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Revisiting the link between COVID-19 incidence and infection fatality rate during the first pandemic wave
Benjamin Glémain, Walid Ghosn, Paul Moulaire, Xavier de Lamballerie, Marie Zins, Gianluca Severi, Mathilde Touvier, Jean‐François Deleuze, Fabrice Carrat, Pierre‐Yves Ancel, Marie-Aline Charles, Sofiane Kab, Adeline Renuy, Stéphane Le-Got, Céline Ribet, Mireille Pellicer, Emmanuel Wiernik, Marcel Goldberg, Fanny Artaud, Pascale Gerbouin-Rérolle, Mélody Enguix, C Laplanche, Roselyn Gomes-Rima, Lyan Hoang, Emmanuelle Correia, Alpha Amadou Barry, Nadège Senina, Julien Allègre, Fabien Szabo de Edelenyi, Nathalie Druesne‐Pecollo, Younes Esseddik, Serge Herçberg, Mélanie Deschasaux, Valérie Benhammou, Anass Ritmi, Laetitia Marchand‐Martin, Cécile Zaros, Elodie Lordmi, Adriana Candea, Sophie de Visme, Thierry Siméon, Xavier Thierry, Bertrand Geay, Marie‐Noëlle Dufourg, Karen Milcent, Delphine Rahib, Nathalie Lydié, Clovis Lusivika‐Nzinga, Grégory Pannetier, Nathanaël Lapidus, Isabelle Goderel, Céline Dorival, Jérôme Nicol, Olivier Robineau, Cindy J. Lai, Liza Belhadji, Hélène Espérou, Sandrine Couffin-Cadièrgues, Jean‐Marie Gagliolo, Hélène Blanché, Jean-Marc Sébaoun, Jean-Christophe Beaudoin, Lætitia Gressin, Ouissam Ouili, Läétitia Ninove, Stéphane Priet, Paola Mariela Saba Villarroel, Toscane Fourié, Souand Mohamed Ali, Abdenour Amroun, Morgan Seston, Nazlı Ayhan, Boris Pastorino
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Résumé fourni par la source
Several studies found an association between COVID-19 incidence, cumulated over the first pandemic wave, and the risk of death for infected individuals. They attributed this association to hospital overload. We studied this association across the French departments using 82,467 serological samples and a hierarchical Bayesian model with spatial smoothing. In high-incidence areas, we hypothesized that hospital overload would increase infection fatality rate (IFR) without increasing infection hospitalization rate (IHR). The analyses were adjusted for intensive care beds per capita, age of the population, and diabetes prevalence (as a surrogate for obesity). We found that increasing departmental incidence from 3 to 9% rose IFR from 0.42 to 1.14% (difference 0.72%, 95% CI 0.49-1.01%), and IHR from 1.66 to 3.61% (difference 1.94%, 95% CI 1.18-2.80%). An increase in incidence from 6 to 12% in people under 60 was associated with an increased proportion of people over 60 among those infected, from 11.6 to 17.4% (difference 5.8%, 95% CI 2.9-8.8%). Higher incidence increased the risk of death for infected individuals and their risk of hospitalization by the same magnitude. These findings could be explained by a higher age among infected individuals in high-incidence areas, rather by than hospital overload.
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