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Estimates of the severity of COVID-19 disease | |
Robert Verity Han Fu Amy Dighe Neil Ferguson Peter Winskill Charles Whittaker Natsuko Imai Gina Cuomo-Dannenburg Hayley Thompson Patrick Walker Azra Ghani Christl Donnelly Ilaria Dorigatti Jamie Griffin Anne Cori Marc Baguelin Sangeeta Bhatia Adhiratha Boonyasiri Rich Fitzjohn Katy A M Gaythorpe Lucy C Okell Will Green Arran Hamlet Wes Hinsley Daniel Laydon Gemma Nedjati-Gilani Steven Riley Sabine van-Elsand Erik Volz Haowei Wang Yuanrong Wang Xiayoue Xi Zulma M Cucunuba | |
Novel Coronavirus | |
Acceso Abierto | |
Atribución-NoComercial-SinDerivadas | |
10.1101/2020.03.09.20033357 | |
Background: A range of case fatality ratio (CFR) estimates for COVID 19 have been produced that differ substantially in magnitude. Methods: We used individual-case data from mainland China and cases detected outside mainland China to estimate the time between onset of symptoms and outcome (death or discharge from hospital). We next obtained age-stratified estimates of the CFR by relating the aggregate distribution of cases by dates of onset to the observed cumulative deaths in China, assuming a constant attack rate by age and adjusting for the demography of the population, and age and location-based under ascertainment. We additionally estimated the CFR from individual linelist data on 1,334 cases identified outside mainland China. We used data on the PCR prevalence in international residents repatriated from China at the end of January 2020 to obtain age-stratified estimates of the infection fatality ratio (IFR). Using data on age stratified severity in a subset of 3,665 cases from China, we estimated the proportion of infections that will likely require hospitalisation. Findings: We estimate the mean duration from onset-of-symptoms to death to be 17.8 days (95% credible interval, crI 16.9,19.2 days) and from onset-of-symptoms to hospital discharge to be 22.6 days (95% crI 21.1,24.4 days). We estimate a crude CFR of 3.67% (95% crI 3.56%,3.80%) in cases from mainland China. Adjusting for demography and under-ascertainment of milder cases in Wuhan relative to the rest of China, we obtain a best estimate of the CFR in China of 1.38% (95% crI 1.23%,1.53%) with substantially higher values in older ages. Our estimate of the CFR from international cases stratified by age (under 60 or 60 and above) are consistent with these estimates from China. We obtain an overall IFR estimate for China of 0.66% (0.39%,1.33%), again with an increasing profile with age. Interpretation: These early estimates give an indication of the fatality ratio across the spectrum of COVID-19 disease and demonstrate a strong age-gradient in risk. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This work was supported by Centre funding from the UK Medical Research Council under a concordat with the UK Department for International Development, the NIHR Health Protection Research Unit in Modelling Methodology and the Abdul Latif Jameel Foundation. ### Author Declarations All relevant ethical guidelines have been followed; any necessary IRB and/or ethics committee approvals have been obtained and details of the IRB/oversight body are included in the manuscript. Yes All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Data and code will be available shortly on GitHub. All data has been sourced from the public domain. [https://github.com/mrc-ide/COVID19_CFR_submission.][1] [1]: https://github.com/mrc-ide/COVID19_CFR_submission. | |
Cold Spring Harbor Laboratory Press | |
2020 | |
Preimpreso | |
https://www.medrxiv.org/content/10.1101/2020.03.09.20033357v1 | |
Inglés | |
VIRUS RESPIRATORIOS | |
Aparece en las colecciones: | Artículos científicos |
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