Estimating clinical severity of COVID-19 from the transmission dynamics in Wuhan, China
Estimating clinical severity of COVID-19 from the transmission dynamics in Wuhan, China
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DOI：
10.1038/s41591-020-0822-7
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发表时间：
2020-03-19
期刊：
影响因子：
82.9
通讯作者：
Leung, Gabriel M.
中科院分区：
文献类型：
--
作者：
Wu, Joseph T.;Leung, Kathy;Leung, Gabriel M.
截至2020年2月29日，中国内地有79，394例COVID-19确诊病例及2，838例死亡。其中，48,557例病例和2,169例死亡发生在震中武汉。在新病原体出现期间，一个关键的公共卫生优先事项是估计临床严重程度，这需要适当调整病例确定率和症状发作与死亡之间的延迟。利用公开和发表的信息，我们估计，在武汉，COVID-19（出现症状后死亡的概率）为1.4%（0.9-2.1%），大大低于相应的粗或初治确诊病例死亡风险（2，169/48，557 = 4. 5%）和死亡/死亡+恢复的近似值（1）（2，169/2，169 + 17，572 = 11%）。与30-59岁的人相比，30岁以下和59岁以上的人在出现症状后死亡的可能性分别为0.6（0.3-1.1）和5.1（4.2-6.1）倍。症状性感染的风险随着年龄的增长而增加（例如，在30-60岁的成年人中，每年约为4%）。
As of 29 February 2020 there were 79,394 confirmed cases and 2,838 deaths from COVID-19 in mainland China. Of these, 48,557 cases and 2,169 deaths occurred in the epicenter, Wuhan. A key public health priority during the emergence of a novel pathogen is estimating clinical severity, which requires properly adjusting for the case ascertainment rate and the delay between symptoms onset and death. Using public and published information, we estimate that the overall symptomatic case fatality risk (the probability of dying after developing symptoms) of COVID-19 in Wuhan was 1.4% (0.9-2.1%), which is substantially lower than both the corresponding crude or naive confirmed case fatality risk (2,169/48,557 = 4.5%) and the approximator(1) of deaths/deaths + recoveries (2,169/2,169 + 17,572 = 11%) as of 29 February 2020. Compared to those aged 30-59 years, those aged below 30 and above 59 years were 0.6 (0.3-1.1) and 5.1 (4.2-6.1) times more likely to die after developing symptoms. The risk of symptomatic infection increased with age (for example, at similar to 4% per year among adults aged 30-60 years).