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解析 COVID-19 病死率下降的原因:基于全国和佛罗里达州基层数据的研究。

Unpacking the Drop in COVID-19 Case Fatality Rates: A Study of National and Florida Line-Level Data.

机构信息

Carnegie Mellon University, Pittsburgh, PA, USA.

出版信息

AMIA Annu Symp Proc. 2022 Feb 21;2021:285-294. eCollection 2021.

Abstract

Since the COVID-19 pandemic began, the United States's case fatality rate (CFR) has plummeted. Using national and Florida data, we unpack the drop in CFR between April and December 2020, accounting for such confounders as expanded testing, age distribution shift, and detection-to-death lags. Guided by the insight that treatment improvements in this period should correspond to decreases in hospitalization fatality rate (HFR), and using a block-bootstrapping procedure to quantify uncertainty, we find that although treatment improvements do not follow the same trajectory in Florida and nationally (with Florida undergoing a comparatively severe second peak), by December, significant improvements are observed both in Florida and nationally (at least 17% and 55% respectively). These estimates paint a more realistic picture of improvements than the drop in aggregate CFR (70.8%-91.1%). We publish a website where users can apply our analyses to selected demographics, regions, and dates of interest.

摘要

自 COVID-19 大流行开始以来,美国的病死率 (CFR) 急剧下降。我们利用全国和佛罗里达州的数据,解释了 2020 年 4 月至 12 月期间 CFR 下降的原因,包括扩大检测、年龄分布变化以及检测到死亡的滞后等混杂因素。我们的分析基于这样一个观点,即在此期间的治疗改进应该与住院病死率 (HFR) 的下降相对应,并且使用分块自举程序来量化不确定性,我们发现,尽管治疗改进在佛罗里达州和全国的轨迹并不相同(佛罗里达州经历了相对严重的第二波高峰),但到 12 月,佛罗里达州和全国都观察到了显著的改进(分别至少提高了 17%和 55%)。这些估计比总体 CFR(70.8%-91.1%)的下降更能真实地反映改进情况。我们发布了一个网站,用户可以在该网站上应用我们的分析,选择感兴趣的人口统计学、地区和日期。

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