Estimation of the basic reproduction number, average incubation time, asymptomatic infection rate, and case fatality rate for COVID‐19: Meta‐analysis and sensitivity analysis

He, Wenqing; Yi, Grace Y.; Zhu, Yichen

doi:10.1002/jmv.26041

Cited by 181 publications

(173 citation statements)

References 25 publications

Supporting

Mentioning

156

Contrasting

Unclassified

Order By: Relevance

“…Our estimated overall R0 is slightly greater than WHO estimates of 1.4 to 2.5 [87] [88,89]. Our estimation is similar to the R0 values estimated for the severe acute respiratory syndrome epidemic (R0= 2-3) but greater than the Middle East respiratory syndrome in the Middle East (R0 <1) [90].…”

Section: Discussionsupporting

confidence: 72%

Estimation of novel coronavirus (covid-19) reproduction number and case fatality rate: a systematic review and meta-analysis

Ahammed

Anjum

Rahman

et al. 2020

Preprint

View full text Add to dashboard Cite

Understanding the transmission dynamics and the severity of the novel coronavirus disease 2019 (COVID-19) informs public health interventions, surveillance, and planning. Two important parameters, the basic reproduction number (R0) and case fatality rate (CFR) of COVID-19, help in this understanding process. The objective of this study was to estimate the R0 and CFR of COVID-19 and assess whether the parameters vary in different regions of the world. We carried out a systematic review to retrieve the published estimates of the R0 and the CFR in articles from international databases between 1st January and 31st August 2020. Random-effect models and Forest plots were implemented to evaluate the mean effect size of the R0 and the CFR. Furthermore, the R0 and CFR of the studies were quantified based on geographic location, the tests/thousand population, and the median population age of the countries where studies were conducted. The I2 statistic and the Cochran's Q test were applied to assess statistical heterogeneity among the selected studies. Forty-five studies involving R0 and thirty-four studies involving CFR were included. The pooled estimation of the R0 was 2.69 (95% CI: 2.40, 2.98), and that of the CFR was 2.67 (2.25, 3.13). The CFR in different regions of the world varied significantly, from 2.51 (2.12, 2.95) in Asia to 7.11 (6.38, 7.91) in Africa. We observed higher mean CFR values for the countries with lower tests (3.15 vs. 2.16) and greater median population age (3.13 vs. 2.27). However, the R0 did not vary significantly in different regions of the world. An R0 of 2.69 and CFR of 2.67 indicate the severity of the COVID-19. Although R0 and CFR may vary over time, space, and demographics, we recommend considering these figures in control and prevention measures.

show abstract

Section: Discussionsupporting

confidence: 72%

Estimation of novel coronavirus (covid-19) reproduction number and case fatality rate: a systematic review and meta-analysis

Ahammed

Anjum

Rahman

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…This conclusion is supported by: i) these CMW communities had comparable seroprevalence of about 65-70%; ii) PCR positivity was low and the vast majority of those PCR positive had high Ct value suggestive of an earlier rather than recent infection [20,21]; iii) only few persons had active infection (Ct value <25) and no significant infection cluster was identified in any of these CMW communities during this study (suggestive of isolated infections and unsustainable infection transmission for clusters to occur); iv) the level of 65-70% infection exposure is in concordance with that predicted using the "classical" formula for herd immunity of 0 11 R  [22,23], with R0, the basic reproduction number, being at 2.5-4 [24,25].…”

Section: Discussionsupporting

confidence: 68%

Evidence for and level of herd immunity against SARS-CoV-2 infection: the ten-community study

