Infection fatality rate of SARS-CoV2 in a super-spreading event in Germany

• Published in: Nature communications Vol. 11; no. 1; p. 5829
• Main Authors: Streeck, Hendrik, Schulte, Bianca, Kümmerer, Beate M., Richter, Enrico, Höller, Tobias, Fuhrmann, Christine, Bartok, Eva, Dolscheid-Pommerich, Ramona, Berger, Moritz, Wessendorf, Lukas, Eschbach-Bludau, Monika, Kellings, Angelika, Schwaiger, Astrid, Coenen, Martin, Hoffmann, Per, Stoffel-Wagner, Birgit, Nöthen, Markus M., Eis-Hübinger, Anna M., Exner, Martin, Schmithausen, Ricarda Maria, Schmid, Matthias, Hartmann, Gunther
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 17.11.2020; Nature Publishing Group; Nature Portfolio
• Subjects: 49/1; 49/90; 631/326/596/4130; 692/308/174; 692/699/255/2514; Adolescent; Adult; Age; Aged; Aged, 80 and over; Biomaterials; Biomedical materials; Child; Community involvement; Community participation; Comorbidity; COVID-19 - epidemiology; COVID-19 - etiology; COVID-19 - mortality; COVID-19 - transmission; COVID-19 Testing - statistics & numerical data; Family Characteristics; Fatalities; Female; Germany - epidemiology; Humanities and Social Sciences; Humans; Immunoglobulin G; Immunoglobulin G - blood; Infections; Male; Middle Aged; Mortality; multidisciplinary; Pandemics; Polymerase Chain Reaction; Population; Population characteristics; Population studies; Prevalence; SARS-CoV-2 - genetics; Science; Science (multidisciplinary); Seroepidemiology; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Spreading; Viral diseases; Young Adult; Germany
• ISSN: 2041-1723; 2041-1723
• DOI: 10.1038/s41467-020-19509-y

A SARS-CoV2 super-spreading event occurred during carnival in a small town in Germany. Due to the rapidly imposed lockdown and its relatively closed community, this town was seen as an ideal model to investigate the infection fatality rate (IFR). Here, a 7-day seroepidemiological observational study was performed to collect information and biomaterials from a random, household-based study population. The number of infections was determined by IgG analyses and PCR testing. We found that of the 919 individuals with evaluable infection status, 15.5% (95% CI:[12.3%; 19.0%]) were infected. This is a fivefold higher rate than the reported cases for this community (3.1%). 22.2% of all infected individuals were asymptomatic. The estimated IFR was 0.36% (95% CI:[0.29%; 0.45%]) for the community and 0.35% [0.28%; 0.45%] when age-standardized to the population of the community. Participation in carnival increased both infection rate (21.3% versus 9.5%, p  < 0.001) and number of symptoms (estimated relative mean increase 1.6, p  = 0.007). While the infection rate here is not representative for Germany, the IFR is useful to estimate the consequences of the pandemic in places with similar healthcare systems and population characteristics. Whether the super-spreading event not only increases the infection rate but also affects the IFR requires further investigation. Here the authors present a SARS-CoV2 seroepidemiological observational study from a random, household-based study population in a small town in Germany, showing the effect of a super-spreading event on infection rate, severity, and potentially infection fatality rate.