Temporal estimates of case-fatality rate for COVID-19 outbreaks in Canada and the United States
Temporal estimates of case-fatality rate for COVID-19 outbreaks in Canada and the United States
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DOI：
10.1503/cmaj.200711
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发表时间：
2020-06-22
影响因子：
14.6
通讯作者：
Moghadas, Seyed M.
中科院分区：
文献类型：
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作者：
Abdollahi, Elaheh;Champredon, David;Moghadas, Seyed M.
背景：与 2019 年冠状病毒病 (COVID-19) 相关的病死率 (CFR) 估计在不同人群环境中存在很大差异。我们试图估计和比较加拿大和美国的 COVID-19 CFR，同时调整原油 CFR 的 2 个潜在偏差。方法：我们使用了 2020 年 1 月 31 日至 4 月 22 日加拿大和美国确诊的 COVID-19 病例和死亡的每日发病率。我们采用统计方法，通过将生存间隔考虑为疾病发病和死亡之间的滞后时间，同时考虑到 COVID-19 病例的报告率低于 50%（95% 置信区间 10%-50%），以最大限度地减少粗 CFR 的偏差。结果：利用加拿大确诊病例的数据，我们估计 2020 年 4 月 22 日的粗 CFR 为 4.9%，调整后的 CFR 为 5.5%（可信区间 [CrI] 4.9%-6.4%）。在我们考虑了低于 50% 的各种报告率后，调整后的 CFR 估计为 1.6%（CrI 0.7%-3.1%）。 2020年4月20日美国原油CFR预计为5.4%，调整后CFR为6.1%（CrI 5.4%-6.9%）。美国的报告率低于 50%，调整后的 CFR 为 1.78（CrI 0.8%-3.6%）。解释：我们的估计表明，如果报告率低于 50%，则加拿大调整后的 COVID-19 病死率可能低于 2%。美国的 CFR 预估值高于加拿大，但调整后的 CFR 仍低于 2%。病例报告的量化可以更准确地衡量严重急性呼吸综合征冠状病毒2的毒力和疾病负担。
BACKGROUND: Estimates of the case-fatality rate (CFR) associated with coronavirus disease 2019 (COVID-19) vary widely in different population settings. We sought to estimate and compare the COVID-19 CFR in Canada and the United States while adjusting for 2 potential biases in crude CFR. METHODS: We used the daily incidence of confirmed COVID-19 cases and deaths in Canada and the US from Jan. 31 to Apr. 22, 2020. We applied a statistical method to minimize bias in the crude CFR by accounting for the survival interval as the lag time between disease onset and death, while considering reporting rates of COVID-19 cases less than 50% (95% confidence interval 10%-50%). RESULTS: Using data for confirmed cases in Canada, we estimated the crude CFR to be 4.9% on Apr. 22, 2020, and the adjusted CFR to be 5.5% (credible interval [CrI] 4.9%-6.4%). After we accounted for various reporting rates less than 50%, the adjusted CFR was estimated at 1.6% (CrI 0.7%-3.1%). The US crude CFR was estimated to be 5.4% on Apr. 20, 2020, with an adjusted CFR of 6.1% (CrI 5.4%-6.9%). With reporting rates of less than 50%, the adjusted CFR for the US was 1.78 (CrI 0.8%-3.6%). INTERPRETATION: Our estimates suggest that, if the reporting rate is less than 50%, the adjusted CFR of COVID-19 in Canada is likely to be less than 2%. The CFR estimates for the US were higher than those for Canada, but the adjusted CFR still remained below 2%. Quantification of case reporting can provide a more accurate measure of the virulence and disease burden of severe acute respiratory syndrome coronavirus 2.