Age could be driving variable SARS-CoV-2 epidemic trajectories worldwide
Age could be driving variable SARS-CoV-2 epidemic trajectories worldwide
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DOI：
10.1371/journal.pone.0237959
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发表时间：
2020-08-20
期刊：
影响因子：
3.7
通讯作者：
Abu-Raddad, Laith J.
中科院分区：
文献类型：
--
作者：
Ayoub, Houssein H.;Chemaitelly, Hiam;Abu-Raddad, Laith J.
目前有记录的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染的地理传播显示出异质性。这项研究探讨了年龄在潜在驱动各国感染传播、流行潜力、疾病严重程度和死亡率差异方面的作用。一个描述SARS-CoV-2传播动态的按年龄分层的确定性数学模型被应用于人口≥ 100万的159个国家和地区。假设大流行病的最坏情况，结果表明，由于人口年龄分布的差异，流行病的轨迹可能存在明显的区域差异。在非洲区域（中位年龄：18.9岁），中位R（0）为1.05，而欧洲地区为2.05（中位年龄：41.7岁），中位数（每百人）的最终累积感染率为22.5重症和/或危重症病例发生率为3.3（vs. 69.0），死亡率为0.5（vs. 3.9）。年龄可能是全球SARS-CoV-2流行轨迹变化的驱动因素。在成人和/或老年人口众多而儿童人口较少的国家，如果不采取干预措施，可能会出现大规模和迅速的流行病。与此同时，年龄组群主要较年轻的国家可能会经历规模较小和速度较慢的流行病。然而，这些预测不应导致自满，因为这一流行病仍可能在几乎所有地方造成严重伤亡。
Current geographic spread of documented severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections shows heterogeneity. This study explores the role of age in potentially driving differentials in infection spread, epidemic potential, and rates of disease severity and mortality across countries. An age-stratified deterministic mathematical model that describes SARS-CoV-2 transmission dynamics was applied to 159 countries and territories with a population >= 1 million. Assuming worst-case scenario for the pandemic, the results indicate that there could be stark regional differences in epidemic trajectories driven by differences in the distribution of the population by age. In the African Region (median age: 18.9 years), the medianR(0)was 1.05 versus 2.05 in the European Region (median age: 41.7 years), and the median (per 100 persons) for the final cumulative infection incidence was 22.5 (versus 69.0), for severe and/or critical disease cases rate was 3.3 (versus 13.0), and for death rate was 0.5 (versus 3.9). Age could be a driver of variable SARS-CoV-2 epidemic trajectories worldwide. Countries with sizable adult and/or elderly populations and smaller children populations may experience large and rapid epidemics in absence of interventions. Meanwhile, countries with predominantly younger age cohorts may experience smaller and slower epidemics. These predictions, however, should not lead to complacency, as the pandemic could still have a heavy toll nearly everywhere.