Age-Stratified SARS-CoV-2 Infection Fatality Rates in New York City estimated from serological data

  1. Chloe G. Rickards
  2. A. Marm Kilpatrick

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Abstract

Importance

COVID-19 has killed hundreds of thousands of people in the US and >1 million globally. Estimating the age-specific infection fatality rate (IFR) of SARS-CoV-2 for different populations is crucial for assessing the fatality of COVID-19 and for appropriately allocating limited vaccine supplies to minimize mortality.

Objective

To estimate IFRs for COVID-19 in New York City and compare them to IFRs from other countries.

Design, Setting, Participants

We used data from a published serosurvey of 5946 individuals 18 years or older conducted April 19-28, 2020 with time series of COVID-19 confirmed cases and deaths for five age-classes from the New York City Department of Health and Mental Hygiene. We inferred age-specific IFRs using a Bayesian framework that accounted for the distribution of delay between infection and seroconversion and infection and death.

Main Outcome and Measure

Infection fatality rate.

Results

We found that IFRs increased approximately 77-fold with age, with a nearly linear increase on a log scale, from 0.07% (0.055%-0.086%) in 18-44 year olds to 5.4% (4.3%-6.3%) in individuals 75 and older. New York City IFRs were higher for 18-44 year olds and 45-64 year olds (0.58%; 0.45%-0.75%) than Spanish, English, and Swiss populations, but IFRs for 75+ year olds were lower than for English populations and similar to Spanish and Swiss populations.

Conclusions and Relevance

These results suggest that the age-specific fatality of COVID-19 differs among developed countries and raises questions about factors underlying these differences.

Key Points

Question

How do age-specific infection fatality rates (IFR) for COVID-19 in the U.S. compare to other populations?

Findings

We estimated age-specific IFRs of SARS-CoV-2 using seroprevalence data and deaths in New York City. IFRs increased more than 75-fold with age, from 0.07% in 18-45 year olds to 5.3% in individuals over 75. IFRs in New York City were higher than IFRs in England, Geneva, France and Spain for individuals younger than 64 years old, but similar for older individuals.

Meaning

The age-specific fatality of COVID-19 varies significantly among developed nations for unknown reasons.

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  1. ScreenIT

    SciScore for 10.1101/2020.10.16.20214023: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: Thank you for sharing your code.

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    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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  2. Version published to 10.1101/2020.10.16.20214023v1 on medRxiv