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...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-02-01
|
| Series: | Infectious Diseases of Poverty |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40249-020-00785-1 |
| _version_ | 1818611588128571392 |
|---|---|
| author | Eduardo A. Undurraga Gerardo Chowell Kenji Mizumoto |
| author_facet | Eduardo A. Undurraga Gerardo Chowell Kenji Mizumoto |
| author_sort | Eduardo A. Undurraga |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-16T15:32:43Z |
| format | Article |
| id | doaj.art-15ac8036c52a474eb67c48a7bb43ac80 |
| institution | Directory Open Access Journal |
| issn | 2049-9957 |
| language | English |
| last_indexed | 2024-12-16T15:32:43Z |
| publishDate | 2021-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Infectious Diseases of Poverty |
| spelling | doaj.art-15ac8036c52a474eb67c48a7bb43ac802022-12-21T22:26:17ZengBMCInfectious Diseases of Poverty2049-99572021-02-0110111110.1186/s40249-020-00785-1COVID-19 case fatality risk by age and gender in a high testing setting in Latin America: Chile, March–August 2020Eduardo A. Undurraga0Gerardo Chowell1Kenji Mizumoto2Escuela de Gobierno, Pontificia Universidad Católica de ChileDepartment of Population Health Sciences, School of Public Health, Georgia State UniversityGraduate School of Advanced Integrated Studies in Human Survivability, Kyoto University Yoshida-Nakaadachi-ChoAbstract 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.https://doi.org/10.1186/s40249-020-00785-1COVID-19ChileDeath risk by age groupTime-delay adjusted case fatality rateLatin America |
| spellingShingle | Eduardo A. Undurraga Gerardo Chowell Kenji Mizumoto COVID-19 case fatality risk by age and gender in a high testing setting in Latin America: Chile, March–August 2020 Infectious Diseases of Poverty COVID-19 Chile Death risk by age group Time-delay adjusted case fatality rate Latin America |
| title | COVID-19 case fatality risk by age and gender in a high testing setting in Latin America: Chile, March–August 2020 |
| title_full | COVID-19 case fatality risk by age and gender in a high testing setting in Latin America: Chile, March–August 2020 |
| title_fullStr | COVID-19 case fatality risk by age and gender in a high testing setting in Latin America: Chile, March–August 2020 |
| title_full_unstemmed | COVID-19 case fatality risk by age and gender in a high testing setting in Latin America: Chile, March–August 2020 |
| title_short | COVID-19 case fatality risk by age and gender in a high testing setting in Latin America: Chile, March–August 2020 |
| title_sort | covid 19 case fatality risk by age and gender in a high testing setting in latin america chile march august 2020 |
| topic | COVID-19 Chile Death risk by age group Time-delay adjusted case fatality rate Latin America |
| url | https://doi.org/10.1186/s40249-020-00785-1 |
| work_keys_str_mv | AT eduardoaundurraga covid19casefatalityriskbyageandgenderinahightestingsettinginlatinamericachilemarchaugust2020 AT gerardochowell covid19casefatalityriskbyageandgenderinahightestingsettinginlatinamericachilemarchaugust2020 AT kenjimizumoto covid19casefatalityriskbyageandgenderinahightestingsettinginlatinamericachilemarchaugust2020 |