Jeremijenko

Chemaitelly

Ayoub

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Qatar experienced a large severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic that disproportionately affected the craft and manual workers (CMWs) who constitute 60% of the population. This study aimed to investigate level of immunity in communities within this population as well as infection exposure required to achieve herd immunity. Methods: Anti-SARS-CoV-2 seropositivity was assessed in ten CMW communities between June 21 and September 9, 2020. PCR positivity, infection positivity (antibody and/or PCR positive), and infection severity rate were also estimated. Associations with anti-SARS-CoV-2 positivity were investigated using regression analyses. Results: Study included 4,970 CMWs who were mostly men (95.0%) and <40 years of age (71.5%). Seropositivity ranged from 54.9% (95% CI: 50.2-59.4%) to 83.8% (95% CI: 79.1-87.7%) in the different CMW communities. Pooled mean seropositivity across all communities was 66.1% (95% CI: 61.5-70.6%). PCR positivity ranged from 0.0% to 10.5% (95% CI: 7.4-14.8%) in the different CMW communities. Pooled mean PCR positivity was 3.9% (95% CI: 1.6-6.9%). Median cycle threshold (Ct) value was 34.0 (range: 15.8-37.4). The majority (79.5%) of PCR-positive individuals had Ct value >30 indicative of earlier rather than recent infection. Infection positivity (antibody and/or PCR positive) ranged from 62.5% (95% CI: 58.3-66.7%) to 83.8% (95% CI: 79.1-87.7%) in the different CMW communities. Pooled mean infection positivity was 69.5% (95% CI: 62.8-75.9%). Only five infections were ever severe and one was ever critical, an infection severity rate of 0.2% (95% CI: 0.1-0.4%). Conclusions: Based on an extended range of epidemiological measures, active infection is rare in these communities with limited if any sustainable infection transmission for clusters to occur. At least some CMW communities in Qatar have reached or nearly reached herd immunity for SARS-CoV-2 infection at a proportion of ever infection of 65-70%.

show abstract

“…Two types of SARS-CoV-2 epidemics were simulated in this generic population: one assuming a basic reproduction number (R 0 ) of 3.0, re ecting the natural course of the epidemic in absence of any social or physical distancing interventions [12,13], and one assuming an R 0 of 1.6, re ecting an epidemic in presence of these interventions, such as that of Qatar where R 0 was estimated at about 1.6 [10].…”

Section: Analysis Scenariosmentioning

confidence: 99%

Analyzing inherent biases in SARS-CoV-2 PCR and serological epidemiologic metrics

Makhoul

Abou-Hijleh

Seedat

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Prospective observational data show that infected persons with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain polymerase chain reaction (PCR) positive for a prolonged duration, and that detectable antibodies develop slowly with time. We aimed to analyze how these effects can bias key epidemiological metrics used to track and monitor SARS-CoV-2 epidemics.Methods An age-structured mathematical model was constructed to simulate progression of SARS-CoV-2 epidemics in populations. PCR testing to diagnose infection and cross-sectional surveys to measure seroprevalence were also simulated. Analyses were conducted on simulated outcomes assuming a natural epidemic time course and an epidemic in presence of interventions.Results The prolonged PCR positivity biased the epidemiological measures. There was a lag of 10 days between the true epidemic peak and the actually-observed peak. Prior to epidemic peak, PCR positivity rate was 2-fold higher than that based only on current active infection, and half of those tested positive by PCR were in the prolonged PCR positivity stage after infection clearance. Post epidemic peak, PCR positivity rate poorly predicted true trend in active infection. Meanwhile, the prolonged PCR positivity did not appreciably bias estimation of the basic reproduction number R0. The time delay in development of detectable antibodies biased measured seroprevalence. The actually-observed seroprevalence substantially underestimated true prevalence of ever infection, with the underestimation being most pronounced around epidemic peak.Conclusions Caution is warranted in interpreting PCR and serological testing data, and any drawn inferences need to factor the effects of the investigated biases for an accurate assessment of epidemic dynamics.

show abstract

Estimation of the basic reproduction number, average incubation time, asymptomatic infection rate, and case fatality rate for COVID‐19: Meta‐analysis and sensitivity analysis

Cited by 181 publications

References 25 publications

Estimation of novel coronavirus (covid-19) reproduction number and case fatality rate: a systematic review and meta-analysis

Estimation of novel coronavirus (covid-19) reproduction number and case fatality rate: a systematic review and meta-analysis

Evidence for and level of herd immunity against SARS-CoV-2 infection: the ten-community study

Analyzing inherent biases in SARS-CoV-2 PCR and serological epidemiologic metrics

Contact Info

Product

Resources

About