The global case fatality rate of coronavirus disease 2019 by continents and national income: A meta-analysis.

Urology Institute, University Hospitals, Case Western Reserve University, Cleveland, Ohio, USA. Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea. Hospital Medicine Center, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea. Yonsei University College of Medicine, Seoul, Republic of Korea. College of Medicine, Gyeongsang National University, Jinju, Republic of Korea. Department of Nephrology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea. Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea. Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & Metabolism, Medical University Innsbruck, Innsbruck, Austria. Luton & Dunstable University Hospital NHS Foundation Trust, Luton, UK. Department of Internal Medicine IV, Nephrology and Hypertension, Medical University Innsbruck, Innsbruck, Austria. Department of Psychiatry, University of Ottawa, Ontario, Canada. Department of Mental Health, The Ottawa Hospital, Ontario, Canada. Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program University of Ottawa, Ottawa, Ontario, Canada. School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada. University of Florida College of Medicine, Gainesville, Florida, USA. Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Versailles, France. Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain. ICREA, Barcelona, Spain. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK. Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institutet, Stockholm, Sweden. Department of Gerontology Health and Welfare, Pai Chai University, Daejeon, Republic of Korea. Department of Gastroenterology, Azerbaijan Medical University School of Medicine, Baku, Azerbaijan. Research Unit in Epidemiology and Diversity of Microorganisms, Department of Biology, University of Nouakchott Al Aasriya, Nouakchott, Mauritania. Yemen Field Epidemiology Training Program, Sana'a, Yemen. College of Medicine, University of Sharjah, Sharjah, United Arab Emirates. Burjeel Cancer Institute, Burjeel Medical City, Abu Dhabi, United Arab Emirates. Iranian Center of Excellence in Health Management (IceHM), School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran. Student Research Committee (SRC), Tabriz University of Medical Sciences, Tabriz, Iran. Road Traffic Injury Research Center, Iranian International Safe Community Support Center, Tabriz University of Medical Sciences, Tabriz, Iran. School of Medicine, Mongolian National University of Medical Sciences, Ulan Bator, Mongolia. Department of Family and Community Medicine, Faculty of Medicine, Damascus University, Damascus, Syria. Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine. Servicio de Infectología, Hospital Universitario "Dr José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico. Department of Research and Health Technology Assessment, Gorgas Memorial Institute for Health Studies, Panama City, Panama. Ministry of Health Guyana, Georgetown, Guyana. Tuberculosis Research and Prevention Center NGO, Yerevan, Armenia. Centre for Biosecurity Studies, University of the West Indies, Cave Hill, St. Michael, Barbados. Department of Health, Medicine and Caring Sciences, Pain and Rehabilitation Centre, Linkoping University, Linkoping, Sweden. Faculty of Medicine, University of Sciences, Techniques, and Technology, Bamako, Mali. IRCCS Azienda Ospedaliero-Universitaria di Bologna, Respiratory and Critical Care Unit, S. Orsola-Malpighi Hospital, Bologna, Italy. Medical Research Unit, School of Medicine Universitas Syiah Kuala, Banda Aceh, Indonesia. School of Medicine, Royal College of Surgeons in Ireland-Bahrain, Busaiteen, Kingdom of Bahrain. National Institute of Health, Islamabad, Pakistan. Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan. Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia. Postgraduate Institute of Medicine, University of Colombo, Colombo, Sri Lanka. Department of Pediatrics, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia. School of Medicine, National University of Galway Ireland, Galway, Ireland. Department of Health, Behavior, and Society, Faculty of Public Health, Jimma University, Jimma, Ethiopia. Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK. Saw Swee Hock School of Public Health, National University of Singapore, Siangapore. Division of Endocrinology, Diabetes and Metabolic Disease in Split, Clinical Hospital Centre Split, School of Medicine Split, Šoltanska 1, Split, Croatia. Department Anaesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University, Szczecin, Poland. College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone. Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China. Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA. Department of Community Medicine, Department of Primary Care Sciences, University of Zimbabwe, Faculty of Medicine and Health Sciences, Harare, Zimbabwe. Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh. Department of Public Health, Daffodil International University, Dhaka, Bangladesh. CHINTA Research Bangladesh, Dhaka, Bangladesh. Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina. Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam. Sechenov First Moscow State Medical University, Moscow, Russia. Department of Dermatology, "St. Parascheva" Clinical Hospital of Infectious Diseases, Galati, Romania. Department of Gynecologic Surgery and Oncology, Carmel Medical Center, Haifa, Israel. Instituto Nacional de Cancerología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico. Institute for Training & Research in Population Studies (IFORD), The University of Yaoundé II, Soa, Cameroon. Department of Anaesthesia and Intensive Care, Zealand University Hospital Roskilde, Roskilde, Denmark. Mobile Laboratory for Hemorrhagic and Respiratory Viruses in Ndjamena, Ndjamena, Chad. Department of Medical Research (Lower Myanmar), Myanmar Health Ministry, Yangon, Myanmar. Tampere University, Tampere, Pirkanmaa, Finland. Department of Community Medicine, University College Hospital, Ibadan, Nigeria. Department of Internal Medicine, University of Cyprus Medical School, Nicosia, Cyprus. Division of Cardiology, Clínica Olivos, Buenos Aires, Argentina. Department of Preventive Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. Waikato Clinical School, Auckland University Medical School, Hamilton, New Zealand. College of Pharmacy, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil. Pharmacy Division, National Institute of Industrial Property, Rio de Janeiro, Rio de Janeiro, Brazil. National Public Health Laboratory, Kathmandu, Nepal. Department of Pediatrics & pediatric nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Department of Anesthesiology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India. University Hospital Shefqet Ndroqi, Tirana, Albania. Fundación Octaedro, Quito, Ecuador. Universidad Cientifica del Sur, Lima, Perú. Department of Emergency Medicine, Hippokratio Hospital, Athens, Greece. Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia. The Tashkent Medical Academy, Tashkent, Uzbekistan. Faculty of Medicine, University of Montenegro, Podgorica, Montenegro. Unit of Physiology, Department of Basic Sciences, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo. Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Dresden, Germany. Centre of Reproduction, Development and Aging, Faculty of Health Sciences, Institute of Translational Medicine, University of Macau, Taipa, Macau, China. Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Canada. Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, Canada. Faculty of Medicine, University Ferhat Abbas, Setif, Algeria. The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK.

