Assessing the age specificity of infection fatality rates for COVID-19: systematic review, meta-analysis, and public policy implications.
Assessing the age specificity of infection fatality rates for COVID-19: systematic review, meta-analysis, and public policy implications.
复制标题
DOI：
10.1007/s10654-020-00698-1
复制
发表时间：
2020-12
影响因子：
13.6
通讯作者：
Meyerowitz-Katz G
中科院分区：
文献类型：
--
作者：
Levin AT;Hanage WP;Owusu-Boaitey N;Cochran KB;Walsh SP;Meyerowitz-Katz G
确定COVID-19的特定年龄感染死亡率，为有助于保护弱势年龄组的公共卫生政策和沟通提供信息。通过在线搜索2020年9月18日之前公开发布的已发表文章、预印本和政府报告，收集了COVID-19流行率的研究。系统性综述包括113项研究，其中27项研究（涵盖34个地理位置）符合纳入标准，并被纳入荟萃分析。使用患病率数据以及研究中点日期后4周报告的死亡率计算特定IFR，反映了死亡率和报告的典型滞后。使用Stata中的荟萃回归程序分析不同年龄的感染病死率（IFR）。我们的分析发现，年龄与COVID-19的IFR之间存在指数关系。儿童和年轻成人的估计年龄特异性IFR非常低（例如，10岁时为0.002%，25岁时为0.01%），但逐渐增加到55岁时为0.4%，65岁时为1.4%，75岁时为4.6%，85岁时为15%。此外，我们的研究结果表明，在不同地理位置的人群IFR中，约90%的变化反映了人口年龄组成的差异以及相对脆弱的年龄组暴露于病毒的程度。这些结果表明，COVID-19不仅对老年人而且对中年人都是危险的，对中年人来说，感染死亡率比致命车祸的年化风险高两个数量级，比季节性流感危险得多。此外，COVID-19的整体IFR不应被视为一个固定参数，而应与特定年龄的感染模式有内在联系。因此，减少老年人感染的公共卫生措施可以大大减少总死亡人数。本文的在线版本（10.1007/s10654-020-00698-1）包含补充材料，可供授权用户使用。
Determine age-specific infection fatality rates for COVID-19 to inform public health policies and communications that help protect vulnerable age groups. Studies of COVID-19 prevalence were collected by conducting an online search of published articles, preprints, and government reports that were publicly disseminated prior to 18 September 2020. The systematic review encompassed 113 studies, of which 27 studies (covering 34 geographical locations) satisfied the inclusion criteria and were included in the meta-analysis. Age-specific IFRs were computed using the prevalence data in conjunction with reported fatalities 4 weeks after the midpoint date of the study, reflecting typical lags in fatalities and reporting. Meta-regression procedures in Stata were used to analyze the infection fatality rate (IFR) by age. Our analysis finds a exponential relationship between age and IFR for COVID-19. The estimated age-specific IFR is very low for children and younger adults (e.g., 0.002% at age 10 and 0.01% at age 25) but increases progressively to 0.4% at age 55, 1.4% at age 65, 4.6% at age 75, and 15% at age 85. Moreover, our results indicate that about 90% of the variation in population IFR across geographical locations reflects differences in the age composition of the population and the extent to which relatively vulnerable age groups were exposed to the virus. These results indicate that COVID-19 is hazardous not only for the elderly but also for middle-aged adults, for whom the infection fatality rate is two orders of magnitude greater than the annualized risk of a fatal automobile accident and far more dangerous than seasonal influenza. Moreover, the overall IFR for COVID-19 should not be viewed as a fixed parameter but as intrinsically linked to the age-specific pattern of infections. Consequently, public health measures to mitigate infections in older adults could substantially decrease total deaths. The online version of this article (10.1007/s10654-020-00698-1) contains supplementary material, which is available to authorized users.
登录
查看更多内容
影响因子：
13.6
作者：
Clarke, Candice;Prendecki, Maria;Willicombe, Michelle
通讯作者：
Willicombe, Michelle
DOI：
10.1016/s0140-6736(20)32009-2
发表时间：
2020-10-24
期刊：
Lancet (London, England)
影响因子：
--
作者：
Anand S;Montez-Rath M;Han J;Bozeman J;Kerschmann R;Beyer P;Parsonnet J;Chertow GM
通讯作者：
Chertow GM
影响因子：
33.9
作者：
Biggs, Holly M.;Harris, Jennifer B.;Tate, Jacqueline E.
通讯作者：
Tate, Jacqueline E.
影响因子：
9.4
作者：
Bryan, Andrew;Pepper, Gregory;Greninger, Alexander L.
通讯作者：
Greninger, Alexander L.
影响因子：
19
作者：
Bogogiannidou, Zacharoula;Vontas, Alexandros;Hadjichristodoulou, Christos
通讯作者：
Hadjichristodoulou, Christos