COVID-19 pandemic in Europe. Although the rate of increase in new COVID-19 cases has dropped, there is not much decline in the case-fatality rates and no increase in case-recovery rates. The case-fatality rate of COVID-19 in Europe was estimated to be in the range of 4% to 4.5% and a minimum of 4 weeks (as of 11 May) is expected to have the figure below 1% in a country with an average caseincrease rate. Monitoring case fatalities in Belgium, the Netherlands and Sweden, and treatment successes in Germany and Austria play a role of utmost importance.

Seroprevalence and correlates of SARS-CoV-2 neutralizing antibodies: Results from a population-based study in Bonn, Germany

“…We found an extremely low prevalence of SARS-CoV-2 seropositivity in Bonn, a middle-large city in the western part of Germany with a relatively low burden of COVID-19, both regionally and internationally. 16,17 In addition, we found that: Our findings also confirm that limited exposure of the local population to SARS-CoV-2 most likely accounts for the relatively low rates of regional COVID-19-related hospitalizations and mortality, supporting the efficacy of early implementation of social distancing and confinement measures in Germany. 16,17 The current seroprevalence estimates are lower than the two other German community-based serosurveys.…”

“…16,17 In addition, we found that: Our findings also confirm that limited exposure of the local population to SARS-CoV-2 most likely accounts for the relatively low rates of regional COVID-19-related hospitalizations and mortality, supporting the efficacy of early implementation of social distancing and confinement measures in Germany. 16,17 The current seroprevalence estimates are lower than the two other German community-based serosurveys. 14,15 However, both these previous serosurveys were conducted in communities following super-spreading events, and are unlikely to reflect the state of other regions in Germany with relatively low COVID-19 burden.…”

“…Only two of these were population-based studies, 14,15 while the remaining assessments targeted industrial workers, health-care providers, mothers, students/teachers or blood donors. 12 COVID-19-related morbidity and mortality rates have been relatively low in Germany compared to other (European) countries, 16,17 yet the true exposure state of the population could be much higher given the unknown proportion of SARS-CoV-2 infections with mild or asymptomatic course. 9 An important challenge for accurate assessment of SARS-CoV-2 seroprevalence, especially in regions with a relatively low infection rate, is insufficient specificity of the serological tests.…”

Lopinavir/ritonavir: Repurposing an old drug for HIV infection in COVID-19 treatment

“…The spectrum of clinical manifestations of COVID-19 can vary from a mild respiratory syndrome to an Acute Respiratory Distress Syndrome (ARDS) requiring mechanical ventilation [ [12] , [13] , [14] , [15] ], where older age and comorbidities increase the risk of a more severe disease [ 16 , 17 ]. Case fatality rate has been reported to be around 4–4.5%, anyway varying widely among different countries and different testing strategies [ [18] , [19] , [20] ]. Up to date, only remdesivir and dexamethasone proved to be effective in clinical trials: remdesivir shortened the length of hospitalization, anyway without a meaningful impact on mortality [ 21 ], while dexamethasone significantly reduced mortality in patients requiring supplemental oxygen [ 22 ].…”

Temporal changes in co-morbidities and mortality in patients hospitalized for COVID-19 in Italy

“…Such increase was paralleled by an increase in mortality from 9.5% in March to 12.1% afterwards [6] . In a recent meta-analysis of data gathered from 36 European countries [7] , the case-fatality rate of patients with COVID-19 progressively rose from 1.5% in the week subsequent to the first death to 6.5% at the sixth week, with an average case-fatality of 4.5%. However, the meta-analysis could not adjust for the changes in the clinical characteristics of subjects across the different Countries over the examined time period [7] .…”