Escuela de Gobierno, Pontificia Universidad Católica de Chile, Vicuña Mackenna 4860, Macul, CP 7820436, Santiago, Región Metropolitana, Chile.
Millennium Initiative for Collaborative Research in Bacterial Resistance (MICROB-R), Santiago, Chile.
Infect Dis Poverty. 2021 Feb 3;10(1):11. doi: 10.1186/s40249-020-00785-1.
Early severity estimates of coronavirus disease 2019 (COVID-19) are critically needed to assess the potential impact of the ongoing pandemic in different demographic groups. Here we estimate the real-time delay-adjusted case fatality rate across nine age groups by gender in Chile, the country with the highest testing rate for COVID-19 in Latin America.
We used a publicly available real-time daily series of age-stratified COVID-19 cases and deaths reported by the Ministry of Health in Chile from the beginning of the epidemic in March through August 31, 2020. We used a robust likelihood function and a delay distribution to estimate real-time delay-adjusted case-fatality risk and estimate model parameters using a Monte Carlo Markov Chain in a Bayesian framework.
As of August 31, 2020, our estimates of the time-delay adjusted case fatality rate (CFR) for men and women are 4.16% [95% Credible Interval (CrI): 4.09-4.24%] and 3.26% (95% CrI: 3.19-3.34%), respectively, while the overall estimate is 3.72% (95% CrI: 3.67-3.78%). Seniors aged 80 years and over have an adjusted CFR of 56.82% (95% CrI: 55.25-58.34%) for men and 41.10% (95% CrI: 40.02-42.26%) for women. Results showed a peak in estimated CFR during the June peak of the epidemic. The peak possibly reflects insufficient laboratory capacity, as illustrated by high test positivity rates (33% positive 7-day average nationally in June), which may have resulted in lower reporting rates.
Severity estimates from COVID-19 in Chile suggest that male seniors, especially among those aged ≥ 70 years, are being disproportionately affected by the pandemic, a finding consistent with other regions. The ongoing pandemic is imposing a high death toll in South America, and Chile has one of the highest reported mortality rates globally thus far. These real-time estimates may help inform public health officials' decisions in the region and underscore the need to implement more effective measures to ameliorate fatality.
新冠病毒病 2019（COVID-19）的早期严重程度估计对于评估不同人群中正在进行的大流行的潜在影响至关重要。在这里，我们按性别估计了智利九个年龄组的实时延迟调整病死率，智利是拉丁美洲 COVID-19 检测率最高的国家。
我们使用了智利卫生部从 2020 年 3 月大流行开始到 8 月 31 日公布的实时年龄分层 COVID-19 病例和死亡的公共可用的每日系列。我们使用稳健的似然函数和延迟分布来估计实时延迟调整后的病死率，并在贝叶斯框架中使用蒙特卡罗马尔可夫链来估计模型参数。
截至 2020 年 8 月 31 日，我们对男性和女性的时间延迟调整病死率（CFR）的估计分别为 4.16%（95%可信区间（CrI）：4.09-4.24%）和 3.26%（95% CrI：3.19-3.34%），而总体估计值为 3.72%（95% CrI：3.67-3.78%）。80 岁及以上的老年人的调整后 CFR 为男性 56.82%（95% CrI：55.25-58.34%）和女性 41.10%（95% CrI：40.02-42.26%）。结果显示，在 6 月大流行高峰期，估计的 CFR 出现峰值。这一峰值可能反映了实验室能力不足，因为全国 6 月的检测阳性率（7 天平均阳性率为 33%）较高，这可能导致报告率较低。
来自智利 COVID-19 的严重程度估计表明，男性老年人，尤其是 70 岁及以上的老年人，受到大流行的不成比例的影响，这一发现与其他地区一致。南美洲正在遭受高死亡率的打击，而智利是迄今为止全球报告死亡率最高的国家之一。这些实时估计可能有助于为该地区的公共卫生官员提供决策信息，并强调需要采取更有效的措施来减轻死亡率。
