Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran.
Department of Epidemiology & Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
J Prev Med Hyg. 2021 Jul 30;62(2):E311-E320. doi: 10.15167/2421-4248/jpmh2021.62.2.1627. eCollection 2021 Jun.
The ongoing novel coronavirus disease 2019 (COVID-19) is the leading cause of morbidity and mortality due to its contagious nature and absence of vaccine and treatment. Although numerous primary studies reported extremely variable case fatality rate (CFR) of COVID-19, no review study attempted to estimate the CFR of COVID-19. The current systematic review and meta-analysis were aimed to assess the pooled CFR of COVID-19.
Electronic databases: PubMed, Science Direct, Scopus, and Google Scholar were searched to retrieve the eligible primary studies that reported CFR of COVID-19. Keywords: ("COVID-19"OR "COVID-2019" OR "severe acute respiratory syndrome coronavirus 2"OR "severe acute respiratory syndrome coronavirus 2" OR "2019-nCoV" OR "SARS-CoV-2" OR "2019nCoV" OR (("Wuhan" AND ("coronavirus" OR "coronavirus")) AND (2019/12[PDAT] OR 2020[PDAT]))) AND ("mortality "OR "mortality" OR ("case" AND "fatality" AND "rate") OR "case fatality rate") were used as free text and MeSH term in searching process. A random-effects model was used to estimate the CFR in this study. I statistics, Cochran's Q test, and T were used to assess the functional heterogeneity between included studies.
The overall pooled CFR of COVID 19 was 10.0%(95% CI: 8.0-11.0); P < 0.001; I = 99.7). The pooled CFR of COVID-19 in general population was 1.0% (95% CI: 1.0-3.0); P < 0.001; I = 94.3), while in hospitalized patients was 13.0% (95% CI: 9.0-17.0); P < 0.001, I = 95.6). The pooled CFR in patients admitted in intensive care unit (ICU) was 37.0% (95% CI: 24.0-51.0); P < 0.001, I = 97.8) and in patients older than 50 years was 19.0% (95% CI: 13.0-24.0); P < 0.001; I = 99.8).
The present review results highlighted the need for transparency in testing and reporting policies and denominators used in CFR estimation. It is also necessary to report the case's age, sex, and the comorbidity distribution of all patients, which essential in comparing the CFR among different segments of the population.
由于新型冠状病毒病 2019（COVID-19）具有传染性且尚无疫苗和治疗方法，因此是导致发病率和死亡率的主要原因。尽管许多初步研究报告了 COVID-19 非常不同的病死率（CFR），但没有综述研究试图估计 COVID-19 的 CFR。本系统评价和荟萃分析旨在评估 COVID-19 的合并 CFR。
电子数据库：PubMed、Science Direct、Scopus 和 Google Scholar 被用来检索报告 COVID-19 CFR 的合格的原始研究。关键词：("COVID-19"或"COVID-2019"或"严重急性呼吸系统综合症冠状病毒 2"或"严重急性呼吸系统综合症冠状病毒 2"或"2019-nCoV"或"SARS-CoV-2"或"2019nCoV"或（("武汉"和（"冠状病毒"或"冠状病毒"))和（2019/12[PDAT]或 2020[PDAT]））和（"死亡率"或"死亡率"或（"病例"和"病死率"和"率"）或"病死率"）被用作搜索过程中的自由文本和 MeSH 术语。本研究采用随机效应模型估计 CFR。I 统计量、Cochran's Q 检验和 T 检验用于评估纳入研究之间的功能异质性。
COVID-19 总体合并 CFR 为 10.0%（95%CI：8.0-11.0）；P<0.001；I=99.7）。普通人群中 COVID-19 的合并 CFR 为 1.0%（95%CI：1.0-3.0）；P<0.001；I=94.3），而住院患者为 13.0%（95%CI：9.0-17.0）；P<0.001；I=95.6）。入住重症监护病房（ICU）的患者合并 CFR 为 37.0%（95%CI：24.0-51.0）；P<0.001；I=97.8），年龄大于 50 岁的患者合并 CFR 为 19.0%（95%CI：13.0-24.0）；P<0.001；I=99.8）。
本综述结果强调了在 CFR 估计中需要透明度，包括检测和报告政策以及使用的分母。还需要报告病例的年龄、性别以及所有患者的合并症分布情况，这对于比较不同人群的 CFR 至关重要。
