Dataset Information

Older age groups and country-specific case fatality rates of COVID-19 in Europe, USA and Canada.

ABSTRACT:

Purpose

To evaluate the association between the percentages of older age groups among confirmed SARS-CoV-2 infections and the country-specific case fatality rate (CFR).

Methods

This ecological study analyzed data from the 20 most severely affected European countries, USA and Canada, in which national health authorities provided data on age distribution and gender among confirmed SARS-CoV-2 cases and deaths.

Results

The proportion of individuals older than 70 years among confirmed SARS-CoV-2 cases differed markedly between the countries, ranging from 4.9 to 40.4%. There was a strong linear association between the proportion of individuals older than 75 years and the country-specific CFRs (R²?=?0.803 for all countries, R²?=?0.961 after exclusion of three countries with incongruent data). Each 5% point increase of this older age group among confirmed SARS-CoV-2 cases was associated with an increase in CFR of 2.5% points (95% CI 1.9-3.1).

Conclusion

Data from 20 European countries and the USA and Canada showed that the variance of crude CFR of COVID-19 is predominantly (80-96%) determined by the proportion of older individuals who are diagnosed with SARS-CoV-2. The age distribution of SARS-CoV-2 infections is still far from being homogeneous. Detailed demographic data have to be taken into account in all the analyses on COVID-19-associated mortality. We urgently call for standardized data collection by national health authorities.

SUBMITTER: Hoffmann C

PROVIDER: S-EPMC7585357 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

Older age groups and country-specific case fatality rates of COVID-19 in Europe, USA and Canada.

Hoffmann Christian C Wolf Eva E

Infection 20201024 1

<h4>Purpose</h4>To evaluate the association between the percentages of older age groups among confirmed SARS-CoV-2 infections and the country-specific case fatality rate (CFR).<h4>Methods</h4>This ecological study analyzed data from the 20 most severely affected European countries, USA and Canada, in which national health authorities provided data on age distribution and gender among confirmed SARS-CoV-2 cases and deaths.<h4>Results</h4>The proportion of individuals older than 70 years among con ...[more]

PMID: 33098532

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Project description:The new coronavirus (COVID-19) infection reported in China in December 2019 has become a pandemic in a few weeks, affecting the entire world. In this respect, it is crucial to determine the case-increase, case-fatality, and case-recovery rates to control COVID-19. In this study, the case-increase, case-fatality, and case-recovery rates of COVID-19 in 36 European countries were analyzed with the meta-analysis method using data released by the health organizations and WHO. The data were obtained from the website of health organizations of 36 European countries and the website of WHO until 11 May 2020. The analyses were carried out on 1 744 704 COVID-19-diagnosed cases in 36 European countries. The case-increase, case-fatality and case-recovery rates of COVID-19 were calculated using 95% confidence intervals (95% CI), single-arm meta-analysis, cross-temporal meta-analysis, and meta-regression random-effects model. The standardized case-increase rate of COVID-19 is 5% (95% CI [0.040, 0.063]) and the average case-increase rate in European countries has started to decline by around 3% (95% CI [0.047, 0.083]) weekly. The countries with the highest rate of case increase are Belgium, Sweden, Russia, the Netherlands and the United Kingdom. Although the case-fatality rate of COVID-19 patients was 4.5% as of May 11 (95% CI [0.037-0.055]), this rate is 6.3% (95% CI [0.047, 0.083]) in standardized time (6th week). The case-recovery rates of patients are 46% (95% CI [0.376-0.547]). This study presents important results regarding the COVID-19 pandemic in Europe. Although the rate of increase in new COVID-19 cases has dropped, there is not much decline in the case-fatality rates and no increase in case-recovery rates. The case-fatality rate of COVID-19 in Europe was estimated to be in the range of 4% to 4.5% and a minimum of 4 weeks (as of 11 May) is expected to have the figure below 1% in a country with an average case-increase rate. Monitoring case fatalities in Belgium, the Netherlands and Sweden, and treatment successes in Germany and Austria play a role of utmost importance.

Project description:BackgroundThere is wide variation in coronavirus disease 2019 (COVID-19) case-fatality rates (CFRs) across countries, leading to uncertainty about the true lethality of the disease. A large part of this variation may be due to the ages of individuals who are tested and identified.ObjectiveTo measure the contribution of distortions from the age distributions of confirmed cases to CFRs within and across populations.DesignCross-sectional demographic study using aggregate data on COVID-19 cases and deaths by age.SettingPopulation-based data from China, France, Germany, Italy, the Netherlands, South Korea, Spain, Switzerland, and the United States.ParticipantsAll individuals with confirmed COVID-19, as reported by each country as of 19 April 2020 (n = 1 223 261).MeasurementsAge-specific COVID-19 CFRs and age-specific population shares by country.ResultsThe overall observed CFR varies widely, with the highest rates in Italy (9.3%) and the Netherlands (7.4%) and the lowest rates in South Korea (1.6%) and Germany (0.7%). Adjustment for the age distribution of cases explains 66% of the variation across countries, with a resulting age-standardized median CFR of 1.9%. Among a larger sample of 95 countries, the observed variation in COVID-19 CFRs is 13 times larger than what would be expected on the basis of just differences in the age composition of countries.LimitationThe age-adjusted rates assume that, conditional on age, COVID-19 mortality among diagnosed cases is the same as that among undiagnosed cases and that individuals of all ages are equally susceptible to severe acute respiratory syndrome coronavirus 2 infection.ConclusionSelective testing and identification of older cases considerably warps estimates of the lethality of COVID-19 within populations and comparisons across countries. Removing age distortions and focusing on differences in age-adjusted case fatality will be essential for accurately comparing countries' performance in caring for patients with COVID-19 and for monitoring the epidemic over time.Primary funding sourceAlexander von Humboldt Foundation.

Dataset Information

Older age groups and country-specific case fatality rates of COVID-19 in Europe, USA and Canada.

Purpose

Methods

Results

Conclusion

Publications

Older age groups and country-specific case fatality rates of COVID-19 in Europe, USA and Canada.

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