Several studies found an association between COVID-19 incidence, cumulated over the first pandemic wave, and the risk of death for infected individuals. They attributed this association to hospital overload. We studied this association across the French departments using 82,467 serological samples and a hierarchical Bayesian model with spatial smoothing. In high-incidence areas, we hypothesized that hospital overload would increase infection fatality rate (IFR) without increasing infection hospitalization rate (IHR). The analyses were adjusted for intensive care beds per capita, age of the population, and diabetes prevalence (as a surrogate for obesity). We found that increasing departmental incidence from 3 to 9% rose IFR from 0.42 to 1.14% (difference 0.72%, 95% CI 0.49-1.01%), and IHR from 1.66 to 3.61% (difference 1.94%, 95% CI 1.18-2.80%). An increase in incidence from 6 to 12% in people under 60 was associated with an increased proportion of people over 60 among those infected, from 11.6 to 17.4% (difference 5.8%, 95% CI 2.9-8.8%). Higher incidence increased the risk of death for infected individuals and their risk of hospitalization by the same magnitude. These findings could be explained by a higher age among infected individuals in high-incidence areas, rather by than hospital overload.
Auteur : Glemain Benjamin, Assaad Charles, Ghosn Walid, Moulaire Paul, de Lamballerie Xavier, Zins Marie, Severi Gianluca, Touvier Mathilde, Deleuze Jean-François, Lapidus Nathanaël, Carrat Fabrice, Ancel Pierre-Yves, Charles Marie-Aline, Kab Sofiane, Renuy Adeline, Le-Got Stephane, Ribet Celine, Pellicer Mireille, Wiernik Emmanuel, Goldberg Marcel, Artaud Fanny, Gerbouin-Rérolle Pascale, Enguix Mélody, Laplanche Camille, Gomes-Rima Roselyn, Hoang Lyan, Correia Emmanuelle, Barry Alpha Amadou, Senina Nadège, Allegre Julien, Szabo de Edelenyi Fabien, Druesne-Pecollo Nathalie, Esseddik Younes, Hercberg Serge, Deschasaux Mélanie, Benhammou Valérie, Ritmi Anass, Marchand Laetitia, Zaros Cecile, Lordmi Elodie, Candea Adriana, de Visme Sophie, Simeon Thierry, Thierry Xavier, Geay Bertrand, Dufourg Marie-Noelle, Milcent Karen, Rahib Delphine, Lydié Nathalie, Lusivika-Nzinga Clovis, Pannetier Gregory, Lapidus Nathanael, Goderel Isabelle, Dorival Céline, Nicol Jérôme, Robineau Olivier, Lai Cindy, Belhadji Liza, Esperou Hélène, Couffin-Cadiergues Sandrine, Gagliolo Jean-Marie, Blanché Hélène, Sébaoun Jean-Marc, Beaudoin Jean-Christophe, Gressin Laetitia, Morel Valérie, Ouili Ouissam, Ninove Laetitia, Priet Stéphane, Villarroel Paola Mariela Saba, Fourié Toscane, Mohamed Ali Souand, Amroun Abdenour, Seston Morgan, Ayhan Nazli, Pastorino Boris
Scientific reports, 2025, vol. 15, n°. 1, p. 15638
