A systematic review and meta-analysis of published research data on COVID-19 infection fatality rates.
A systematic review and meta-analysis of published research data on COVID-19 infection fatality rates.
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DOI：
10.1016/j.ijid.2020.09.1464
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发表时间：
2020-12
期刊：
影响因子：
--
通讯作者：
Merone L
中科院分区：
文献类型：
--
作者：
Meyerowitz-Katz G;Merone L
在冠状病毒病-2019年(新冠肺炎)大流行期间，一个重要的未知因素是感染死亡率。这与病死率(CFR)不同，CFR是对死亡人数的估计，也不同于占总病例数的比例，包括轻度和无症状的病例。虽然CFR对专家来说非常有价值，但IFR越来越多地被政策制定者和公众要求作为对新冠肺炎总体死亡率的估计。PubMed、Medline、SSRN和Medrxiv在2020年4月25日使用一组术语和布尔运算符进行搜索，并在2020年5月14日、2020年5月21日和2020年6月16日重新搜索。两位作者都对文章进行了筛选。在STATA 15.1中使用Metan命令进行Meta分析，基于从每项研究提取的IFR和可信区间。谷歌/谷歌学者被用来评估与政府报告有关的灰色文献。在排除后，在2020年2月至6月期间发表的来自多个国家的最终荟萃分析中纳入了对IFR的24项估计。Meta分析显示，IFR点估计为0.68%(0.53%-0.82%)，异质性很高(p<；0.001)。基于对截至2020年7月在新冠肺炎上发表的证据的系统综述和荟萃分析，该疾病在人群中的IFR为0.68%(0.53%-0.82%)。然而，由于荟萃分析中的异质性很高，很难知道这是否代表一个完全无偏的点估计。很可能，由于年龄和潜在的人口合并症，不同的地方将由于疾病而经历不同的国际财务报告准则。考虑到死亡率记录方面的问题，这也可能代表了对IFR真实数字的低估。迫切需要对按年龄分层的国际财务报告准则进行更多研究，以便为这方面的决策提供信息。
An important unknown during the coronavirus disease-2019 (COVID-19) pandemic has been the infection fatality rate (IFR). This differs from the case fatality rate (CFR) as an estimate of the number of deaths and as a proportion of the total number of cases, including those who are mild and asymptomatic. While the CFR is extremely valuable for experts, IFR is increasingly being called for by policy makers and the lay public as an estimate of the overall mortality from COVID-19. Pubmed, Medline, SSRN, and Medrxiv were searched using a set of terms and Boolean operators on 25/04/2020 and re-searched on 14/05/2020, 21/05/2020 and 16/06/2020. Articles were screened for inclusion by both authors. Meta-analysis was performed in Stata 15.1 by using the metan command, based on IFR and confidence intervals extracted from each study. Google/Google Scholar was used to assess the grey literature relating to government reports. After exclusions, there were 24 estimates of IFR included in the final meta-analysis, from a wide range of countries, published between February and June 2020. The meta-analysis demonstrated a point estimate of IFR of 0.68% (0.53%–0.82%) with high heterogeneity (p < 0.001). Based on a systematic review and meta-analysis of published evidence on COVID-19 until July 2020, the IFR of the disease across populations is 0.68% (0.53%–0.82%). However, due to very high heterogeneity in the meta-analysis, it is difficult to know if this represents a completely unbiased point estimate. It is likely that, due to age and perhaps underlying comorbidities in the population, different places will experience different IFRs due to the disease. Given issues with mortality recording, it is also likely that this represents an underestimate of the true IFR figure. More research looking at age-stratified IFR is urgently needed to inform policymaking on this front.
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