The Risks of Dying from COVID-19

First released on October 28, 2022. Additional information has been added.

This article features a study from Stanford University examining the risk of dying among the non-elderly (<70 years) from COVID-19.

The authors are from Stanford University, the Università Cattolica del
Sacro Cuore in Italy, and the Université de Montréal in Canada 

The authors chose the <70-year-old population because they comprise 94% of the global population. 86% are younger than 60 years.

Age-specific fatality rates are essential to know the specific death risk for the age groups. Often the higher death rates that pertain to the elderly are used to make health-related policies applied to all ages.

The Infection Fatality Rate (IFR) is the number of deaths due to COVID-19 divided by the total number of people who had COVID-19. This study grouped the IFRs by age.

Method

COVID-19 death data from 29 countries (24 high-income, five others) were obtained during the pre-vaccination period. CV19 diagnoses were made by seroprevalence. (Presence of antibody against SARS-CoV-2 in the blood). Data were obtained from Serotracker and Pubmed.

SeroTracker is a dashboard and data platform for SARS-CoV-2 serosurveys. It conducts an ongoing systematic review to track serosurveys (antibody testing-based surveillance efforts).

Pubmed is a repository of medical research.

Results

Infection Fatality Rates by age group

• 0-19 years old – 0.0003% (3 in 1,000,000) Three people died due to COVID-19 out of one million who had COVID-19 in the 0-19-year-old age group.
• 20-29 years –    0.003%   (3 in 100,000)
• 30-39 years –    0.011%   (1.1 in 10,000)
• 40-49 years –    0.035%   (3.5 in 10,000)
• 50-59 years –    0.129%   (1.29 in 1,000)
• 60-69 years –    0.501%   (5 in 1,000)

Overall using 31 national seroprevalence studies during the pre-vaccination era, the median infection fatality rate of COVID-19 was estimated to be 0.035% for people aged 0-59 years and 0.095% for those aged 0-69 years.

The figure shows the Infection fatality rate (IFR) and 95% confidence interval per country for <60 years old.

IFR is lower compared to other studies

The Infection Fatality Rate in this study is lower compared to previous studies. One of which is the work of Levin et al., who found the following IFR rates:

• 0.002% at age 10
• 0.01% at age 25
• 0.4% at age 55
• 1.4% at age 65

According to Pezzulo et al., the difference in the results could be due to more limited national representative studies’ and non-national samples with potentially more significant bias. They also probably included mostly hard-hit countries that may tend to have the highest IFR estimates. The third reason is that the data was multiplied by a factor of under-ascertainment of COVID-19 deaths.[2]

Research by Ayoub et al. agrees with the Stanford study, with 0.107% IFR across all ages combined.

In their discussion,

Globally, out of every 10,000 infections, only 11 would result in COVID-19 deaths.

Out of every 1000 infections, only 6 would be severe and only 2 would be critical per WHO classification[4].

Nineteen would be hospitalized in an acute-care bed and 4 in an ICU bed.[3]

Note that these IFRs are from the pre-vaccination period. Natural immunity developed from previous infections and newer variants with lower virulence may further lower the risk.

• A multinational study shows why the Omicron variant has low fatality and high infectivity.
• Omicron infections elicit neutralizing antibodies against variants of concern.
• The COVID-19 reinfection risk at 18 months is low at 0.32%
• Naturally acquired antibodies from COVID-19 last up to 20 months
• T cells from previous infections and shots are protective against the Omicron variant
• Pre-Existing T-Cells Stop COVID-19 Before it Starts
• Harvard: Immunity from mild COVID-19 infection much better than vaccination

Another factor to consider is that effective medicines like ivermectin, hydroxychloroquine, and vitamin D were not widely used in the early stages of the pandemic. IFR would have been lower if those were widely used.

• A new study shows a 100% decreased hospitalization rate with regular ivermectin use
• Ivermectin prevents binding to human cells by blocking the spike protein
• City-wide use of ivermectin lowered COVID-19 cases, hospitalizations, and deaths in Itajaí, Brazil
• What makes ivermectin a kick-ass antiviral?
• IVMMETA.COM: A website of studies on ivermectin’s efficacy

These low IFR may not necessarily apply to everyone. Obesity, hypertension, diabetes, smoking, and immune-compromised people have a higher risk. That is why efforts should be made to lower the risks with diet, exercise, and medication compliance.

Study: Intermittent fasting results in better COVID-19 outcomes

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Related:

1. USA study: Adults and children with the Omicron variant have milder COVID-19
2. COVID-19 infections among infants: Symptoms and who gets hospitalized
3. USA study: Adults and children with the Omicron variant have milder COVID-19
4. COVID-19 in children 0-17 years old have a low risk of death and hospitalization
5. Children 5-11 Years Old have Mild COVID-19
6. Asymptomatic or mild symptomatic COVID-19 elicits effective and long-lasting antibody responses in children and adolescents

References:

 

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