London School of Hygiene and Tropical Medicine, London, UK.
Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin, Turin, Italy.
Eur J Epidemiol. 2021 Jan;36(1):1-9. doi: 10.1007/s10654-020-00711-7. Epub 2021 Jan 18.
The Covid-19 death rate increases exponentially with age, and the main risk factors are having underlying conditions such as hypertension, diabetes, cardiovascular disease, severe chronic respiratory disease and cancer. These characteristics are consistent with the multi-step model of disease. We applied this model to Covid-19 case fatality rates (CFRs) from China, South Korea, Italy, Spain and Japan. In all countries we found that a plot of log(CFR) against log(age) was approximately linear with a slope of about 5. We also conducted similar analyses for selected other respiratory diseases. SARS showed a similar log-log age-pattern to that of Covid-19, albeit with a lower slope, whereas seasonal and pandemic influenza showed quite different age-patterns. Thus, death from Covid-19 and SARS appears to follow a distinct age-pattern, consistent with a multi-step model of disease that in the case of Covid-19 is probably defined by comorbidities and age producing immune-related susceptibility.
新冠病毒死亡率随年龄呈指数级增长，主要危险因素是存在高血压、糖尿病、心血管疾病、严重慢性呼吸道疾病和癌症等基础疾病。这些特征与疾病的多步骤模型一致。我们将该模型应用于中国、韩国、意大利、西班牙和日本的新冠病毒病死率（CFR）。在所有国家，我们发现 log(CFR) 与 log(age) 的关系图大致呈线性，斜率约为 5。我们还对其他选定的呼吸道疾病进行了类似的分析。SARS 的对数-对数年龄模式与新冠病毒相似，尽管斜率较低，而季节性流感和大流行性流感则呈现出截然不同的年龄模式。因此，新冠病毒和 SARS 导致的死亡似乎遵循一种明显的年龄模式，与疾病的多步骤模型一致，在新冠病毒的情况下，这种模式可能是由合并症和年龄引起的免疫相关易感性所定义的。
