Estimates of SARS-CoV-2 Hospitalization and Fatality Rates in the Prevaccination Period, United States

Emerg Infect Dis. 2024 Jun;30(6):1144-1153. doi: 10.3201/eid3006.231285.

Abstract

Few precise estimates of hospitalization and fatality rates from COVID-19 exist for naive populations, especially within demographic subgroups. We estimated rates among persons with SARS-CoV-2 infection in the United States during May 1-December 1, 2020, before vaccines became available. Both rates generally increased with age; fatality rates were highest for persons >85 years of age (24%) and lowest for children 1-14 years of age (0.01%). Age-adjusted case hospitalization rates were highest for African American or Black, not Hispanic persons (14%), and case-fatality rates were highest for Asian or Pacific Islander, not Hispanic persons (4.4%). Eighteen percent of hospitalized patients and 44.2% of those admitted to an intensive care unit died. Male patients had higher hospitalization (6.2% vs. 5.2%) and fatality rates (1.9% vs. 1.5%) than female patients. These findings highlight the importance of collecting surveillance data to devise appropriate control measures for persons in underserved racial/ethnic groups and older adults.

Keywords: 2019 novel coronavirus disease; COVID-19; SARS-CoV-2; United States; hospitalization; severe acute respiratory syndrome coronavirus 2; vaccine-preventable diseases; viruses.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • COVID-19 Vaccines / administration & dosage
  • COVID-19* / epidemiology
  • COVID-19* / mortality
  • Child
  • Child, Preschool
  • Ethnicity / statistics & numerical data
  • Female
  • Hospitalization* / statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • SARS-CoV-2*
  • United States / epidemiology
  • Young Adult

Substances

  • COVID-19 Vaccines