Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 26, Number 6—June 2020
Research Letter

Case-Fatality Risk Estimates for COVID-19 Calculated by Using a Lag Time for Fatality

Nick WilsonComments to Author , Amanda Kvalsvig, Lucy Telfar Barnard, and Michael G. Baker
Author affiliations: University of Otago Department of Public Health, Wellington, New Zealand

Main Article


Crude and adjusted estimates of case-fatality risk for COVID-19 in 4 populations*

Location Cumulative deaths† Cumulative confirmed cases† Crude CFR, % Adjusted deaths‡ Adjusted cumulative confirmed cases‡ Adjusted CFR, % (95% CI)§
China¶ 3,015 80,565 3.74 2,627 75,569 3.48 (3.35–3.61)
China, excluding Hubei Province# 113 13,099 0.86 104 12,907 0.81 (0.67–0.98)
82 countries, territories, and areas** 27 2,285 1.18 15 354 4.24 (2.58–6.87)
Cruise ship
0.63 (0.25–1.61)
*CFR, case-fatality risk; COVID-19, coronavirus disease.
†Calculated by using data on laboratory-confirmed COVID-19 cases reported by the World Health Organization on March 5, 2020 (1).
‡Calculated by using cumulative confirmed cases as of February 21, 2020.
§Calculated using OpenEpi v3 ( by using the Score (Wilson) method.
¶Includes Hong Kong, Macau, and Taiwan.
#We excluded Hubei Province because COVID-19 appears to have originated in this province and cases might have been missed because of shortages of appropriate diagnostic tests or health system overload.
**Includes 82 countries, territories, and areas outside of China and reporting cases on March 5, 2020; excludes areas with >500 cases (i.e., Italy, Iran, and South Korea) because of the possibility of uncontrolled spread and missed diagnoses in these localities.

Main Article

  1. World Health Organization. Coronavirus disease 2019 (COVID-19) situation report—45, 5 Mar 2020 [cited 2020 Mar 6].
  2. Cowling  BJ, Leung  GM. Epidemiological research priorities for public health control of the ongoing global novel coronavirus (2019-nCoV) outbreak. Euro Surveill. 2020;25: Epub ahead of print. DOIPubMedGoogle Scholar
  3. Donnelly  CA, Ghani  AC, Leung  GM, Hedley  AJ, Fraser  C, Riley  S, et al. Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong. Lancet. 2003;361:17616. DOIPubMedGoogle Scholar
  4. Yang  X, Yu  Y, Xu  J, Shu  H, Xia  J, Liu  H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;S2213-2600(20)30079-5; Epub ahead of print. DOIPubMedGoogle Scholar
  5. World Health Organization. Coronavirus disease 2019 (COVID-19) situation report—32, 21 Feb 2020 [cited 2020 Mar 6].
  6. Linton  NM, Kobayashi  T, Yang  Y, Hayashi  K, Akhmetzhanov  AR, Jung  SM, et al. Incubation period and other epidemiological characteristics of 2019 novel coronavirus infections with right truncation: a statistical analysis of publicly available case data. J Clin Med. 2020;9:538. DOIPubMedGoogle Scholar
  7. National Institute of Infectious Diseases. Japan. Field briefing: Diamond Princess COVID-19 cases, 19 February 2020 [cited 2020 Feb 29].
  8. The Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19)—China, 2020. China CDC Weekly 2020 [cited 2020 Feb 29].

Main Article

Page created: May 19, 2020
Page updated: May 19, 2020
Page reviewed: May 19, 2020
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.