Abstract
BackgroundUnderstanding and monitoring the demographics of SARS-CoV-2 infection can inform strategies for prevention. Surveillance monitoring has suggested that the age distribution of people infected with SARS-CoV-2 has changed since the pandemic began, but no formal analysis has been performed.MethodsRetrospective review of SARS-CoV-2 molecular testing results from a national reference laboratory was performed. Result distributions by age and positivity were compared between early period (March-April 2020) and late periods (June-July 2020) of the COVID-19 pandemic. Additionally, a sub-analysis compared changing age distributions between inpatients and outpatients.ResultsThere were 277,601 test results of which 19320 (7.0%) were positive. The median age of infected people declined over time (p < 0.0005). In March-April, the median age of positive people was 40.8 years (Interquartile range (IQR): 29.0–54.1). In June-July, the median age of positive people was 35.8 years (IQR: 24.0–50.2). The positivity rate of patients under 50 increased from 6.0 to 10.6 percent and the positivity rate for those over 50 decreased from 6.3 to 5.0 percent between the early and late periods. The trend was only observed for outpatient populations.ConclusionsWe confirm that there is a trend toward decreasing age among persons with laboratory-confirmed SARS-CoV-2 infection, but that these trends seem to be specific to the outpatient population. Overall, this suggests that observed age-related trends are driven by changes in testing patterns rather than true changes in the epidemiology of SARS-CoV-2 infection. This calls for caution in interpretation of routine surveillance data until testing patterns stabilize.
Highlights
Since its first detection in China in December 2019, the SARS-CoV-2 virus has emerged to cause a global pandemic
The median age of infected people declined over time (p < 0.0005)
We confirm that there is a trend toward decreasing age among persons with laboratory-confirmed SARS-CoV-2 infection, but that these trends seem to be specific to the outpatient population
Summary
Since its first detection in China in December 2019, the SARS-CoV-2 virus has emerged to cause a global pandemic. Over 31 million confirmed SARS-CoV-2 infections have been detected globally with 965,000 deaths due to COVID-19 [1]. Understanding of the demographics of persons infected with SARS-CoV-2 is essential for informing the public health response to the COVID-19 pandemic. Age is a major factor in determining the risk of severe illness outcomes [2, 3], so data on the age distribution of infected persons can help guide expectations about demands on hospital resources. In the United States, surveillance data suggest that mean age of infected patients is decreasing compared to the early stages of the COVID-19 pandemic. In Washington State, for example, 35% of detected cases in March were aged 60 years or older, compared to 12% in July [5]
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