The Global Case-Fatality Rate of COVID-19 Has Been Declining Since May 2020.
The Global Case-Fatality Rate of COVID-19 Has Been Declining Since May 2020.
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DOI：
10.4269/ajtmh.20-1496
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发表时间：
2021-04-21
期刊：
影响因子：
--
通讯作者：
Uddin MJ
中科院分区：
文献类型：
--
作者：
Hasan MN;Haider N;Stigler FL;Khan RA;McCoy D;Zumla A;Kock RA;Uddin MJ
本研究的目的是使用全球报告的COVID-19病例和死亡率数据，评估COVID-19报告病死率（rCFR）随时间变化的趋势。我们从世卫组织2020年1月1日至12月31日的每日情况报告中收集了每日COVID-19诊断和死亡数据。我们进行了三个时间序列模型[简单指数平滑、自回归综合移动平均和自动预测时间序列（Prophet）]，以确定COVID-19的全球rCFR趋势。我们使用β回归模型来研究每个国家的rCFR和潜在预测因子之间的关联，以及每个变量的报告发病率比（IRR）。全球每周累计COVID-19 rCFR在第17周（2020年4月22日至28日）达到峰值7. 23%。我们发现，全球每日COVID-19的rCFR值在第17周（前高峰期）之前呈上升趋势，然后在第53周（后高峰期）之前呈强劲下降趋势，下降至2.2%（2020年12月29日至31日）。在rCFR峰值前，65岁及以上人群比例和肥胖患病率与COVID-19 rCFR显著相关。全球COVID-19 rCFR的下降趋势不仅仅是因为COVID-19检测的增加，因为每千人COVID-19检测的预测价值很差。rCFR下降的原因可能是年轻人感染率增加，或者是医疗保健管理的改善、预防感染和/或重新利用几种药物，这些药物对降低COVID-19导致的死亡率具有有益作用。
The objective of this study was to evaluate the trend of reported case fatality rate (rCFR) of COVID-19 over time, using globally reported COVID-19 cases and mortality data. We collected daily COVID-19 diagnoses and mortality data from the WHO’s daily situation reports dated January 1 to December 31, 2020. We performed three time-series models [simple exponential smoothing, auto-regressive integrated moving average, and automatic forecasting time-series (Prophet)] to identify the global trend of rCFR for COVID-19. We used beta regression models to investigate the association between the rCFR and potential predictors of each country and reported incidence rate ratios (IRRs) of each variable. The weekly global cumulative COVID-19 rCFR reached a peak at 7.23% during the 17th week (April 22–28, 2020). We found a positive and increasing trend for global daily rCFR values of COVID-19 until the 17th week (pre-peak period) and then a strong declining trend up until the 53rd week (post-peak period) toward 2.2% (December 29–31, 2020). In pre-peak of rCFR, the percentage of people aged 65 and above and the prevalence of obesity were significantly associated with the COVID-19 rCFR. The declining trend of global COVID-19 rCFR was not merely because of increased COVID-19 testing, because COVID-19 tests per 1,000 population had poor predictive value. Decreasing rCFR could be explained by an increased rate of infection in younger people or by the improvement of health care management, shielding from infection, and/or repurposing of several drugs that had shown a beneficial effect on reducing fatality because of COVID-19.
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