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COVID-19 Infection Fatality Rate Associated with Incidence—A Population-Level Analysis of 19 Spanish Autonomous Communities

by Chris Kenyon 1,2
1
HIV/STI Unit, Institute of Tropical Medicine, 2000 Antwerp, Belgium
2
Division of Infectious Diseases and HIV Medicine, University of Cape Town, Cape Town 7700, South Africa
Biology 2020, 9(6), 128; https://doi.org/10.3390/biology9060128
Received: 16 May 2020 / Revised: 10 June 2020 / Accepted: 11 June 2020 / Published: 16 June 2020
(This article belongs to the Section Evolutionary Biology)
Previous studies have found large variations in the COVID-19 infection fatality rate (IFR). This study hypothesized that IFR would be influenced by COVID-19 epidemic intensity. We tested the association between epidemic intensity and IFR using serological results from a recent large SARS-CoV-2 serosurvey (N = 60,983) in 19 Spanish regions. The infection fatality rate for Spain as a whole was 1.15% and varied between 0.13% and 3.25% in the regions (median 1.07%, IQR 0.69–1.32%). The IFR by region was positively associated with SARS-CoV-2 seroprevalence (rho = 0.54; p = 0.0162), cases/100,000 (rho = 0.75; p = 0.002), hospitalizations/100,000 (rho = 0.78; p = 0.0001), mortality/100,000 (rho = 0.77; p = 0.0001) and case fatality rate (rho = 0.49; p = 0.0327). These results suggest that the SARS-CoV-2 IFR is not fixed. The Spanish regions with more rapid and extensive spread of SARS-CoV-2 had higher IFRs. These findings are compatible with the theory that slowing the spread of COVID-19 down reduces the IFR and case fatality rate via preventing hospitals from being overrun, and thus allowing better and lifesaving care. View Full-Text
Keywords: SARS CoV-2; COVID-19; case fatality rate; epidemiology; infection fatality rate SARS CoV-2; COVID-19; case fatality rate; epidemiology; infection fatality rate
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Kenyon, C. COVID-19 Infection Fatality Rate Associated with Incidence—A Population-Level Analysis of 19 Spanish Autonomous Communities. Biology 2020, 9, 128.

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