{"doi":"10.1016/j.jiph.2025.102698","title":"COVID-19 case fatality rate and infection fatality rate from 2020 to 2023: Nationwide analysis in Austria","abstract":"<h4>Background</h4>Comprehensive analyses of COVID-19 case fatality rates (CFRs) and infection fatality rates (IFRs) that span the entire pandemic are not yet available but critical to retrospectively evaluate the COVID-19 disease burden and its related public health policies. We used nationwide individual participant data from Austria, the continental country with the highest SARS-CoV-2 testing rate per capita, to calculate COVID-19 CFR and estimate IFR covering the entire pandemic.<h4>Methods</h4>This retrospective observational study included all Austrian residents and covered the time from February 2020 to May 2023, examining CFRs overall, monthly, and during dominant SARS-CoV-2 variant periods. CFRs were calculated for the whole population and stratified according to immunization status (presence of previous vaccination and/or infection), age, gender and nursing home residency. We additionally estimated the IFRs based on estimations of undocumented infections using a test positivity model.<h4>Results</h4>The overall CFR of 30-day COVID-19 mortality was 0.31 % but varied depending on month, with the highest being 5.9 % in April 2020 and the lowest 0.07 % in January 2022. The variant periods reflected this trend of decreasing CFR, with the highest for Wuhan-Hu-1 (2.05 %) and the lowest for BA.1 (0.08 %). Overall CFRs were particularly high in the group without any previous immunizing event (0.67 %), the elderly (85 + year group: 7.88 %) and in nursing home residents (7.92 %). Nursing home residents accounted for 30.82 % of all COVID-19 deaths while representing only 1.22 % of diagnosed infections. Total SARS-CoV-2 infections were estimated to be almost double than confirmed cases with a corresponding overall IFR of 0.16 %.<h4>Conclusion</h4>This estimation of nationwide CFR and IFR across the entirety of the SARS-CoV-2 pandemic gives crucial insights into the period-dependent variability of the severity of diagnosed COVID-19 cases and its risk factors. Our findings further underline the disproportionate severity of COVID-19 among the elderly and especially nursing home residents.","journal":"Journal of Infection and Public Health","year":2025,"id":5539,"datarank":0.31191623125197543,"base_score":2.0794415416798357,"endowment":2.0794415416798357,"self_citation_contribution":0.31191623125197543,"citation_network_contribution":0.0,"self_endowment_contribution":0.31191623125197543,"citer_contribution":0.0,"corpus_percentile":47.35557363710333,"corpus_rank":648,"citation_count":8,"citer_count":3,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.8083,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-04-01","fair_score":23.3333,"fair_percentile":2.550571679859279,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":17137,"name":"Alena Chalupka","orcid":"0009-0000-3291-1456","position":1,"is_corresponding":false},{"id":17138,"name":"Lukas Richter","orcid":"0000-0001-6982-6239","position":2,"is_corresponding":false},{"id":17139,"name":"Martin Sprenger","orcid":"0000-0002-7232-6515","position":3,"is_corresponding":false},{"id":14475,"name":"Wolfgang Rauch","orcid":"0000-0002-6462-2832","position":4,"is_corresponding":false},{"id":3316,"name":"Robert Krause","orcid":"0000-0003-1558-0397","position":5,"is_corresponding":false},{"id":17140,"name":"Peter Willeit","orcid":"0000-0002-1866-7159","position":6,"is_corresponding":false},{"id":54429,"name":"Harald Schennach","orcid":null,"position":7,"is_corresponding":false},{"id":54430,"name":"Bernhard Benka","orcid":"0000-0002-0913-8677","position":8,"is_corresponding":false},{"id":42714,"name":"Dirk Werber","orcid":"0000-0002-8076-788X","position":9,"is_corresponding":false},{"id":17141,"name":"Tracy  Beth Høeg","orcid":"0000-0002-2341-6573","position":10,"is_corresponding":false},{"id":3313,"name":"Stefan Pilz","orcid":"0000-0002-7959-1311","position":12,"is_corresponding":false},{"id":148,"name":"John P. 