GAINS, Le Mans University, 72000, Le Mans, France.
GATE, University of Lyon 2, 69000, Lyon, France.
Sci Rep. 2021 Nov 4;11(1):21650. doi: 10.1038/s41598-021-01034-7.
The SARS-CoV2 has now spread worldwide causing over four million deaths. Testing strategies are highly variable between countries and their impact on mortality is a major issue. Retrospective multicenter study with a prospective database on all inpatients throughout mainland France. Using fixed effects models, we exploit policy discontinuities at region borders in France to estimate the effect of testing on the case fatality rate. In France, testing policies are determined at a regional level, generating exogenous variation in testing rates between departments on each side of a region border. We compared all contiguous department pairs located on the opposite sides of a region border. The increase of one percentage point in the test rate is associated with a decrease of 0.0015 percentage point in the death rate, that is, for each additional 2000 tests, we could observe three fewer deaths. Our study suggests that COVID-19 population testing could have a significant impact on the mortality rate which should be considered in decision-making. As concern grows over the current second wave of COVID-19, our findings support the implementation of large-scale screening strategies in such epidemic contexts.
SARS-CoV2 现已在全球范围内传播，导致超过 400 万人死亡。各国之间的检测策略差异很大，其对死亡率的影响是一个主要问题。这是一项回顾性多中心研究，建立了一个针对法国大陆所有住院患者的前瞻性数据库。我们利用法国地区边界的政策不连续性，使用固定效应模型来估计检测对病死率的影响。在法国，检测政策是在地区层面上确定的，这导致了地区边界两侧各部门之间的检测率存在外生差异。我们比较了位于地区边界相反两侧的所有连续的部门对。检测率每增加 1 个百分点，死亡率就会降低 0.0015 个百分点，也就是说，每增加 2000 次检测，就可以观察到死亡人数减少 3 人。我们的研究表明，COVID-19 人群检测可能对死亡率有重大影响，在决策时应考虑这一点。随着人们对当前 COVID-19 第二波疫情的担忧加剧，我们的研究结果支持在这种流行情况下实施大规模筛查策略。