Journal of medical virology. 2022;(6):2402-2413

Abstract

The aim of this study is to provide a more accurate representation of COVID-19's case fatality rate (CFR) by performing meta-analyses by continents and income, and by comparing the result with pooled estimates. We used multiple worldwide data sources on COVID-19 for every country reporting COVID-19 cases. On the basis of data, we performed random and fixed meta-analyses for CFR of COVID-19 by continents and income according to each individual calendar date. CFR was estimated based on the different geographical regions and levels of income using three models: pooled estimates, fixed- and random-model. In Asia, all three types of CFR initially remained approximately between 2.0% and 3.0%. In the case of pooled estimates and the fixed model results, CFR increased to 4.0%, by then gradually decreasing, while in the case of random-model, CFR remained under 2.0%. Similarly, in Europe, initially, the two types of CFR peaked at 9.0% and 10.0%, respectively. The random-model results showed an increase near 5.0%. In high-income countries, pooled estimates and fixed-model showed gradually increasing trends with a final pooled estimates and random-model reached about 8.0% and 4.0%, respectively. In middle-income, the pooled estimates and fixed-model have gradually increased reaching up to 4.5%. in low-income countries, CFRs remained similar between 1.5% and 3.0%. Our study emphasizes that COVID-19 CFR is not a fixed or static value. Rather, it is a dynamic estimate that changes with time, population, socioeconomic factors, and the mitigatory efforts of individual countries.

Methodological quality

Publication Type : Meta-Analysis

Metadata