西班牙卡洛斯三世健康研究所Marina Pollán团队研究了西班牙社区居民SARS-CoV-2感染的死亡风险。2020年11月27日，该研究发表在《英国医学杂志》上。

为了基于covid-19死亡和全因超额死亡来评估SARS-CoV-2感染的致死风险，研究组针对西班牙的covid-19第一波大流行进行了一项全国血清流行病学研究。2020年4月27日至6月22日，西班牙通过全国血清流行病学调查筛查SARS-CoV-2感染，共纳入61098位参与者。主要结局为西班牙社区居民中SARS-CoV-2的总体以及特定年龄和性别的感染死亡风险。

Covid-19确诊死亡的总感染死亡风险为0.8%，超额死亡风险为1.1%。男性感染死亡风险为1.1％至1.4％不等，女性感染死亡风险为0.6％至0.8％不等。50岁以后，感染致死风险急剧上升，年龄在80岁及以上的男性感染致死风险为11.6％到16.4％不等，80岁及以上女性从4.6％到6.5%不等。

研究结果表明，50岁以后，SARS-CoV-2感染致死风险增大，且男性比女性更明显。Covid-19的致死率高于其他常见呼吸系统疾病（如季节性流感）。

附：英文原文

Title: Infection fatality risk for SARS-CoV-2 in community dwelling population of Spain: nationwide seroepidemiological study

Author: Roberto Pastor-Barriuso, Beatriz Pérez-Gómez, Miguel A Hernán, Mayte Pérez-Olmeda, Raquel Yotti, Jesús Oteo-Iglesias, Jose L Sanmartín, Inmaculada León-Gómez, Aurora Fernández-García, Pablo Fernández-Navarro, Israel Cruz, Mariano Martín, Concepción Delgado-Sanz, Nerea Fernández de Larrea, Jose León Paniagua, Juan F Muoz-Montalvo, Faustino Blanco, Amparo Larrauri, Marina Pollán

Issue&Volume: 2020/11/27

Abstract:

Objective To estimate the infection fatality risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), based on deaths with confirmed coronavirus disease 2019 (covid-19) and excess deaths from all causes.

Design Nationwide seroepidemiological study.

Setting First wave of covid-19 pandemic in Spain.

Participants Community dwelling individuals of all ages.

Main outcome measures The main outcome measure was overall, and age and sex specific, infection fatality risk for SARS-CoV-2 (the number of covid-19 deaths and excess deaths divided by the estimated number of SARS-CoV-2 infections) in the community dwelling Spanish population. Deaths with laboratory confirmed covid-19 were obtained from the National Epidemiological Surveillance Network (RENAVE) and excess all cause deaths from the Monitoring Mortality System (MoMo), up to 15 July 2020. SARS-CoV-2 infections in Spain were derived from the estimated seroprevalence by a chemiluminescent microparticle immunoassay for IgG antibodies in 61098 participants in the ENE-COVID nationwide seroepidemiological survey between 27 April and 22 June 2020.

Results The overall infection fatality risk was 0.8% (19228 of 2.3 million infected individuals, 95% confidence interval 0.8% to 0.9%) for confirmed covid-19 deaths and 1.1% (24778 of 2.3 million infected individuals, 1.0% to 1.2%) for excess deaths. The infection fatality risk was 1.1% (95% confidence interval 1.0% to 1.2%) to 1.4% (1.3% to 1.5%) in men and 0.6% (0.5% to 0.6%) to 0.8% (0.7% to 0.8%) in women. The infection fatality risk increased sharply after age 50, ranging from 11.6% (8.1% to 16.5%) to 16.4% (11.4% to 23.2%) in men aged 80 or more and from 4.6% (3.4% to 6.3%) to 6.5% (4.7% to 8.8%) in women aged 80 or more.

Conclusion The increase in SARS-CoV-2 infection fatality risk after age 50 appeared to be more noticeable in men than in women. Based on the results of this study, fatality from covid-19 was greater than that reported for other common respiratory diseases, such as seasonal influenza.

DOI: 10.1136/bmj.m4509

Source: https://www.bmj.com/content/371/bmj.m4509