Journal Article

Infection fatality risk for SARS-CoV-2 in community dwelling population of Spain: nationwide seroepidemiological study

Martín, Mariano, Delgado-Sanz, Concepción, Pérez-Gómez, Beatriz, Yotti, Raquel, Hernán, Miguel A, León Paniagua, Jose, Sanmartín, Jose L, Muñoz-Montalvo, Juan F, Oteo-Iglesias, Jesús, Blanco, Faustino, Larrauri, Amparo, Fernández-Navarro, Pablo, Pérez-Olmeda, Mayte, León-Gómez, Inmaculada, Cruz, Israel, Pollán, Marina, Fernández-García, Aurora, Fernández de Larrea, Nerea, Pastor-Barriuso, Roberto

2020

Overview

AbstractObjectiveTo estimate the infection fatality risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), based on deaths with confirmed coronavirus disease 2019 (covid-19) and excess deaths from all causes.DesignNationwide seroepidemiological study.SettingFirst wave of covid-19 pandemic in Spain.ParticipantsCommunity dwelling individuals of all ages.Main outcome measuresThe main outcome measure was overall, and age and sex specific, infection fatality risk for SARS-CoV-2 (the number of covid-19 deaths and excess deaths divided by the estimated number of SARS-CoV-2 infections) in the community dwelling Spanish population. Deaths with laboratory confirmed covid-19 were obtained from the National Epidemiological Surveillance Network (RENAVE) and excess all cause deaths from the Monitoring Mortality System (MoMo), up to 15 July 2020. SARS-CoV-2 infections in Spain were derived from the estimated seroprevalence by a chemiluminescent microparticle immunoassay for IgG antibodies in 61 098 participants in the ENE-COVID nationwide seroepidemiological survey between 27 April and 22 June 2020.ResultsThe overall infection fatality risk was 0.8% (19 228 of 2.3 million infected individuals, 95% confidence interval 0.8% to 0.9%) for confirmed covid-19 deaths and 1.1% (24 778 of 2.3 million infected individuals, 1.0% to 1.2%) for excess deaths. The infection fatality risk was 1.1% (95% confidence interval 1.0% to 1.2%) to 1.4% (1.3% to 1.5%) in men and 0.6% (0.5% to 0.6%) to 0.8% (0.7% to 0.8%) in women. The infection fatality risk increased sharply after age 50, ranging from 11.6% (8.1% to 16.5%) to 16.4% (11.4% to 23.2%) in men aged 80 or more and from 4.6% (3.4% to 6.3%) to 6.5% (4.7% to 8.8%) in women aged 80 or more.ConclusionThe increase in SARS-CoV-2 infection fatality risk after age 50 appeared to be more noticeable in men than in women. Based on the results of this study, fatality from covid-19 was greater than that reported for other common respiratory diseases, such as seasonal influenza.

• Publisher: BMJ Publishing Group LTD,BMJ Publishing Group Ltd
• Subject: Adolescent / Adult / Age / Age Factors / Aged / Aged, 80 and over / Antibodies / Antibodies, Viral - blood / Censuses / Child / Child, Preschool / Confidence intervals / Coronaviridae / Coronaviruses / COVID-19 / COVID-19 - mortality / Epidemiology / Estimates / Fatalities / Female / Households / Humans / Immunoassay / Immunoglobulin G / Immunoglobulin G - blood / Infant / Infant, Newborn / Infections / Influenza / Laboratories / Long term health care / Male / Middle Aged / Mortality / Pandemics / Population / Respiratory diseases / Risk / Seroepidemiologic Studies / Seroepidemiology / Severe acute respiratory syndrome coronavirus 2 / Sex Factors / Spain - epidemiology / Young Adult