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Pearce N, Moirano G, Maule M, et al. Does death from Covid-19 arise from a multi-step process?. Eur J Epidemiol. 2021;36(1):1-9doi: 10.1007/s10654-020-00711-7.
Pearce, N., Moirano, G., Maule, M., Kogevinas, M., Rodo, X., Lawlor, D. A., Vandenbroucke, J., Vandenbroucke-Grauls, C., Polack, F. P., & Custovic, A. (2021). Does death from Covid-19 arise from a multi-step process?. European journal of epidemiology, 36(1), 1-9. https://doi.org/10.1007/s10654-020-00711-7
Pearce, Neil, et al. "Does death from Covid-19 arise from a multi-step process?." European journal of epidemiology vol. 36,1 (2021): 1-9. doi: https://doi.org/10.1007/s10654-020-00711-7
Pearce N, Moirano G, Maule M, Kogevinas M, Rodo X, Lawlor DA, Vandenbroucke J, Vandenbroucke-Grauls C, Polack FP, Custovic A. Does death from Covid-19 arise from a multi-step process?. Eur J Epidemiol. 2021 Jan;36(1):1-9. doi: 10.1007/s10654-020-00711-7. Epub 2021 Jan 18. PMID: 33459897; PMCID: PMC7812338.
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Eur J Epidemiol. 2021 Jan;36(1):1-9. doi: 10.1007/s10654-020-00711-7. Epub 2021 Jan 18.

Does death from Covid-19 arise from a multi-step process?.

European journal of epidemiology

Neil Pearce, Giovenale Moirano, Milena Maule, Manolis Kogevinas, Xavier Rodo, Deborah A Lawlor, Jan Vandenbroucke, Christina Vandenbroucke-Grauls, Fernando P Polack, Adnan Custovic

Affiliations

  1. London School of Hygiene and Tropical Medicine, London, UK. [email protected].
  2. Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin, Turin, Italy.
  3. ISGlobal, Barcelona, Spain.
  4. IMIM (Hospital del Mar Research Institute), Barcelona, Spain.
  5. ICREA, Barcelona, Spain.
  6. MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.
  7. Population Health, Bristol Medical School, University of Bristol, Bristol, UK.
  8. London School of Hygiene and Tropical Medicine, London, UK.
  9. Leiden University Medical Center, Leiden, The Netherlands.
  10. Aarhus University, Aarhus, Denmark.
  11. Department of Medical Microbiology and Infection Prevention, Amsterdam UMC, Amsterdam, The Netherlands.
  12. Fundacion INFANT, Buenos Aires, Argentina.
  13. Department of Pediatrics, Vanderbilt University, Nashville, TN, USA.
  14. National Heart and Lung Institute, Imperial College London, London, UK.

PMID: 33459897 PMCID: PMC7812338 DOI: 10.1007/s10654-020-00711-7

Abstract

The Covid-19 death rate increases exponentially with age, and the main risk factors are having underlying conditions such as hypertension, diabetes, cardiovascular disease, severe chronic respiratory disease and cancer. These characteristics are consistent with the multi-step model of disease. We applied this model to Covid-19 case fatality rates (CFRs) from China, South Korea, Italy, Spain and Japan. In all countries we found that a plot of log(CFR) against log(age) was approximately linear with a slope of about 5. We also conducted similar analyses for selected other respiratory diseases. SARS showed a similar log-log age-pattern to that of Covid-19, albeit with a lower slope, whereas seasonal and pandemic influenza showed quite different age-patterns. Thus, death from Covid-19 and SARS appears to follow a distinct age-pattern, consistent with a multi-step model of disease that in the case of Covid-19 is probably defined by comorbidities and age producing immune-related susceptibility.

Keywords: Covid-19; Epidemiology; Infectious diseases; Mortality

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