Center for Disease Dynamics, Economics and Policy, New Delhi, India.
Princeton Environmental Institute, Princeton University, Princeton, NJ, USA.
Science. 2020 Nov 6;370(6517):691-697. doi: 10.1126/science.abd7672. Epub 2020 Sep 30.
Although most cases of coronavirus disease 2019 (COVID-19) have occurred in low-resource countries, little is known about the epidemiology of the disease in such contexts. Data from the Indian states of Tamil Nadu and Andhra Pradesh provide a detailed view into severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission pathways and mortality in a high-incidence setting. Reported cases and deaths have been concentrated in younger cohorts than would be expected from observations in higher-income countries, even after accounting for demographic differences across settings. Among 575,071 individuals exposed to 84,965 confirmed cases, infection probabilities ranged from 4.7 to 10.7% for low-risk and high-risk contact types, respectively. Same-age contacts were associated with the greatest infection risk. Case fatality ratios spanned 0.05% at ages of 5 to 17 years to 16.6% at ages of 85 years or more. Primary data from low-resource countries are urgently needed to guide control measures.
虽然大多数 2019 年冠状病毒病（COVID-19）病例发生在资源匮乏的国家，但对这些国家的疾病流行病学情况知之甚少。来自印度泰米尔纳德邦和安得拉邦的数据详细显示了高发病率环境中严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的传播途径和死亡率。与高收入国家的观察结果相比，报告的病例和死亡人数集中在年龄较小的队列中，即使考虑到不同环境下的人口差异也是如此。在接触了 84965 例确诊病例的 575071 人中，低风险和高风险接触类型的感染概率分别为 4.7%至 10.7%。同年龄的接触者与最大的感染风险相关。发病死亡率从 5 至 17 岁年龄组的 0.05%到 85 岁或以上年龄组的 16.6%不等。迫切需要来自资源匮乏国家的原始数据来指导控制措施。
