The contribution of the age distribution of cases to COVID-19 case fatality across countries

• Verfasst von: Sudharsanan, Nikkil [VerfasserIn]
• Verfasst von: Didzun, Oliver [VerfasserIn]
• Verfasst von: Bärnighausen, Till [VerfasserIn]
• Verfasst von: Geldsetzer, Pascal [VerfasserIn]
• Titel: The contribution of the age distribution of cases to COVID-19 case fatality across countries
• Titelzusatz: a 9-country demographic study
• Verf.angabe: Nikkil Sudharsanan, PhD; Oliver Didzun; Till Bärnighausen, MD; and Pascal Geldsetzer, ScD
• E-Jahr: 2020
• Jahr: 22 July 2020
• Umfang: 7 S.
• Fussnoten: Gesehen am 17.12.2020
• Titel Quelle: Enthalten in: Annals of internal medicine
• Ort Quelle: Philadelphia, Pa. : Coll., 1927
• Jahr Quelle: 2020
• Band/Heft Quelle: 173(2020), 9, Seite 714-720
• ISSN Quelle: 1539-3704
• DOI: doi:10.7326/M20-2973
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Adolescent
• Sach-SW: Adult
• Sach-SW: Age Factors
• Sach-SW: Aged
• Sach-SW: Aged, 80 and over
• Sach-SW: Child
• Sach-SW: Child, Preschool
• Sach-SW: China
• Sach-SW: Coronavirus Infections
• Sach-SW: COVID-19
• Sach-SW: Cross-Sectional Studies
• Sach-SW: France
• Sach-SW: Germany
• Sach-SW: Humans
• Sach-SW: Infant
• Sach-SW: Infant, Newborn
• Sach-SW: Italy
• Sach-SW: Middle Aged
• Sach-SW: Netherlands
• Sach-SW: Pandemics
• Sach-SW: Pneumonia, Viral
• Sach-SW: Republic of Korea
• Sach-SW: Risk Factors
• Sach-SW: Spain
• Sach-SW: Switzerland
• Sach-SW: United States
• Sach-SW: Young Adult
• K10plus-PPN: 174314878X

Abstract

BACKGROUND: There 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. - OBJECTIVE: To measure the contribution of distortions from the age distributions of confirmed cases to CFRs within and across populations. - DESIGN: Cross-sectional demographic study using aggregate data on COVID-19 cases and deaths by age. - SETTING: Population-based data from China, France, Germany, Italy, the Netherlands, South Korea, Spain, Switzerland, and the United States. - PARTICIPANTS: All individuals with confirmed COVID-19, as reported by each country as of 19 April 2020 (n = 1 223 261). - MEASUREMENTS: Age-specific COVID-19 CFRs and age-specific population shares by country. - RESULTS: The 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. - LIMITATION: The 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. - CONCLUSION: Selective 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 SOURCE: Alexander von Humboldt Foundation.