Assessing the age- and gender-dependence of the severity and case fatality rates of COVID-19 disease in Spain
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ArticleKAUST Department
Applied Mathematics and Computational Science ProgramBiological and Environmental Sciences and Engineering (BESE) Division
Biostatistics Group
Computer, Electrical and Mathematical Sciences and Engineering (CEMSE) Division
Marine Science Program
Numerical Mathematics Group
Red Sea Research Center (RSRC)
Statistics Program
Date
2020-06-02Permanent link to this record
http://hdl.handle.net/10754/665453
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Background: The assessment of the severity and case fatality rates of coronavirus disease 2019 (COVID-19) and the determinants of its variation is essential for planning health resources and responding to the pandemic. The interpretation of case fatality rates (CFRs) remains a challenge due to different biases associated with surveillance and reporting. For example, rates may be affected by preferential ascertainment of severe cases and time delay from disease onset to death. Using data from Spain, we demonstrate how some of these biases may be corrected when estimating severity and case fatality rates by age group and gender, and identify issues that may affect the correct interpretation of the results. Methods: Crude CFRs are estimated by dividing the total number of deaths by the total number of confirmed cases. CFRs adjusted for preferential ascertainment of severe cases are obtained by assuming a uniform attack rate in all population groups, and using demography-adjusted under-ascertainment rates. CFRs adjusted for the delay between disease onset and death are estimated by using as denominator the number of cases that could have a clinical outcome by the time rates are calculated. A sensitivity analysis is carried out to compare CFRs obtained using different levels of ascertainment and different distributions for the time from disease onset to death. Results: COVID-19 outcomes are highly influenced by age and gender. Different assumptions yield different CFR values but in all scenarios CFRs are higher in old ages and males. Conclusions: The procedures used to obtain the CFR estimates require strong assumptions and although the interpretation of their magnitude should be treated with caution, the differences observed by age and gender are fundamental underpinnings to inform decision-making.Citation
Moraga, P., Ketcheson, D. I., Ombao, H. C., & Duarte, C. M. (2020). Assessing the age- and gender-dependence of the severity and case fatality rates of COVID-19 disease in Spain. Wellcome Open Research, 5, 117. doi:10.12688/wellcomeopenres.15996.1Publisher
F1000 Research LtdJournal
Wellcome Open ResearchAdditional Links
https://wellcomeopenresearch.org/articles/5-117/v1ae974a485f413a2113503eed53cd6c53
10.12688/wellcomeopenres.15996.1
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Articles; Biological and Environmental Science and Engineering (BESE) Division; Red Sea Research Center (RSRC); Marine Science Program; Applied Mathematics and Computational Science Program; Statistics Program; Numerical Mathematics Group; Computer, Electrical and Mathematical Science and Engineering (CEMSE) Division
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