Journal
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
Volume 51, Issue 2, Pages 429-439Publisher
OXFORD UNIV PRESS
DOI: 10.1093/ije/dyac015
Keywords
SARS-CoV-2; COVID-19; fatality; infection fatality rate; pandemic; seroepidemiologic study; Mexico
Categories
Funding
- Mexican Government through the National Health and Nutrition Survey
- Centers for Disease Control and Prevention of the United States of America through the CDC-Mexico Cooperative Agreement for Surveillance, Epidemiology, and Laboratory Capacity [NU50CK000493]
- Consejo Nacional de Ciencia y Tecnologia [FORDECYT-PRONACES/1303/20]
Ask authors/readers for more resources
The infection fatality rates (IFRs) of SARS-CoV-2 in Mexico increased with age, with variations across urban and rural areas and regions, indicating potential influences of population characteristics, pandemic containment measures, and healthcare capabilities on lethality at the local level.
Background Estimates of SARS-CoV-2 infection fatality rates (IFRs) in developing countries remain poorly characterized. Mexico has one of the highest reported COVID-19 case-fatality rates worldwide, although available estimates do not consider serologic assessment of prior exposure nor all SARS-CoV-2-related deaths. We aimed to estimate sex- and age-specific IFRs for SARS-CoV-2 in Mexico. Methods The total number of people in Mexico with evidence of prior SARS-CoV-2 infection was derived from National Survey of Health and Nutrition-COVID-19 (ENSANUT 2020 Covid-19)-a nationally representative serosurvey conducted from August to November 2020. COVID-19 mortality data matched to ENSANUT's dates were retrieved from the death-certificate registry, which captures the majority of COVID-19 deaths in Mexico, and from the national surveillance system, which covers the subset of COVID-19 deaths that were identified by the health system and were confirmed through a positive polymerase chain reaction test. We analysed differences in IFRs by urbanization and region. Results The national SARS-CoV-2 IFR was 0.47% (95% CI 0.44, 0.50) using death certificates and 0.30% (95% CI 0.28, 0.33) using surveillance-based deaths. The IFR increased with age, being close to zero at age <30 years, but increasing to 1% at ages 50-59 years in men and 60-69 years in women, and being the highest at >= 80 years for men (5.88%) and women (6.23%). Across Mexico's nine regions, Mexico City (0.99%) had the highest and the Peninsula (0.26%) the lowest certificate-based IFRs. Metropolitan areas had higher certificate-based IFR (0.63%) than rural areas (0.17%). Conclusion After the first wave of the COVID-19 pandemic, the overall IFR in Mexico was comparable with those of European countries. The IFR in Mexico increased with age and was higher in men than in women. The variations in IFRs across regions and places of residence within the country suggest that structural factors related to population characteristics, pandemic containment and healthcare capabilities could have influenced lethality at the local level.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available