COVID-19 case fatality risk by age and gender in a high testing setting in Latin America: Chile, March–August 2020

Abstract

Background Early severity estimates of coronavirus disease 2019 (COVID-19) are critically needed to assess the potential impact of the ongoing pandemic in different demographic groups. Here we estimate the real-time delay-adjusted case fatality rate across nine age groups by gender in Chile, the country with the highest testing rate for COVID-19 in Latin America. Methods We used a publicly available real-time daily series of age-stratified COVID-19 cases and deaths reported by the Ministry of Health in Chile from the beginning of the epidemic in March through August 31, 2020. We used a robust likelihood function and a delay distribution to estimate real-time delay-adjusted case-fatality risk and estimate model parameters using a Monte Carlo Markov Chain in a Bayesian framework. Results As of August 31, 2020, our estimates of the time-delay adjusted case fatality rate (CFR) for men and women are 4.16% [95% Credible Interval (CrI): 4.09–4.24%] and 3.26% (95% CrI: 3.19–3.34%), respectively, while the overall estimate is 3.72% (95% CrI: 3.67–3.78%). Seniors aged 80 years and over have an adjusted CFR of 56.82% (95% CrI: 55.25–58.34%) for men and 41.10% (95% CrI: 40.02–42.26%) for women. Results showed a peak in estimated CFR during the June peak of the epidemic. The peak possibly reflects insufficient laboratory capacity, as illustrated by high test positivity rates (33% positive 7-day average nationally in June), which may have resulted in lower reporting rates. Conclusions Severity estimates from COVID-19 in Chile suggest that male seniors, especially among those aged ≥ 70 years, are being disproportionately affected by the pandemic, a finding consistent with other regions. The ongoing pandemic is imposing a high death toll in South America, and Chile has one of the highest reported mortality rates globally thus far. These real-time estimates may help inform public health officials' decisions in the region and underscore the need to implement more effective measures to ameliorate fatality.

Delay-Adjusted Age-Specific COVID-19 Case Fatality Rates in a High Testing Setting: South Korea, February 2020 to February 2021

“…Furthermore, this study found that both the delay-adjusted and crude CFRs showed substantial variations especially at the beginning of the pandemic in South Korea. Similar patterns have been observed in previous studies concerning delay-adjusted CFRs conducted in South Korea and other countries [ 11 , 25 , 31 , 32 ]. Thus, these results highlight that caution must be applied when interpreting CFRs, particularly earlier in the pandemic, even with adjustment for the delay between diagnosis and death.…”

“…In this study, the time-delay adjusted CFR according to age group was estimated for the ongoing COVID-19 pandemic in South Korea. Consistent with previous studies that estimated the time-delay adjusted COVID-19 CFR according to age group [ 11 , 30 , 31 ], both the crude and the delay-adjusted CFRs for South Korea increased rapidly with age. Specifically, it was shown that the COVID-19 pandemic in South Korea has disproportionately affected adults aged ≥70 years, despite the relatively low overall adjusted CFR (1.97%) for all ages combined.…”

PM2.5 Pollution Strongly Predicted COVID-19 Incidence in Four High-Polluted Urbanized Italian Cities during the Pre-Lockdown and Lockdown Periods

“…Data from several studies suggest that the daily testing of the population provides added benefit in various infectiousness contexts [ 54 , 59 ]. Furthermore, the importance of population density has been ascertained in modeling the spread of diseases and this parameter should be explicitly included in transmission models that predict the impacts of COVID-19 [ 59 ]. Our results corroborate the findings of a great deal of the previous work regarding the necessity of age-based measures that isolate older people.…”

“…Our results corroborate the findings of a great deal of the previous work regarding the necessity of age-based measures that isolate older people. Severity estimates from COVID-19 suggested that mainly those aged ≥70 years were disproportionately affected by the pandemic, a finding consistent among regions [ 59 ]. A context that has recently changed after elderly people have been vaccinated for COVID-19.…”

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“…As of August 31, 2020, the time-delay adjusted case fatality rate (CFR) was 4.16% for men and 3.26% for women in Chile, Latin America [ 19 ]. High case fatality rates have been reported in severe COVID-19 patients.…”