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arXiv 2103.15780q-bio.PE
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COVID - 19负荷模型流行病学参数的定量评估

A quantitative assessment of epidemiological parameters to model COVID- 19 burden

Agnese Zardini, Margherita Galli, Marcello Tirani, Danilo Cereda, Mattia Manica, Filippo Trentini, Giorgio Guzzetta, Valentina Marziano, Raffaella Piccarreta, A… 展开作者

Agnese Zardini, Margherita Galli, Marcello Tirani, Danilo Cereda, Mattia Manica, Filippo Trentini, Giorgio Guzzetta, Valentina Marziano, Raffaella Piccarreta, Alessia Melegaro, Marco Ajelli, Piero Poletti, Stefano Merler

摘要:

由于对无症状和轻症病例的不确定性,仍然缺乏描述SARS-CoV-2感染临床过程的可靠估计。在这项工作中,我们量化了2020年3月至4月期间在意大利确诊病例接触者中确定的1,965名SARS-CoV-2阳性个体中定义SARS-CoV-2感染自然史的阶段之间过渡的年龄特异性概率。病例的受感染接触者通过RT-PCR检测确认,作为接触者追踪活动的一部分,或通过IgG血清学检测进行回顾性确认,并对症状和临床结果进行随访。此外,我们还提供了从更大样本中获得的定义病例临床进展的关键事件之间的时间间隔估计值,该样本包括2020年2月至7月期间确定的95,371例感染。我们发现,年龄超过60岁与39.9%的(95%CI:36.2-43.6%)SARS-CoV-2感染后出现呼吸道症状或发热≥ 37.5 °C的可能性;(95%CI:19.3-25.6%)的感染者需要住院治疗,1%(95%CI:0.4-2.1%)的感染者被送入重症监护室(ICU)。60岁以下个体的相应比例估计分别为27.9%(95%CI:25.4-30.4%)、8.8%(95%CI:7.3-10.5%)和0.4%(95%CI:0.1-0.9%)。感染病死率(IFR)范围为0.2%,(95%CI:0.0-0.6%),在60岁以下的个体中为12.3%(95%CI:6.9-19.7%);这两个年龄组的病死率(CFR)为0.6%(95%CI:0.1-2%)和19.2%(95%CI:10.9-30.1%)。中位住院时间为10(IQR 3-21)天; ICU住院时间为11(IQR 6-19)天。所获得的估计可能有助于完善支持公共卫生决策的数学建模工作。

英文摘要:

Solid estimates describing the clinical course of SARS-CoV-2 infections are still lacking due to under-ascertainment of asymptomatic and mild-disease cases. In this work, we quantify age-specific probabilities of transitions between stages defining the natural history of SARS-CoV-2 infection from 1,965 SARS-CoV-2 positive individuals identified in Italy between March and April 2020 among contacts of confirmed cases. Infected contacts of cases were confirmed via RT-PCR tests as part of contact tracing activities or retrospectively via IgG serological tests and followed-up for symptoms and clinical outcomes. In addition, we provide estimates of time intervals between key events defining the clinical progression of cases as obtained from a larger sample, consisting of 95,371 infections ascertained between February and July 2020. We found that being older than 60 years of age was associated with a 39.9% (95%CI: 36.2-43.6%) likelihood of developing respiratory symptoms or fever >= 37.5 °C after SARS-CoV-2 infection; the 22.3% (95%CI: 19.3-25.6%) of the infections in this age group required hospital care and the 1% (95%CI: 0.4-2.1%) were admitted to an intensive care unit (ICU). The corresponding proportions in individuals younger than 60 years were estimated at 27.9% (95%CI: 25.4-30.4%), 8.8% (95%CI: 7.3-10.5%) and 0.4% (95%CI: 0.1-0.9%), respectively. The infection fatality ratio (IFR) ranged from 0.2% (95%CI: 0.0-0.6%) in individuals younger than 60 years to 12.3% (95%CI: 6.9-19.7%) for those aged 80 years or more; the case fatality ratio (CFR) in these two age classes was 0.6% (95%CI: 0.1-2%) and 19.2% (95% CI: 10.9-30.1%), respectively. The median length of stay in hospital was 10 (IQR 3-21) days; the length of stay in ICU was 11 (IQR 6-19) days. The obtained estimates could be instrumental to refine mathematical modeling work supporting public health decisions.

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