COVID-19–Related Fatalities and Intensive-Care-Unit Admissions by Age Groups in Europe: A Meta-Analysis

  1. Jérémie F. Cohen
  2. Daniël A. Korevaar
  3. Soraya Matczak
  4. Martin Chalumeau
  5. Slimane Allali
  6. Julie Toubiana

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Abstract

Objectives: Precise international estimates of the age breakdown of COVID-19–related deaths and intensive-care-unit (ICU) admissions are lacking. We evaluated the distribution of COVID-19–related fatalities and ICU admissions by age groups in Europe.

Materials and methods: On April 6, 2020, we systematically reviewed official COVID-19–related data from 32 European countries. We included countries that provided data regarding more than 10 COVID-19–related deaths stratified by age according to pre-specified age groups (i.e., <40, 40–69, ≥70 years). We used random-effects meta-analysis to summarize the data.

Results: Thirteen European countries were included in the review, for a total of 31,864 COVID-19–related deaths (range: 27–14,381 per country). In the main meta-analysis (including data from Germany, Hungary, Italy, The Netherlands, Portugal, Spain, Switzerland; 21,522 COVID-19–related fatalities), the summary proportions of individuals <40, 40–69, and ≥70 years old among all COVID-19–related deaths were 0.1% (0.0–0.2; I 2 28.6%), 13.0% (10.8–15.4; I 2 91.5%), and 86.6% (84.2–88.9; I 2 91.5%), respectively. ICU data were available for four countries (France, Greece, Spain, Sweden). The summary proportions of individuals around <40–50, around 40–69, and around ≥60–70 years old among all COVID-19–related ICU admissions were 5.4% (3.4–7.8; I 2 89.0%), 52.6% (41.8–63.3; I 2 98.1%), and 41.8% (32.0–51.9; I 2 99%), respectively.

Conclusions: People under 40 years old represent a small fraction of most severe COVID-19 cases in Europe. These results may help health authorities respond to public concerns and guide future physical distancing and mitigation strategies. Specific measures to protect older people should be considered.

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  1. ScreenIT

    SciScore for 10.1101/2020.04.11.20061721: (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: 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:
    Our study has limitations. First, we could not include all European countries, mainly because official reports on COVID-19 related mortality data by age group were not always available. Second, we could not investigate the potential burden of underlying health conditions and other risk factors such as obesity and chronic lung disease because this information was rarely notified. Third, we investigated COVID-19-related mortality data, but we acknowledge that methods for case ascertainment, case definitions, and SARS-CoV-2 RT-PCR testing strategies varied across countries. Some countries, such as France, provided detailed information only for in-hospital fatalities, which does not account for COVID-related deaths that occurred in other settings such as nursing homes, for a potential overrepresentation of younger patients. Fourth, we focused on COVID-19-related deaths, but future studies should also examine the distribution of age among patients with COVID-19 admitted to intensive care units. Physical distancing is currently recommended in many countries for all age groups to slow the spread of COVID-19 and protect the elderly and, more broadly, the healthcare system. People under 40 years of age represent a very small fraction of the total number of COVID-19-related deaths in Europe. These results, together with evaluations of the impact of comorbidities and risk factors in the course of COVID-19, may help health authorities respond to public concerns and guide future physical ...

    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 10.3389/fmed.2020.560685
  3. Version published to 10.1101/2020.04.11.20061721 on medRxiv