COVID 19 case fatality rate 1.4%, estimates Lancet study

The total number of cases suffering from COVID 19 has crossed 850000 marks globally. In addition to this, the number of global deaths has gone beyond 41000 mark.

In the face of rapidly changing data, a range of case fatality ratio estimates for coronavirus disease 2019 (COVID-19) has been produced that differ substantially in magnitude. The researchers in a new study have tried to provide robust estimates, accounting for censoring and ascertainment biases.

According to a UK study appearing in the Lancet, the case-fatality rate (CFR) in and outside of China is 1.4%.

Researchers from the MRC Center for Global Infectious Disease Analysis at Imperial College London collected individual-case data for patients who died from COVID-19 in Hubei, mainland China (reported by national and provincial health commissions to Feb 8, 2020), and for cases outside of mainland China (from government or ministry of health websites and media reports for 37 countries, as well as Hong Kong and Macau, until Feb 25, 2020). These individual-case data were used to estimate the time between the onset of symptoms and the outcome (death or discharge from hospital). We next obtained age-stratified estimates of the case fatality ratio by relating the aggregate distribution of cases to the observed cumulative deaths in China, assuming a constant attack rate by age and adjusting for demography and age-based and location-based under-ascertainment.

They also estimated the case fatality ratio from individual line-list data on 1334 cases identified outside of mainland China. Using data on the prevalence of PCR-confirmed cases in international residents repatriated from China, we obtained age-stratified estimates of the infection fatality ratio. Furthermore, data on age-stratified severity in a subset of 3665 cases from China were used to estimate the proportion of infected individuals who are likely to require hospitalization.

The researchers who based their findings on case data from people who died from COVID-19 have released the following findings -

1. It is estimated that the period of symptom onset to death is 18 days.

2. The case-fatality rate (CFR) in and outside of China is 1.4% but declined to 0.66 after adjusting for undiagnosed cases.

3. The hospitalization rate was 8.2% for people in their 50s but rose to 18.4% for people ages 80 and older.

The team published its findings yesterday in The Lancet Infectious Diseases.

They concluded that these early estimates give an indication of the fatality ratio across the spectrum of COVID-19 disease and show a strong age gradient in risk of death.

The study's authors write, "Mortality can also be expected to vary with the underlying health of specific populations, given that the risks associated with COVID-19 will be heavily influenced by the presence of underlying comorbidities."

The study's authors acknowledge that reality. They write, "Mortality can also be expected to vary with the underlying health of specific populations, given that the risks associated with COVID-19 will be heavily influenced by the presence of underlying comorbidities."

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DOI:https://doi.org/10.1016/S1473-3099(20)30243-7