Estimates of asymptomatic/hospitalization/ventilation, and case fatality rates (Table)

Clinical Question

What are the best current estimates for the asymptomatic rate, hospitalized rate, ventilated rate, and case fatality rate?

Summary of Information

Asymptomatic Rate

Hospitalized Rate

Ventilated Rate

Case fatality Rate

Global

See below

See below

0.25-4.4%[1][2][3]

EU

N/A

30% (11-41%)[4]

4% (2-8%) [4]

Italy: 9.5%[3]

Spain: 7.7%[3]

Germany: 0.6%[3]

France: 5.7%[3]

UK: 5.2%[3]

Switzerland: 1.7%[3]

Netherlands: 6.3%[3]

Austria: 0.8%[3]

Belgium: 4.0%[3]

Portugal: 1.8%[3]

Norway: 0.5%[3]

Sweden: 3.0%[3]

Denmark: 2.4%[3]

China

Most recent: 3.48%[2]1.2[5]§-33.3%[6]

Of 138 hospitalized patients, 36 (26.0%) were transferred to ICU. Of 36, 4 (11.1%) received high-flow O2 therapy, 15 (41.7%) received noninvasive ventilation, 17 (47.2%) received invasive ventilation including 4 extracorporeal membrane oxygenation.[7]

6.1% mechanical ventilation[8]

2.3%[9]-3.6%[10]-4.3%[7]

5.6%[10]

(Wuhan City 18.9%10)

United States

N/A. Studies have just begun

20.7 - 30.4%[11]

4.9 - 11.5%[11]

Overall: 1.4%[3][12]

New York: 1.2%[3]

California: 2.0%[3]

Washington: 4.7%[3]

Louisiana: 4.3%[3]

Michigan: 2.1%[3]

Florida: 1.2%[3]

Diamond Princess Cruise

16.1-50.6%[10]

Estimated 17.9% based on model(95% Crl 15.5-20.2%)[13]

37 of 381 symptomatic patients required intensive care (9.7%)[14]

9 of 381 symptomatic patients died (1.3%)[14]

1.2-2.3%[15]

Author Information

Authors: Lucas Keyt MS4, Zoey ZoBell MS4, Peter Clements MS4, UC San Diego School of Medicine
Completed on: March 29, 2020
Revisions: Not yet revised

Reviewed by: Marsha-Gail Davis
Reviewed on: 4/18/2020

This summary was written as part of the CoRESPOND Earth 2.0 COVID-19 Rapid Response at UC San Diego. For more information about the project, please visit http://earth2-covid.ucsd.edu

References

  1. Situation update worldwide, as of 29 April 2020. European Centre for Disease Prevention and Control. https://www.ecdc.europa.eu/en/geographical-distribution-2019-ncov-cases. Accessed April 29, 2020.
  2. Wilson N, Kvalsvig A, Barnard LT, et al. Case-Fatality Risk Estimates for COVID-19 Calculated by Using a Lag Time for Fatality. Emerg Infect Dis. 2020;26(6).  [PMID:32168463]
  3. Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020.  [PMID:32087114]
  4. Coronavirus Disease 2019 (COVID-19)Pandemic: Increased Transmission in the EU/EEA and the UK – Seventh Update. European Centre for Disease Prevention and Control, Stockholm; 2020. https://www.ecdc.europa.eu/sites/default/files/documents/RRA-seventh-update-Outbreak-of-coronavirus-disease-COVID-19.pdf.
  5. Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. [The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China]. Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41(2):145-151.  [PMID:32064853]
  6. Nishiura H, Kobayashi T, Suzuki A, et al. Estimation of the asymptomatic ratio of novel coronavirus infections (COVID-19). Int J Infect Dis. 2020.  [PMID:32179137]
  7. Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020.  [PMID:32031570]
  8. Guan WJ, Ni ZY, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020.  [PMID:32109013]
  9. Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. [The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China]. Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41(2):145-151. doi:10.3760/cma.j.issn.0254-6450.2020.02.003
  10. Baud D, Qi X, Nielsen-Saines K, et al. Real estimates of mortality following COVID-19 infection. Lancet Infect Dis. 2020.  [PMID:32171390]
  11. “Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United States, February 12–March 16, 2020.” Morbidity and Mortality Weekly Report. CDC Covid-19 Response Team.
  12. Coronavirus Disease 2019 (COVID-19). Center for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html. Published April 24, 2020.
  13. Mizumoto K, Kagaya K, Zarebski A, et al. Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Euro Surveill. 2020;25(10).  [PMID:32183930]
  14. Ministry of Health, Labour and Welfare. About new coronavirus infections [Japanese]. Tokyo, Japan: Ministry of Health, Labour and Welfare; 2020. https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000164708_00001.htmlexternal icon
  15. Russell TW, Hellewell J, Jarvis CI, et al. Estimating the infection and case fatality ratio for coronavirus disease (COVID-19) using age-adjusted data from the outbreak on the Diamond Princess cruise ship, February 2020. Euro Surveill. 2020;25(12).  [PMID:32234121]
  16. Mizumoto K, Chowell G. Estimating the Risk of 2019 Novel Coronavirus Death during the Course of the Outbreak in China, 2020. Infectious Diseases (except HIV/AIDS); 2020. doi:10.1101/2020.02.19.20025163