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Bull World Health Organ . Infection fatality rate of COVID-19 inferred from seroprevalence data

tetano

Editor, Senior Moderator
Bull World Health Organ


. 2021 Jan 1;99(1):19-33F.
doi: 10.2471/BLT.20.265892. Epub 2020 Oct 14.
Infection fatality rate of COVID-19 inferred from seroprevalence data


John P A Ioannidis[SUP] 1 [/SUP]



Affiliations

Abstract

in English, French, Spanish, Arabic, Chinese, Russian
Objective: To estimate the infection fatality rate of coronavirus disease 2019 (COVID-19) from seroprevalence data.
Methods: I searched PubMed and preprint servers for COVID-19 seroprevalence studies with a sample size ? 500 as of 9 September 2020. I also retrieved additional results of national studies from preliminary press releases and reports. I assessed the studies for design features and seroprevalence estimates. I estimated the infection fatality rate for each study by dividing the cumulative number of COVID-19 deaths by the number of people estimated to be infected in each region. I corrected for the number of immunoglobin (Ig) types tested (IgG, IgM, IgA).
Findings: I included 61 studies (74 estimates) and eight preliminary national estimates. Seroprevalence estimates ranged from 0.02% to 53.40%. Infection fatality rates ranged from 0.00% to 1.63%, corrected values from 0.00% to 1.54%. Across 51 locations, the median COVID-19 infection fatality rate was 0.27% (corrected 0.23%): the rate was 0.09% in locations with COVID-19 population mortality rates less than the global average (< 118 deaths/million), 0.20% in locations with 118-500 COVID-19 deaths/million people and 0.57% in locations with > 500 COVID-19 deaths/million people. In people younger than 70 years, infection fatality rates ranged from 0.00% to 0.31% with crude and corrected medians of 0.05%.
Conclusion: The infection fatality rate of COVID-19 can vary substantially across different locations and this may reflect differences in population age structure and case-mix of infected and deceased patients and other factors. The inferred infection fatality rates tended to be much lower than estimates made earlier in the pandemic.
 
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