Age could be driving variable SARS-CoV-2 epidemic trajectories worldwide

PLoS One. 2020 Aug 20;15(8):e0237959. doi: 10.1371/journal.pone.0237959. eCollection 2020.

Abstract

Current geographic spread of documented severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections shows heterogeneity. This study explores the role of age in potentially driving differentials in infection spread, epidemic potential, and rates of disease severity and mortality across countries. An age-stratified deterministic mathematical model that describes SARS-CoV-2 transmission dynamics was applied to 159 countries and territories with a population ≥1 million. Assuming worst-case scenario for the pandemic, the results indicate that there could be stark regional differences in epidemic trajectories driven by differences in the distribution of the population by age. In the African Region (median age: 18.9 years), the median R0 was 1.05 versus 2.05 in the European Region (median age: 41.7 years), and the median (per 100 persons) for the final cumulative infection incidence was 22.5 (versus 69.0), for severe and/or critical disease cases rate was 3.3 (versus 13.0), and for death rate was 0.5 (versus 3.9). Age could be a driver of variable SARS-CoV-2 epidemic trajectories worldwide. Countries with sizable adult and/or elderly populations and smaller children populations may experience large and rapid epidemics in absence of interventions. Meanwhile, countries with predominantly younger age cohorts may experience smaller and slower epidemics. These predictions, however, should not lead to complacency, as the pandemic could still have a heavy toll nearly everywhere.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Betacoronavirus*
  • COVID-19
  • Child
  • Child, Preschool
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / mortality
  • Coronavirus Infections / transmission*
  • Coronavirus Infections / virology
  • Disease Progression
  • Disease Transmission, Infectious
  • Female
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Models, Theoretical*
  • Mortality
  • Pandemics
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / mortality
  • Pneumonia, Viral / transmission*
  • Pneumonia, Viral / virology
  • SARS-CoV-2
  • Severity of Illness Index
  • Young Adult

Grants and funding

This publication was made possible by NPRP grant number 9-040-3-008 and NPRP grant number 12S-0216-190094 from the Qatar National Research Fund (a member of Qatar Foundation). The authors are also grateful for support provided by the Biomedical Research Program and the Biostatistics, Epidemiology, and Biomathematics Research Core, both at Weill Cornell Medicine-Qatar. GM acknowledges support by UK Research and Innovation as part of the Global Challenges Research Fund, grant number ES/P010873/1. The statements made herein are solely the responsibility of the authors. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The publication of this article was funded by the Qatar National Library.