Underestimation of COVID-19 cases in Japan: an analysis of RT-PCR testing for COVID-19 among 47 prefectures in Japan.
Betacoronavirus
COVID-19
COVID-19 Testing
Clinical Laboratory Techniques
/ methods
Coronavirus Infections
/ diagnosis
Cross-Sectional Studies
Hospital Bed Capacity
/ statistics & numerical data
Humans
Incidence
Japan
/ epidemiology
Pandemics
Pneumonia, Viral
/ diagnosis
Reverse Transcriptase Polymerase Chain Reaction
/ statistics & numerical data
SARS-CoV-2
Journal
QJM : monthly journal of the Association of Physicians
ISSN: 1460-2393
Titre abrégé: QJM
Pays: England
ID NLM: 9438285
Informations de publication
Date de publication:
01 Aug 2020
01 Aug 2020
Historique:
received:
12
05
2020
revised:
12
06
2020
pubmed:
24
6
2020
medline:
15
8
2020
entrez:
24
6
2020
Statut:
ppublish
Résumé
Under the unique Japanese policy to restrict reverse transcriptase-polymerase chain reaction (RT-PCR) testing against severe acute respiratory syndrome coronavirus 2, a nationwide number of its confirmed cases and mortality remains to be low. Yet the information is lacking on geographical differences of these measures and their associated factors. Evaluation of prefecture-based geographical differences and associated predictors for the incidence and number of RT-PCR tests for coronavirus disease 2019 (COVID-19). Cross-sectional study using regression and correlation analysis. We retrieved domestic laboratory-confirmed cases, deaths and the number of RT-PCR testing for COVID-19 from 15 January to 6 April 2020 in 47 prefectures in Japan, using publicly available data by the Ministry of Health, Labour and Welfare. We did descriptive analyses of these three measures and identified significant predictors for the incidence and RT-PCR testing through multiple regression analyses and correlates with the number of deaths through correlation analysis. The median prefectural-level incidence and number of RT-PCR testing per 100 000 population were 1.14 and 38.6, respectively. Multiple regression analyses revealed that significant predictors for the incidence were prefectural-level population (P < 0.001) and the number of RT-PCR testing (P = 0.03); and those for RT-PCR testing were the incidence (P = 0.025), available beds (P = 0.045) and cluster infections (P = 0.034). Considering bidirectional association between the incidence and RT-PCR testing, there may have been an underdiagnosed population for the infection. The restraint policy for RT-PCR testing should be revisited to meet the increasing demand under the COVID-19 epidemic.
Sections du résumé
BACKGROUND
BACKGROUND
Under the unique Japanese policy to restrict reverse transcriptase-polymerase chain reaction (RT-PCR) testing against severe acute respiratory syndrome coronavirus 2, a nationwide number of its confirmed cases and mortality remains to be low. Yet the information is lacking on geographical differences of these measures and their associated factors.
AIM
OBJECTIVE
Evaluation of prefecture-based geographical differences and associated predictors for the incidence and number of RT-PCR tests for coronavirus disease 2019 (COVID-19).
DESIGN
METHODS
Cross-sectional study using regression and correlation analysis.
METHODS
METHODS
We retrieved domestic laboratory-confirmed cases, deaths and the number of RT-PCR testing for COVID-19 from 15 January to 6 April 2020 in 47 prefectures in Japan, using publicly available data by the Ministry of Health, Labour and Welfare. We did descriptive analyses of these three measures and identified significant predictors for the incidence and RT-PCR testing through multiple regression analyses and correlates with the number of deaths through correlation analysis.
RESULTS
RESULTS
The median prefectural-level incidence and number of RT-PCR testing per 100 000 population were 1.14 and 38.6, respectively. Multiple regression analyses revealed that significant predictors for the incidence were prefectural-level population (P < 0.001) and the number of RT-PCR testing (P = 0.03); and those for RT-PCR testing were the incidence (P = 0.025), available beds (P = 0.045) and cluster infections (P = 0.034).
CONCLUSION
CONCLUSIONS
Considering bidirectional association between the incidence and RT-PCR testing, there may have been an underdiagnosed population for the infection. The restraint policy for RT-PCR testing should be revisited to meet the increasing demand under the COVID-19 epidemic.
Identifiants
pubmed: 32573730
pii: 5861542
doi: 10.1093/qjmed/hcaa209
pmc: PMC7454847
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
551-555Informations de copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Références
Ann Intern Med. 2020 May 5;172(9):577-582
pubmed: 32150748
Lancet. 2020 Mar 21;395(10228):931-934
pubmed: 32164834
QJM. 2020 May 28;:
pubmed: 32467977