Estimating the infection-fatality risk of SARS-CoV-2 in New York City during the spring 2020 pandemic wave: a model-based analysis.
Estimating the infection-fatality risk of SARS-CoV-2 in New York City during the spring 2020 pandemic wave: a model-based analysis.
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DOI：
10.1016/s1473-3099(20)30769-6
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发表时间：
2021-03
期刊：
影响因子：
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通讯作者：
Shaman J
中科院分区：
文献类型：
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作者：
Yang W;Kandula S;Huynh M;Greene SK;Van Wye G;Li W;Chan HT;McGibbon E;Yeung A;Olson D;Fine A;Shaman J
随着2019冠状病毒病大流行的持续发展，感染致死风险（即所有感染者（包括无症状和轻度感染者）的死亡风险）对于衡量未来数月或数年2019冠状病毒病造成的死亡负担至关重要。在这里，我们估计严重急性呼吸综合征冠状病毒2（SARS-CoV-2）在纽约市，纽约州，美国的第一个流行中心，在那里的感染致死风险仍然不清楚的感染致死风险。在这项基于模型的分析中，我们开发了一个元人群网络模型推理系统，利用现有的病例、死亡率和流动性数据，估计2020年春季大流行浪潮期间纽约市的潜在SARS-CoV-2感染率。基于这些估计，我们进一步估计了2020年3月1日至6月6日期间（即在城市开始分阶段重新开放之前）所有年龄段的感染死亡风险，并分别估计了五个年龄组（<25岁，25-44岁，45-64岁，65-74岁和≥75岁）。2020年3月1日至6月6日期间，纽约市居民中有205639人实验室确诊感染SARS-CoV-2，21447人确诊和可能与COVID-19相关的死亡。 我们估计纽约市的总体感染致死风险为1.39%（95%可信区间1.04 - 1.77）。我们估计的两个最大年龄组的感染致死风险（65-74岁和≥75岁）远高于年轻年龄组，累计估计感染致死风险为0.116%（0.0729 - 0.148）25-44岁，0.939%（0.729 - 1.19），65 - 74岁为4.87%（3.37 - 6.89），75岁及以上为14.2%（10.2 - 18.1）。特别是，65-74岁人群的每周感染致死风险估计高达6.72%（5.52 - 8.01），75岁及以上人群为19.1%（14.7 - 21.9）。我们的研究结果是基于对纽约市与COVID-19相关的死亡人数比其他地方更完整的确定，因此可能反映了COVID-19导致的死亡负担比其他地方之前报告的更高。鉴于SARS-CoV-2的高感染致死风险，政府必须对感染率和人口健康结果负责并密切监测，并在COVID-19大流行展开时及时采取公共卫生应对措施。国家过敏和传染病研究所、国家科学基金会快速反应研究计划和纽约市健康和心理卫生部。
As the COVID-19 pandemic continues to unfold, the infection-fatality risk (ie, risk of death among all infected individuals including those with asymptomatic and mild infections) is crucial for gauging the burden of death due to COVID-19 in the coming months or years. Here, we estimate the infection-fatality risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in New York City, NY, USA, the first epidemic centre in the USA, where the infection-fatality risk remains unclear. In this model-based analysis, we developed a meta-population network model-inference system to estimate the underlying SARS-CoV-2 infection rate in New York City during the 2020 spring pandemic wave using available case, mortality, and mobility data. Based on these estimates, we further estimated the infection-fatality risk for all ages overall and for five age groups (<25, 25–44, 45–64, 65–74, and ≥75 years) separately, during the period March 1 to June 6, 2020 (ie, before the city began a phased reopening). During the period March 1 to June 6, 2020, 205 639 people had a laboratory-confirmed infection with SARS-CoV-2 and 21 447 confirmed and probable COVID-19-related deaths occurred among residents of New York City. We estimated an overall infection-fatality risk of 1·39% (95% credible interval 1·04–1·77) in New York City. Our estimated infection-fatality risk for the two oldest age groups (65–74 and ≥75 years) was much higher than the younger age groups, with a cumulative estimated infection-fatality risk of 0·116% (0·0729–0·148) for those aged 25–44 years and 0·939% (0·729–1·19) for those aged 45–64 years versus 4·87% (3·37–6·89) for those aged 65–74 years and 14·2% (10·2–18·1) for those aged 75 years and older. In particular, weekly infection-fatality risk was estimated to be as high as 6·72% (5·52–8·01) for those aged 65–74 years and 19·1% (14·7–21·9) for those aged 75 years and older. Our results are based on more complete ascertainment of COVID-19-related deaths in New York City than other places and thus probably reflect the true higher burden of death due to COVID-19 than that previously reported elsewhere. Given the high infection-fatality risk of SARS-CoV-2, governments must account for and closely monitor the infection rate and population health outcomes and enact prompt public health responses accordingly as the COVID-19 pandemic unfolds. National Institute of Allergy and Infectious Diseases, National Science Foundation Rapid Response Research Program, and New York City Department of Health and Mental Hygiene.