Predicted COVID-19 fatality rates based on age, sex, comorbidities and health system capacity
Predicted COVID-19 fatality rates based on age, sex, comorbidities and health system capacity
复制标题
DOI：
10.1136/bmjgh-2020-003094
复制
发表时间：
2020-09-01
影响因子：
8.1
通讯作者：
Bold, Tessa
中科院分区：
文献类型：
--
作者：
Ghisolfi, Selene;Almas, Ingvild;Bold, Tessa
早期报告表明，新冠肺炎的死亡率在不同国家之间差异很大，但非随机检测和不完整的生命登记系统使得无法直接估计许多低收入和中等收入国家的感染死亡率。为了填补这一缺口，我们估计了从高收入地区向低收入地区推算IFR估计值所需的调整。考虑到年龄、性别和相关合并症分布的差异，21个世界地区的预测IFR存在很大差异，从撒哈拉以南非洲西部的0.11%到高收入亚太地区的1.07%不等。然而，这些预测必须被视为低收入和中等收入国家的下限，因为它们是以卫生系统先进国家的死亡率为基础的。为了调整卫生系统的能力，我们纳入了儿童呼吸道合胞病毒感染死亡相对几率的地区差异。这一调整极大地削弱了但并未完全消除在最低收入环境中预测的基于人口统计学的优势，区域估计预测的新冠肺炎IFR从撒哈拉以南非洲的0.37%到东欧的1.45%不等。
Early reports suggest the fatality rate from COVID-19 varies greatly across countries, but non-random testing and incomplete vital registration systems render it impossible to directly estimate the infection fatality rate (IFR) in many low- and middle-income countries. To fill this gap, we estimate the adjustments required to extrapolate estimates of the IFR from high-income to lower-income regions. Accounting for differences in the distribution of age, sex and relevant comorbidities yields substantial differences in the predicted IFR across 21 world regions, ranging from 0.11% in Western Sub-Saharan Africa to 1.07% for high-income Asia Pacific. However, these predictions must be treated as lower bounds in low- and middle-income countries as they are grounded in fatality rates from countries with advanced health systems. To adjust for health system capacity, we incorporate regional differences in the relative odds of infection fatality from childhood respiratory syncytial virus. This adjustment greatly diminishes but does not entirely erase the demography-based advantage predicted in the lowest income settings, with regional estimates of the predicted COVID-19 IFR ranging from 0.37% in Western Sub-Saharan Africa to 1.45% for Eastern Europe.