Abstract
Objective: Determine age-specific infection fatality rates for COVID-19 to inform public health policies and communications that help protect vulnerable age groups.Methods: Studies of COVID-19 prevalence were collected by conducting an online search of published articles, preprints, and government reports. A total of 89 studies were reviewed in depth and screened. Studies of 31 locations satisfied the inclusion criteria and were included in the meta-analysis. Age-specific IFRs were computed using the prevalence data in conjunction with reported fatalities four weeks after the midpoint date of the study, reflecting typical lags in fatalities and reporting. Meta-regression procedures in Stata were used to analyze IFR by age.Results: Our analysis finds a exponential relationship between age and IFR for COVID-19. The estimated age-specific IFRs are very low for children and younger adults but increase progressively to 0.4% at age 55, 1.3% at age 65, 4.5% at age 75, and 15% at age 85. We find that differences in the age structure of the population and the age-specific prevalence of COVID-19 explain 90% of the geographical variation in population IFR.Discussion: These results indicate that COVID-19 is hazardous not only for the elderly but also for middle-aged adults, for whom the infection fatality rate is two orders of magnitude greater than the annualized risk of a fatal automobile accident and far more dangerous than seasonal influenza. Moreover, the overall IFR for COVID-19 should not be viewed as a fixed parameter but as intrinsically linked to the age-specific pattern of infections. Consequently, public health measures to mitigate infections in older adults could substantially decrease total deaths.Funding Statement: No funding was received for conducting this study.Declaration of Interests: The authors have no financial interests nor any other conflicts of interest related to this study.
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