Evaluating the massive underreporting and undertesting of COVID-19 cases in multiple global epicenters
Evaluating the massive underreporting and undertesting of COVID-19 cases in multiple global epicenters
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DOI：
10.1016/j.pulmoe.2020.05.015
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发表时间：
2021-02-13
期刊：
影响因子：
11.7
通讯作者：
Khosrawipour, V
中科院分区：
文献类型：
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作者：
Lau, H.;Khosrawipour, T.;Khosrawipour, V
背景：随着全球 COVID-19 的持续爆发，观察到不同的病例数和死亡率。虽然实际病例数似乎很模糊，但与 COVID-19 相关的死亡率数字似乎更为准确。在本研究中，我们使用死亡率作为主要指标来评估COVID-19病例漏报和漏检的程度。方法：我们分析了世界卫生组织提供的关于2020年3月17日国际COVID-19病例和死亡人数发展情况的所有可用数据。计算了中国、韩国、日本、意大利、法国、西班牙、德国、伊朗的粗病死风险（cCFR）和调整病死风险（aCFR）和美国。此外，还得出了每个国家/地区的倍数变化 (FC)。结果：检测到西班牙的 aCFR 和 FC 最高。根据 FC 值，法国、美国、意大利和西班牙显示大量未发现的 COVID-19 病例。对于这些国家，我们的研究结果表明，实际 COVID-19 病例总数的检出率仅为 1-2%。结论：由于检测能力有限，死亡率数字可能是许多国家 COVID-19 病例传播的更好指标。我们的数据表明，法国、意大利、美国、伊朗和西班牙等国家的未发现和漏报病例数量极高。检测可用性和能力、遏制以及整体医疗保健和医疗基础设施方面的差异导致每个国家的死亡率和 COVID-19 病例数存在显着差异。 (C) 2020 葡萄牙肺炎学会。由 Elsevier Espana, S.L.U. 出版
Background: With continuous global COVID-19 outbreak, differing case numbers and mortality rates are observed. While actual case numbers appear vague, mortality numbers related to COVID-19 seem more precise. In this study, we used the mortality rate as the main indicator to evaluate the extent of underreporting and underdetection of COVID-19 cases.Methods: We have analyzed all available data provided by the World Health Organization on the development of international COVID-19 cases and mortality numbers on March 17th, 2020. A crude case-fatality risk (cCFR) and adjusted case-fatality risk (aCFR) was calculated for China, South Korea, Japan, Italy, France, Spain, Germany, Iran and the United States. Additionally, a fold-change (FC) was derived for each country.Results: The highest aCFR and FC were detected for Spain. Based on their FC values, an extremely high number of undetected COVID-19 cases was displayed in France, the United States, Italy and Spain. For these countries, our findings indicate a detection rate of only 1-2% of total actual COVID-19 cases.Conclusions: Due to limited testing capacities, mortality numbers may serve as a better indicator for COVID-19 case spread in many countries. Our data indicate that countries like France, Italy, the United States, Iran and Spain have extremely high numbers of undetected and underreported cases. Differences in testing availability and capacity, containment as well as overall health care and medical infrastructure result in significantly different mortality rates and COVID-19 case numbers for each respective country. (C) 2020 Sociedade Portuguesa de Pneumologia. Published by Elsevier Espana, S.L.U.