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00925njm 22002777a 4500 dc Pastor-Barriuso, Roberto author Perez-Gomez, Beatriz author Hernán, Miguel A author Perez-Olmeda, Mayte author Yotti-Alvarez, Raquel author Oteo-Iglesias, Jesus author Sanmartín, Jose L author Leon-Gomez, Inmaculada author Fernandez-Garcia, Aurora author Fernandez-Navarro, Pablo L author Cruz, Israel author Martín, Mariano author Delgado-Sanz, Concepcion author Fernandez de Larrea-Baz, Nerea author León Paniagua, Jose author Muñoz-Montalvo, Juan F author Blanco, Faustino author Larrauri, Amparo author Pollan-Santamaria, Marina author ENE-COVID Study Group author 2020-11-27 To estimate the infection fatality risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), based on deaths with confirmed coronavirus disease 2019 (covid-19) and excess deaths from all causes. Nationwide seroepidemiological study. First wave of covid-19 pandemic in Spain. Community dwelling individuals of all ages. The main outcome measure was overall, and age and sex specific, infection fatality risk for SARS-CoV-2 (the number of covid-19 deaths and excess deaths divided by the estimated number of SARS-CoV-2 infections) in the community dwelling Spanish population. Deaths with laboratory confirmed covid-19 were obtained from the National Epidemiological Surveillance Network (RENAVE) and excess all cause deaths from the Monitoring Mortality System (MoMo), up to 15 July 2020. SARS-CoV-2 infections in Spain were derived from the estimated seroprevalence by a chemiluminescent microparticle immunoassay for IgG antibodies in 61 098 participants in the ENE-COVID nationwide seroepidemiological survey between 27 April and 22 June 2020. The overall infection fatality risk was 0.8% (19 228 of 2.3 million infected individuals, 95% confidence interval 0.8% to 0.9%) for confirmed covid-19 deaths and 1.1% (24 778 of 2.3 million infected individuals, 1.0% to 1.2%) for excess deaths. The infection fatality risk was 1.1% (95% confidence interval 1.0% to 1.2%) to 1.4% (1.3% to 1.5%) in men and 0.6% (0.5% to 0.6%) to 0.8% (0.7% to 0.8%) in women. The infection fatality risk increased sharply after age 50, ranging from 11.6% (8.1% to 16.5%) to 16.4% (11.4% to 23.2%) in men aged 80 or more and from 4.6% (3.4% to 6.3%) to 6.5% (4.7% to 8.8%) in women aged 80 or more. The increase in SARS-CoV-2 infection fatality risk after age 50 appeared to be more noticeable in men than in women. Based on the results of this study, fatality from covid-19 was greater than that reported for other common respiratory diseases, such as seasonal influenza. BMJ. 2020 Nov 27;371:m4509. 10.1136/bmj.m4509 1756-1833 BMJ (Clinical research ed.) 33246972 http://hdl.handle.net/20.500.12105/11485 Infection fatality risk for SARS-CoV-2 in community dwelling population of Spain: nationwide seroepidemiological study