SARS-CoV-2 infection hospitalization, severity, criticality, and fatality rates in Qatar

  1. Shaheen Seedat
  2. Hiam Chemaitelly
  3. Houssein H. Ayoub
  4. Monia Makhoul
  5. Ghina R. Mumtaz
  6. Zaina Al Kanaani
  7. Abdullatif Al Khal
  8. Einas Al Kuwari
  9. Adeel A. Butt
  10. Peter Coyle
  11. Andrew Jeremijenko
  12. Anvar Hassan Kaleeckal
  13. Ali Nizar Latif
  14. Riyazuddin Mohammad Shaik
  15. Hadi M. Yassine
  16. Mohamed G. Al Kuwari
  17. Hamad Eid Al Romaihi
  18. Mohamed H. Al-Thani
  19. Roberto Bertollini
  20. Laith J. Abu-Raddad

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Abstract

The SARS-CoV-2 pandemic resulted in considerable morbidity and mortality as well as severe economic and societal disruptions. Despite scientific progress, true infection severity, factoring both diagnosed and undiagnosed infections, remains poorly understood. This study aimed to estimate SARS-CoV-2 age-stratified and overall morbidity and mortality rates based on analysis of extensive epidemiological data for the pervasive epidemic in Qatar, a country where < 9% of the population are ≥ 50 years. We show that SARS-CoV-2 severity and fatality demonstrate a striking age dependence with low values for those aged < 50 years, but rapidly growing rates for those ≥ 50 years. Age dependence was particularly pronounced for infection criticality rate and infection fatality rate. With Qatar’s young population, overall SARS-CoV-2 severity and fatality were not high with < 4 infections in every 1000 being severe or critical and < 2 in every 10,000 being fatal. Only 13 infections in every 1000 received any hospitalization in acute-care-unit beds and < 2 in every 1000 were hospitalized in intensive-care-unit beds. However, we show that these rates would have been much higher if Qatar’s population had the demographic structure of Europe or the United States. Epidemic expansion in nations with young populations may lead to considerably lower disease burden than currently believed.

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  1. Version published to 10.1038/s41598-021-97606-8
  2. ScreenIT

    SciScore for 10.1101/2020.11.29.20240416: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    The model was coded, fitted, and analyzed using MATLAB R2019a [20].
    MATLAB
    suggested: (MATLAB, RRID:SCR_001622)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations may have affected this study. We estimated rates of infection morbidity and mortality, not accounting for potential differences by sex, comorbidities, or other factors. Model estimations are contingent on the validity and generalizability of input data. Available input data were most complete at the national level, and although there could be subpopulation differences in the highly diverse population of Qatar, these could not be factored in the model given insufficient data at the subpopulation level. Despite these limitations, our model, tailored to the complexity of the epidemic in Qatar, was able to reproduce the observed epidemic trends, and provided profound insights about healthcare needs and infection morbidity and mortality. In conclusion, SARS-CoV-2 morbidity and mortality demonstrate a strikingly strong age dependence. With its young population structure, both morbidity and mortality were low in Qatar, and not much higher than those typically seen in a seasonal influenza epidemic in the United States [21, 22]. Out of every 1,000 infections, only 3.7 infections were severe or critical, and out of every 10,000 infections, only 1.9 infections were fatal. However, these rates would have been much higher if the population of Qatar had a similar demographic structure to that found in Europe or the United States. These findings suggest that SARS-CoV-2 morbidity and mortality may vary immensely by country or region, and that the pandemic expansion in nations wit...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2020.11.29.20240416v1 on medRxiv