Evidence map›Paper›PMID 36341800›Full record

SynthesisEnvironmental research2023

Age-stratified infection fatality rate of COVID-19 in the non-elderly population.

Angelo Maria Pezzullo, Cathrine Axfors, Despina G Contopoulos-Ioannidis, Alexandre Apostolatos, John P A Ioannidis

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Environmental research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
44citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

44 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
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  5. Article
  6. Risks and benefits of face masks in children.Frontiers in pediatrics · 2026
    Review
  7. Article
  8. Article
  9. Article
  10. Article
  11. WHO'Frontiers in public health · 2025
    Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Excess Deaths in Korea During the COVID-19 Pandemic: 2020-2022.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2024
    Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Angelo Maria PezzulloMeta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA; Sezione di Igiene, Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy.
Cathrine AxforsMeta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA.
Despina G Contopoulos-IoannidisMeta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA; Division of Infectious Diseases, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
Alexandre ApostolatosMeta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA; Faculty of Medicine, Université de Montréal, Montreal, Canada.
John P A IoannidisMeta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA; Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, Stanford University, Stanford, CA, USA. Electronic address: jioannid@stanford.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The largest burden of COVID-19 is carried by the elderly, and persons living in nursing homes are particularly vulnerable. However, 94% of the global population is younger than 70 years and 86% is younger than 60 years. The objective of this study was to accurately estimate the infection fatality rate (IFR) of COVID-19 among non-elderly people in the absence of vaccination or prior infection. In systematic searches in SeroTracker and PubMed (protocol: https://osf.io/xvupr), we identified 40 eligible national seroprevalence studies covering 38 countries with pre-vaccination seroprevalence data. For 29 countries (24 high-income, 5 others), publicly available age-stratified COVID-19 death data and age-stratified seroprevalence information were available and were included in the primary analysis. The IFRs had a median of 0.034% (interquartile range (IQR) 0.013-0.056%) for the 0-59 years old population, and 0.095% (IQR 0.036-0.119%) for the 0-69 years old. The median IFR was 0.0003% at 0-19 years, 0.002% at 20-29 years, 0.011% at 30-39 years, 0.035% at 40-49 years, 0.123% at 50-59 years, and 0.506% at 60-69 years. IFR increases approximately 4 times every 10 years. Including data from another 9 countries with imputed age distribution of COVID-19 deaths yielded median IFR of 0.025-0.032% for 0-59 years and 0.063-0.082% for 0-69 years. Meta-regression analyses also suggested global IFR of 0.03% and 0.07%, respectively in these age groups. The current analysis suggests a much lower pre-vaccination IFR in non-elderly populations than previously suggested. Large differences did exist between countries and may reflect differences in comorbidities and other factors. These estimates provide a baseline from which to fathom further IFR declines with the widespread use of vaccination, prior infections, and evolution of new variants.

Indexed as

COVID-19AdolescentAdultChildChild, PreschoolComorbidityHumansInfantInfant, NewbornMiddle AgedSARS-CoV-2Seroepidemiologic StudiesVaccinationYoung AdultBiasCOVID-19EpidemicsInfection fatality rateSeroprevalence

Identifiers

PMID36341800
PMCPMC9613797

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.