Previous studies have found large variations in the COVID-19 infection fatality rate (IFR). This study hypothesized that IFR would be influenced by COVID-19 epidemic intensity. We tested the association between epidemic intensity and IFR using serological results from a recent large SARS-CoV-2 serosurvey (N = 60,983) in 19 Spanish regions. The infection fatality rate for Spain as a whole was 1.15% and varied between 0.13% and 3.25% in the regions (median 1.07%, IQR 0.69–1.32%). The IFR by region was positively associated with SARS-CoV-2 seroprevalence (rho = 0.54; p = 0.0162), cases/100,000 (rho = 0.75; p = 0.002), hospitalizations/100,000 (rho = 0.78; p = 0.0001), mortality/100,000 (rho = 0.77; p = 0.0001) and case fatality rate (rho = 0.49; p = 0.0327). These results suggest that the SARS-CoV-2 IFR is not fixed. The Spanish regions with more rapid and extensive spread of SARS-CoV-2 had higher IFRs. These findings are compatible with the theory that slowing the spread of COVID-19 down reduces the IFR and case fatality rate via preventing hospitals from being overrun, and thus allowing better and lifesaving care.
【저자키워드】 COVID-19, SARS CoV-2, Epidemiology, Case fatality rate, Infection fatality rate, 【초록키워드】 SARS-CoV-2, hospital, Variation, Infection, Spread, Epidemic, Region, SARS-CoV-2 seroprevalence, Serosurvey, COVID-19 infection, Spain, Care, association, COVID-19 epidemic, IFR, intensity, Fatality rate, previous study, Spanish, regions, spread of COVID-19, tested, median, reduce, fixed, IQR, serological result, the SARS-CoV-2, 【제목키워드】 Spanish, Rate,