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Is death from Covid-19 a multistep process?
Neil Pearce
Giovenale Moirano
MILENA MARIA MAULE
Manolis Kogevinas
Xavier Rodó
Debbie A Lawlor
Jan P Vandenbroucke
Christina Vandenbroucke-Grauls
Fernando P Polack
Adnan Custovic
Acceso Abierto
Atribución-NoComercial-SinDerivadas
https://doi.org/10.1101/2020.06.01.20116608
https://www.medrxiv.org/content/10.1101/2020.06.01.20116608v1
Covid-19 death has a different relationship with age than is the case for other severe respiratory pathogens. The Covid-19 death rate increases exponentially with age, and the main risk factors are age itself, as well as having underlying conditions such as hypertension, diabetes, cardiovascular disease, severe chronic respiratory disease and cancer. Furthermore, the almost complete lack of deaths in children suggests that infection alone is not sufficient to cause death; rather, one must have gone through a number of changes, either as a result of undefined aspects of aging, or as a result of chronic disease. These characteristics of Covid-19 death are consistent with the multistep model of disease, a model which has primarily been used for cancer, and more recently for amyotrophic lateral sclerosis (ALS). We applied the multi-step model to data on Covid-19 case fatality rates (CFRs) from China, South Korea, Italy, Spain and Japan. In all countries we found that a plot of ln (CFR) against ln (age) was approximately linear with a slope of about 5. As a comparison, we also conducted similar analyses for selected other respiratory diseases. SARS showed a similar log-log age-pattern to that of Covid-19, albeit with a lower slope, whereas seasonal and pandemic influenza showed quite different age-patterns. Thus, death from Covid-19 and SARS appears to follow a distinct age-pattern, consistent with a multistep model of disease that in the case of Covid-19 is probably defined by comorbidities and age producing immune-related susceptibility. Identification of these steps would be potentially important for prevention and therapy for SARS-COV-2 infection.
bioRxiv
03-06-2020
Preimpreso
Inglés
Público en general
VIRUS RESPIRATORIOS
Versión publicada
publishedVersion - Versión publicada
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