review · Journal of Medical Virology
Understanding the case fatality rate of COVID-19 requires accounting for geographical and economic disparities over time. An analysis of global pandemic records evaluated fatality rates across continents and national income brackets using pooled estimates alongside fixed and random statistical models. In Asia, case fatality rates hovered between two and three percent before fluctuating, while European rates peaked significantly higher, reaching up to ten percent under certain models. Across income classifications, high-income nations saw rates reach up to eight percent, whereas middle-income nations peaked near four and a half percent, and low-income nations remained between one and a half and three percent. These variations demonstrate that the case fatality rate is not a static measurement. Instead, it serves as a dynamic metric shaped by calendar dates, regional populations, national socioeconomic conditions, and the public health mitigations implemented by respective governments.
Pandemic metrics frequently rely on worldwide averages that conceal substantial regional variations. By demonstrating how fatality rates fluctuate across continents and income levels, this research clarifies that disease severity cannot be judged through a single global figure. Recognising these differences helps public health planners and analysts interpret international epidemiological statistics with greater context and precision.
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The aim of this study is to provide a more accurate representation of COVID-19's case fatality rate (CFR) by performing meta-analyses by continents and income, and by comparing the result with pooled estimates. We used multiple worldwide data sources on COVID-19 for every country reporting COVID-19 cases. On the basis of data, we performed random and fixed meta-analyses for CFR of COVID-19 by continents and income according to each individual calendar date. CFR was estimated based on the different geographical regions and levels of income using three models: pooled estimates, fixed- and random-model. In Asia, all three types of CFR initially remained approximately between 2.0% and 3.0%. In the case of pooled estimates and the fixed model results, CFR increased to 4.0%, by then gradually decreasing, while in the case of random-model, CFR remained under 2.0%. Similarly, in Europe, initially, the two types of CFR peaked at 9.0% and 10.0%, respectively. The random-model results showed an increase near 5.0%. In high-income countries, pooled estimates and fixed-model showed gradually increasing trends with a final pooled estimates and random-model reached about 8.0% and 4.0%, respectively. In middle-income, the pooled estimates and fixed-model have gradually increased reaching up to 4.5%. in low-income countries, CFRs remained similar between 1.5% and 3.0%. Our study emphasizes that COVID-19 CFR is not a fixed or static value. Rather, it is a dynamic estimate that changes with time, population, socioeconomic factors, and the mitigatory efforts of individual countries.
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DOI: 10.1002/jmv.27610
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