Estimation of the SARS-CoV-2 infection fatality rate in Germany

Providing an answer to the question "How deadly is the coronavirus?" is hampered by several obstacles, in particular, an inherent sample selection effect: A large number of SARS-CoV-2 infections are asymptomatic or induce mild courses of COVID-19 and thus go undetected and unreported. An assessment of the infection fatality rate (IFR) by using officially reported infections and COVID-19-asociated fatalities is thus severely biased. Seroepidemiological studies (as conducted, for example, in Ischgl and Gangelt) are an alternative, but they present other challenges, in particular the typically very small number of reported COVID-19-associated deaths upon which the computation of the IFR must be based.

In the paper "Estimation of the SARS-CoV-2 infection fatality rate in Germany", the interdisciplinary research team composed of Dr. Sönksen, Professor Dimpfl and Professor Grammig (University of Tübingen) as well as Professor Ingo Bechmann from the University of Leipzig's Institute of Anatomy proposes a method that tackles the sample selection issue. Applied to data from Germany, the resulting estimate of 0.83% (95% confidence interval: [0.69%; 0.98%]) is notably higher than the IFR estimate reported in the seroepidemiological study of the German infection hotspot Gangelt by Streeck et al., which was recently published in Nature Communications (0.36% [0.29%; 0.45%]). Under certain restrictions regarding data availability, the method is applicable in other countries and remains valid in light of mutations, vaccination strategies, and new therapy methods.

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