SARS-CoV-2 infection fatality rate after the first epidemic wave in Mexico

Abstract

Background Estimates of SARS-CoV-2 infection fatality rates (IFRs) in developing countries remain poorly characterized. Mexico has one of the highest reported COVID-19 case-fatality rates worldwide, although available estimates do not consider serologic assessment of prior exposure nor all SARS-CoV-2-related deaths. We aimed to estimate sex- and age-specific IFRs for SARS-CoV-2 in Mexico. Methods The total number of people in Mexico with evidence of prior SARS-CoV-2 infection was derived from National Survey of Health and Nutrition-COVID-19 (ENSANUT 2020 Covid-19)—a nationally representative serosurvey conducted from August to November 2020. COVID-19 mortality data matched to ENSANUT’s dates were retrieved from the death-certificate registry, which captures the majority of COVID-19 deaths in Mexico, and from the national surveillance system, which covers the subset of COVID-19 deaths that were identified by the health system and were confirmed through a positive polymerase chain reaction test. We analysed differences in IFRs by urbanization and region. Results The national SARS-CoV-2 IFR was 0.47% (95% CI 0.44, 0.50) using death certificates and 0.30% (95% CI 0.28, 0.33) using surveillance-based deaths. The IFR increased with age, being close to zero at age <30 years, but increasing to 1% at ages 50–59 years in men and 60–69 years in women, and being the highest at ≥80 years for men (5.88%) and women (6.23%). Across Mexico's nine regions, Mexico City (0.99%) had the highest and the Peninsula (0.26%) the lowest certificate-based IFRs. Metropolitan areas had higher certificate-based IFR (0.63%) than rural areas (0.17%). Conclusion After the first wave of the COVID-19 pandemic, the overall IFR in Mexico was comparable with those of European countries. The IFR in Mexico increased with age and was higher in men than in women. The variations in IFRs across regions and places of residence within the country suggest that structural factors related to population characteristics, pandemic containment and healthcare capabilities could have influenced lethality at the local level.

COVID-19 Mortality and Progress Toward Vaccinating Older Adults — World Health Organization, Worldwide, 2020–2022

“…The impact of COVID-19 during the last 3 years has been substantial, and COVID-19 mortality is an important outcome indicator for monitoring the pandemic. These COVID-19 deaths and excess mortality estimates showing that persons aged ≥60 years accounted for more than 80% of total COVID-19 deaths even when controlling for income levels are consistent with the initial SARS-CoV-2–related mortality patterns described in China and subsequently by other countries ( 1 – 3 ). The large disparity observed between reported deaths and estimated excess mortality, especially in upper-middle–, lower-middle–, and low-income countries, makes ascertaining true COVID-19–associated mortality challenging.…”

“…After the emergence of SARS-CoV-2 in late 2019, transmission expanded globally, and on January 30, 2020, COVID-19 was declared a public health emergency of international concern. * Analysis of the early Wuhan, China outbreak (1), subsequently confirmed by multiple other studies (2,3), found that 80% of deaths occurred among persons aged ≥60 years. In anticipation of the time needed for the global vaccine supply to meet all needs, the World Health Organization (WHO) published the Strategic Advisory Group of Experts on Immunization (SAGE) Values Framework and a roadmap for prioritizing use of COVID-19 vaccines in late 2020 (4,5), followed by a strategy brief to outline urgent actions in October 2021.…”

Mortality-Associated Sars-Cov-2 Genomic Variants From Patients Hospitalized for Severe Pneumonia in Aguascalientes, Mexico From 2020 to 2023

“…Among these hospitalized patients, around 1% required mechanical ventilation and had an even higher lethality rate of around 80%. Analyzing patient demographics, age, and patient type are crucial factors in COVID-19 outcomes in Mexico [Torres-Ibarra et al, 2022]. Patients under the age of 65 who require hospitalization have a mortality rate of less than 50%, which increases significantly with advancing age.…”

Counting Cases and Deaths by Age Tells Us About COVID-19’s Infectious and Lethal Components

“…Men have higher levels of Gompertzian Lethality than women but similar levels of Pasteurian Infectivity Gompertzian Analysis reveals that men have a higher level of COVID-19 Gompertzian Lethality (Deaths/Cases), in each age group, than women, taking the form of a higher Gompertzian Height, GH, with both sexes having a somewhat similar Gompertzian Slope, GS (APPENDIX-FIGURE 42). 7 There is no evident male/female difference in Pasteurian Infectivity (Cases/Population).…”