Analysis of the time course of COVID-19 cases and deaths from countries with extensive testing allows accurate early estimates of the age specific symptomatic CFR values.

<h4>Background</h4>Knowing the true infected and symptomatic case fatality ratios (IFR and CFR) for COVID-19 is of high importance for epidemiological model projections. Early in the pandemic many locations had limited testing and reporting, so that standard methods for determining IFR a...

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Main Authors: Jessica E Rothman, David Eidelberg, Samantha L Rothman, Theodore R Holford, Douglas L Rothman
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0253843
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author Jessica E Rothman
David Eidelberg
Samantha L Rothman
Theodore R Holford
Douglas L Rothman
author_facet Jessica E Rothman
David Eidelberg
Samantha L Rothman
Theodore R Holford
Douglas L Rothman
author_sort Jessica E Rothman
collection DOAJ
description <h4>Background</h4>Knowing the true infected and symptomatic case fatality ratios (IFR and CFR) for COVID-19 is of high importance for epidemiological model projections. Early in the pandemic many locations had limited testing and reporting, so that standard methods for determining IFR and CFR required large adjustments for missed cases. We present an alternate approach, based on results from the countries at the time that had a high test to positive case ratio to estimate symptomatic CFR.<h4>Methods</h4>We calculated age specific (0-69, 70-79, 80+ years old) time corrected crude symptomatic CFR values from 7 countries using two independent time to fatality correction methods. Data was obtained through May 7, 2020. We applied linear regression to determine whether the mean of these coefficients had converged to the true symptomatic CFR values. We then tested these coefficients against values derived in later studies as well as a large random serological study in NYC at that time.<h4>Results</h4>The age dependent symptomatic CFR values accurately predicted the percentage of the population infected as reported by two random testing studies in NYC. They also were in good agreement with later studies that estimated age specific IFR and CFR values from serological studies and more extensive data sets available later in the pandemic.<h4>Conclusions</h4>We found that for regions with extensive testing it is possible to get early accurate symptomatic CFR coefficients. These values, in combination with an estimate of the age dependence of infection, allows symptomatic CFR values and percentage of the population that is infected to be determined in similar regions with limited testing.
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spelling doaj.art-e7c3fa5b238d48a8ac8f37299d3824562022-12-22T04:05:17ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01168e025384310.1371/journal.pone.0253843Analysis of the time course of COVID-19 cases and deaths from countries with extensive testing allows accurate early estimates of the age specific symptomatic CFR values.Jessica E RothmanDavid EidelbergSamantha L RothmanTheodore R HolfordDouglas L Rothman<h4>Background</h4>Knowing the true infected and symptomatic case fatality ratios (IFR and CFR) for COVID-19 is of high importance for epidemiological model projections. Early in the pandemic many locations had limited testing and reporting, so that standard methods for determining IFR and CFR required large adjustments for missed cases. We present an alternate approach, based on results from the countries at the time that had a high test to positive case ratio to estimate symptomatic CFR.<h4>Methods</h4>We calculated age specific (0-69, 70-79, 80+ years old) time corrected crude symptomatic CFR values from 7 countries using two independent time to fatality correction methods. Data was obtained through May 7, 2020. We applied linear regression to determine whether the mean of these coefficients had converged to the true symptomatic CFR values. We then tested these coefficients against values derived in later studies as well as a large random serological study in NYC at that time.<h4>Results</h4>The age dependent symptomatic CFR values accurately predicted the percentage of the population infected as reported by two random testing studies in NYC. They also were in good agreement with later studies that estimated age specific IFR and CFR values from serological studies and more extensive data sets available later in the pandemic.<h4>Conclusions</h4>We found that for regions with extensive testing it is possible to get early accurate symptomatic CFR coefficients. These values, in combination with an estimate of the age dependence of infection, allows symptomatic CFR values and percentage of the population that is infected to be determined in similar regions with limited testing.https://doi.org/10.1371/journal.pone.0253843
spellingShingle Jessica E Rothman
David Eidelberg
Samantha L Rothman
Theodore R Holford
Douglas L Rothman
Analysis of the time course of COVID-19 cases and deaths from countries with extensive testing allows accurate early estimates of the age specific symptomatic CFR values.
PLoS ONE
title Analysis of the time course of COVID-19 cases and deaths from countries with extensive testing allows accurate early estimates of the age specific symptomatic CFR values.
title_full Analysis of the time course of COVID-19 cases and deaths from countries with extensive testing allows accurate early estimates of the age specific symptomatic CFR values.
title_fullStr Analysis of the time course of COVID-19 cases and deaths from countries with extensive testing allows accurate early estimates of the age specific symptomatic CFR values.
title_full_unstemmed Analysis of the time course of COVID-19 cases and deaths from countries with extensive testing allows accurate early estimates of the age specific symptomatic CFR values.
title_short Analysis of the time course of COVID-19 cases and deaths from countries with extensive testing allows accurate early estimates of the age specific symptomatic CFR values.
title_sort analysis of the time course of covid 19 cases and deaths from countries with extensive testing allows accurate early estimates of the age specific symptomatic cfr values
url https://doi.org/10.1371/journal.pone.0253843
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