Infection fatality rate of COVID-19 inferred from seroprevalence data

DSA ADS Course - 2021

Infection fatality rate of COVID-19 inferred from seroprevalence data

Seroprevalence, COVID19, Public Policy, Health Policy, Infection Fatality Rates

It is critical to estimate as soon as possible the infection fatality rate of next pandemic pathogen from seroprevalence data. 

Accurate early estimates of infection fatality rates is critical for optimal strategy and policy decision-making in the next pandemic. We must learn from the failures of the public health establishments (locally and worldwide) and academics during C19 policy response failures.

September, 2021


To estimate the infection fatality rate of coronavirus disease 2019 (COVID-19) from seroprevalence data.


I searched PubMed and preprint servers for COVID-19 seroprevalence studies with a sample size ≥500 as of 9 September 2020. I also retrieved additional results of national studies from preliminary press releases and reports. I assessed the studies for design features and seroprevalence estimates. I estimated the infection fatality rate for each study by dividing the cumulative number of COVID-19 deaths by the number of people estimated to be infected in each region. I corrected for the number of immunoglobin (Ig) types tested (IgG, IgM, IgA).


I included 61 studies (74 estimates) and eight preliminary national estimates. Seroprevalence estimates ranged from 0.02% to 53.40%. Infection fatality rates ranged from 0.00% to 1.63%, corrected values from 0.00% to 1.54%. Across 51 locations, the median COVID-19 infection fatality rate was 0.27% (corrected 0.23%): the rate was 0.09% in locations with COVID-19 population mortality rates less than the global average (<118 deaths/million), 0.20% in locations with 118–500 COVID-19 deaths/million people and 0.57% in locations with >500 COVID-19 deaths/million people. In people younger than 70 years, infection fatality rates ranged from 0.00% to 0.31% with crude and corrected medians of 0.05%.


The infection fatality rate of COVID-19 can vary substantially across different locations and this may reflect differences in population age structure and case-mix of infected and deceased patients and other factors. The inferred infection fatality rates tended to be much lower than estimates made earlier in the pandemic.


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