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Ioannidis","orcid":"0000-0003-3118-6859","position":13,"is_corresponding":false},{"id":14474,"name":"Uwe Riedmann","orcid":"0000-0002-2541-9604","position":0,"is_corresponding":true}],"reference_count":41,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-03-01T18:20:47.508186Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":"gold","license":"cc-by","views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":32.0,"fair_a":48.0,"fair_i":0.0,"fair_r":13.3333,"fair_zscore":-1.979,"fair_rationale":{"fair_score":23.33,"has_llm":true,"dimensions":{"F":{"name":"Findable","score":32.0,"criteria":[{"key":"f_has_doi","label":"Has a persistent DOI","kind":"deterministic","weight":1.0,"fraction":1.0,"signal":"DOI present","rationale":null},{"key":"f_repository_presence","label":"Indexed in repositories / literature DBs","kind":"deterministic","weight":1.0,"fraction":0.0,"signal":"datacite=0, pmcid=False, pmid=False","rationale":null},{"key":"f_persistent_ids","label":"Resolvable scholarly identifiers (OpenAlex)","kind":"deterministic","weight":0.5,"fraction":0.0,"signal":"no OpenAlex id","rationale":null},{"key":"f_metadata_richness","label":"Rich, machine-readable metadata","kind":"llm","weight":1.0,"fraction":0.0,"signal":null,"rationale":"The paper provides no metadata, machine-readable or otherwise, beyond the title and abstract."}]},"A":{"name":"Accessible","score":48.0,"criteria":[{"key":"a_open_access","label":"Open Access / files deposited","kind":"deterministic","weight":1.5,"fraction":1.0,"signal":"Open Access","rationale":null},{"key":"a_retrievable","label":"Free full text retrievable","kind":"deterministic","weight":1.0,"fraction":0.0,"signal":"0 OA location(s)","rationale":null},{"key":"a_access_protocol","label":"Clear data/code access protocol","kind":"llm","weight":1.0,"fraction":0.0,"signal":null,"rationale":"No protocol for accessing data or code is mentioned, nor any repository or contact for requests."}]},"I":{"name":"Interoperable","score":0.0,"criteria":[{"key":"i_linked_data","label":"Linked datasets / DataCite relations","kind":"deterministic","weight":1.0,"fraction":0.0,"signal":"linked_datasets=0, datacite=0","rationale":null},{"key":"i_standard_ids","label":"References data via standard accessions","kind":"deterministic","weight":1.0,"fraction":0.0,"signal":"accessions=0, trials=0","rationale":null},{"key":"i_standards","label":"Standard formats, vocabularies & identifiers","kind":"llm","weight":1.0,"fraction":0.0,"signal":null,"rationale":"The text does not specify use of standard formats, vocabularies, or persistent identifiers (e.g., DOIs for data)."}]},"R":{"name":"Reusable","score":13.33,"criteria":[{"key":"r_license","label":"Clear, open reuse license","kind":"deterministic","weight":1.5,"fraction":0.0,"signal":"no license","rationale":null},{"key":"r_downloads","label":"Demonstrated reuse (downloads)","kind":"deterministic","weight":0.5,"fraction":0.0,"signal":"downloads=0","rationale":null},{"key":"r_version","label":"Versioned / maintained","kind":"deterministic","weight":0.5,"fraction":0.0,"signal":"no version chain","rationale":null},{"key":"r_dataset","label":"Classified as a data resource","kind":"deterministic","weight":0.5,"fraction":1.0,"signal":"is_dataset","rationale":null},{"key":"r_reusability","label":"Data-availability statement, license & reproducibility","kind":"llm","weight":2.0,"fraction":0.0,"signal":null,"rationale":"No data-availability statement, license, or reproducibility information is provided in the text."}]}},"suggestions":["Provide a machine-readable metadata file (e.g., DataCite XML) and deposit it with the paper.","Include a clear data-access statement with a repository link (e.g., Zenodo, Figshare) and contact for data requests.","Use standard vocabularies (e.g., ICD-10 codes) and persistent identifiers (DOIs, ORCIDs) for all relevant entities and outputs.","Add a license (e.g., CC BY 4.0) and a reproducibility section detailing how others can obtain or replicate the data and code."],"model":"deepseek/deepseek-v4-flash","agent_version":"fair_agent_v2","fulltext_source":"abstract_only"},"fair_model":"deepseek/deepseek-v4-flash","fair_agent_version":"fair_agent_v2","fair_fulltext_source":"abstract_only","fair_has_llm":true,"fair_computed_at":"2026-06-18T00:50:49.183575Z","clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}