Global between-countries variance in SARS-CoV-2 mortality is driven by reported prevalence, age distribution, and case detection rate
Abstract Objective To explain the global between-countries variance in number of deaths per million citizens (nDpm) and case fatality rate (CFR) due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.Design Systematic analysis.Data sources Worldometer, European Centre for Disease Prevention and Control, United NationsMain outcome measures The explanators of nDpm and CFR were mathematically hypothesised and tested on publicly-available data from 88 countries with linear regression models on May 1st 2020. The derived explanators – age-adjusted infection fatality rate (IFRadj) and case detection rate (CDR) – were estimated for each country based on a SARS-CoV-2 model of China. The accuracy and agreement of the models with observed data was assessed with R2 and Bland-Altman plots, respectively. Sensitivity analyses involved removal of outliers and testing the models at five retrospective and four prospective time points.Results Globally, IFRadj estimates varied between countries, ranging from below 0.2% in the youngest nations, to above 1.3% in Portugal, Greece, Italy, and Japan. The median estimated global CDR of SARS-CoV-2 infections on April 16th 2020 was 12.9%, suggesting that most of the countries have a much higher number of cases than reported.At least 93% and up to 99% of the variance in nDpm was explained by reported prevalence expressed as cases per million citizens (nCpm), IFRadj, and CDR. IFRadj and CDR accounted for up to 97% of the variance in CFR, but this model was less reliable than the nDpm model, being sensitive to outliers (R2 as low as 67.5%).Conclusions The current differences in SARS-CoV-2 mortality between countries are driven mainly by reported prevalence of infections, age distribution, and CDR. The nDpm might be a more stable estimate than CFR in comparing mortality burden between countries..
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Preprint| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
bioRxiv.org - (2020) vom: 29. Dez. Zur Gesamtaufnahme - year:2020 |
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| Sprache: |
Englisch |
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| Beteiligte Personen: |
Babačić, Haris [VerfasserIn] |
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| Links: |
Volltext [kostenfrei] |
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| doi: |
10.1101/2020.05.28.20114934 |
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| PPN (Katalog-ID): |
XBI018069525 |
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| 520 | |a Abstract Objective To explain the global between-countries variance in number of deaths per million citizens (nDpm) and case fatality rate (CFR) due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.Design Systematic analysis.Data sources Worldometer, European Centre for Disease Prevention and Control, United NationsMain outcome measures The explanators of nDpm and CFR were mathematically hypothesised and tested on publicly-available data from 88 countries with linear regression models on May 1st 2020. The derived explanators – age-adjusted infection fatality rate (IFRadj) and case detection rate (CDR) – were estimated for each country based on a SARS-CoV-2 model of China. The accuracy and agreement of the models with observed data was assessed with R2 and Bland-Altman plots, respectively. Sensitivity analyses involved removal of outliers and testing the models at five retrospective and four prospective time points.Results Globally, IFRadj estimates varied between countries, ranging from below 0.2% in the youngest nations, to above 1.3% in Portugal, Greece, Italy, and Japan. The median estimated global CDR of SARS-CoV-2 infections on April 16th 2020 was 12.9%, suggesting that most of the countries have a much higher number of cases than reported.At least 93% and up to 99% of the variance in nDpm was explained by reported prevalence expressed as cases per million citizens (nCpm), IFRadj, and CDR. IFRadj and CDR accounted for up to 97% of the variance in CFR, but this model was less reliable than the nDpm model, being sensitive to outliers (R2 as low as 67.5%).Conclusions The current differences in SARS-CoV-2 mortality between countries are driven mainly by reported prevalence of infections, age distribution, and CDR. The nDpm might be a more stable estimate than CFR in comparing mortality burden between countries. | ||
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