Institute of Virology, University Hospital, University of Bonn, Bonn, Germany.
German Center for Infection Research (DZIF), partner site Bonn-Cologne, Bonn, Germany.
Sci Rep. 2023 Apr 3;13(1):5440. doi: 10.1038/s41598-023-32441-7.
There is an ongoing debate on the COVID-19 infection fatality rate (IFR) and the impact of COVID-19 on overall population mortality. Here, we addressed these issues in a community in Germany with a major superspreader event analyzing deaths over time and auditing death certificates in the community.18 deaths that occurred within the first six months of the pandemic had a positive test for SARS-CoV-2. Six out of 18 deaths had non-COVID-19 related causes of death (COD). Individuals with COVID-19 COD typically died of respiratory failure (75%) and tended to have fewer reported comorbidities (p = 0.029). Duration between first confirmed infection and death was negatively associated with COVID-19 being COD (p = 0.04). Repeated seroprevalence essays in a cross-sectional epidemiological study showed modest increases in seroprevalence over time, and substantial seroreversion (30%). IFR estimates accordingly varied depending on COVID-19 death attribution. Careful ascertainment of COVID-19 deaths is important in understanding the impact of the pandemic.
关于 COVID-19 感染死亡率 (IFR) 和 COVID-19 对总体人口死亡率的影响，目前存在争议。在这里，我们通过分析一段时间内的死亡人数并审核社区内的死亡证明，研究了德国一个有重大超级传播事件的社区中的这些问题。在大流行的前六个月内发生的 18 例死亡病例的 SARS-CoV-2 检测结果呈阳性。18 例死亡中有 6 例与 COVID-19 无关（非 COVID-19 相关死因）。患有 COVID-19 COD 的个体通常死于呼吸衰竭（75%），且报告的合并症较少（p=0.029）。首次确诊感染与死亡之间的时间间隔与 COVID-19 作为 COD 呈负相关（p=0.04）。在一项横断面流行病学研究中反复进行血清学检测表明，血清阳性率随时间呈适度增加，且大量血清学转化率（30%）。因此，IFR 估计值取决于 COVID-19 死亡归因的不同而有所差异。仔细确定 COVID-19 死亡病例对于了解大流行的影响很重要。
