Infection fatality rates increase exponentially with age

4 minute read

And a test of a sample from December last year suggests SARS-CoV-2 was present in Italy months before the first official case.

Welcome to The Medical Republic’s COVID Catch-Up.

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9 December

  • The infection fatality rate for SARS-CoV-2 ranges from as low as 0.002% for children aged 10 up to 15% for those aged 85 years, according to a systematic review and meta-analysis published in the European Journal of Epidemiology.
    Researchers (which including TMR’s favourite epidemiologist Dr Gideon Meyerowitz-Katz, a.k.a @healthnerd) analysed 27 studies that looked at age-specific fatality rates based on seroprevalence rather than reported cases, to ensure the studies included asymptomatic and mild cases of disease.
    The study found an overall population infection fatality rate that ranged from around 0.5% in Salt Lake City to 1.5% in Australia and 2.7% in Italy, with the geographic variations likely the result of differences in the age composition of populations as well as the risk of more vulnerable age groups being exposed to the virus.
    The analysis also pointed to an exponential relationship between age and infection fatality rates, but the authors stressed that this should not diminish the risks of COVID-19 for middle-aged individuals.
    “For example, an English person aged 55–64 years who gets infected with SARS-CoV-2 faces a fatality risk that is more than 200 times higher than the annual risk of dying in a fatal car accident,” the authors wrote.
  • The number of ambulance call-outs and emergency department presentations in New South Wales is still consistently lower than at the same time last year, despite increasing since the massive drop during the pandemic’s first wave.
    According to the latest Healthcare Quarterly from the NSW Bureau of Health Information, ambulance responses declined in late March and early April, have increased steadily since then but are still lower than 2019 levels: the week ending 26 September 2020, there were 3.7% fewer responses compared to the same week in 2019.
    Similarly, emergency department attendances decreased nearly 40% by mid-April but despite a steady increase since then, they were still down 4.6% in the week ending 26 September 2020 compared to the same week last year.
  • A nasopharyngeal swab taken from a child in Milan in early December 2019 has been found positive for SARS-CoV-2, even though the first reported case in Italy didn’t occur until February 21, 2020.
    A study published in Emerging Infectious Diseases examined oropharyngeal swabs taken from 39 patients in Italy from September 2019–February 2020 as part of surveillance for measles. The specimens had been stored in a WHO-accredited laboratory for the study of measles and rubella, which had been “designated as free from SARS-CoV-2”, the authors wrote.
    A sample from a four-year-old boy tested positive for SARS-CoV-2 RNA on RT-PCR. The boy had presented with respiratory symptoms and a measles-like rash. The authors noted that skin manifestations have been seen with COVID-19.
    The finding suggests SARS-CoV-2 was circulating in Italy months before the first case was diagnosed.
    “Long-term, unrecognized spread of SARS-CoV-2 in northern Italy would help explain, at least in part, the devastating impact and rapid course of the first wave of COVID-19 in Lombardy,” the authors wrote.
  • Two population-based studies have found no evidence of an increase in stillbirths during the COVID-19 pandemic.
    The first study, published in JAMA, examined a total of 8867 singleton births during March-June of 2018, 2019 and 2020 at two hospitals in Pennsylvania. This found no suggestion of an increase either in stillbirth or preterm birth during the pandemic compared to the previous two years.
    The second study, also in JAMA, used NHS admissions data from the UK to compare stillbirth rates from April 2019 to June 2020 with those from 2016-2019. Again, there was no evidence of an overall increase in stillbirth rates above baseline during the pandemic.
  • The six new cases of COVID-19 recorded both in NSW and Queensland, two in the Northern Territory and one case in Western Australia yesterday are all returned travellers in quarantine.
    Here are the latest confirmed COVID-19 infection numbers from around Australia to 9pm Tuesday:
    National – 27,987 with 908 deaths
    ACT – 117 (0)
    NSW – 4620 (6)
    NT – 61 (2)
    QLD – 1221 (6)
    SA – 562 (0)
    TAS – 230 (0)
    VIC – 20,345 (0)
    WA – 831 (1)

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