Abstract
SARS-CoV-2 has infected over one hundred million people worldwide and has affected Latin America particularly severely in terms of both cases and deaths. This study aims to determine the association between SARS-CoV-2 testing and COVID-19 fatality rate worldwide over 8 months and to examine how this relationship differs between Latin America and all other countries. This cross-sectional study used March 2021 data from 169 countries. Multivariate regressions predicted COVID-19 fatality (outcome) from the number of SARS-CoV-2 tests (exposure), while controlling for other predictors. Results for March 2021 were compared to results from June 2020. Additionally, results for Latin America were also compared to all other countries except Latin American for March 2021. SARS-CoV-2 testing was associated with a significant decrease in COVID-19 fatality rate in both June 2020 and March 2021 (RR = 0.92; 95% CI 0.87–0.96 and RR = 0.86; 95% CI 0.74–1.00, respectively). SARS-CoV-2 testing was associated with a significant decrease in COVID-19 fatality rate in Latin American countries but not in all other countries (RR = 0.45; 95% CI 0.23–0.89 and RR = 0.95; 95% CI 0.82–1.11, respectively). However, the difference between the risk ratios for June 2020 and March 2021 and between the risk ratios for Latin America and all other countries were not statistically significant. Increased SARS-CoV-2 testing may be a significant predictor of lower COVID-19 case fatality rate, specifically in Latin American countries, due to the existence of a strong association, which may have driven the worldwide results.
Highlights
As of March 2021, there have been over 120 million cases and over 2.5 million deaths attributed to COVID-19 worldwide [1]
SARS-CoV-2 testing was associated with a significant decrease in COVID-19 fatality rate in Latin American countries but not in all other countries (RR = 0.45; 95% CI 0.23–0.89 and RR = 0.95; 95% CI 0.82–1.11, respectively)
To determine the world-wide association between COVID-19 testing and fatality: first, we looked at the descriptive statistics for all variables; second, multivariate regression analyses were conducted to test the association between COVID-19 fatality and number of tests per 100 people, while controlling for case number per 1,000 people, critical case rate, government effectiveness, population aged 65 or older, hospital bed number per 1000 people, communicable disease death rate, and transport infrastructure quality
Summary
As of March 2021, there have been over 120 million cases and over 2.5 million deaths attributed to COVID-19 worldwide [1]. Over 44% of all cases and 48% of all deaths were found in the Americas, primarily in the United States, Brazil, Colombia, Argentina, and Mexico [1]. While the United States has the highest number and percent per population of cases and deaths in the Americas, they have abundant resources dedicated to limiting the spread of disease, treating cases, and vaccinating their population. As of March 2021, roughly 19% of all COVID-19 cases and 28.5% of all COVID-19 deaths worldwide were attributed to Latin America, while the region accounts for approximately 8.4% of the total world population [1, 2]. Latin America has more than a two-fold over-representation of cases as compared to the size of its population [3,4,5]
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