Assessment of basic reproductive number for COVID-19 at global level: A meta-analysis

BACKGROUND: There are large knowledge gaps regarding how transmission of 2019 novel coronavirus disease (COVID-19) occurred in different settings across the world. This study aims to summarize basic reproduction number (R(0)) data and provide clues for designing prevention and control measures. METHODS: Several databases and preprint platforms were retrieved for literature reporting R(0) values of COVID-19. The analysis was stratified by the prespecified modeling method to make the R(0) values comparable, and by country/region to explore whether R(0) estimates differed across the world. The average R(0) values were pooled using a random-effects model. RESULTS: We identified 185 unique articles, yielding 43 articles for analysis. The selected studies covered 5 countries from Asia, 5 countries from Europe, 12 countries from Africa, and 1 from North America, South America, and Australia each. Exponential growth rate model was most favored by researchers. The pooled global R(0) was 4.08 (95% CI, 3.09–5.39). The R(0) estimates for new and shifting epicenters were comparable or even higher than that for the original epicenter Wuhan, China. CONCLUSIONS: The high R(0) values suggest that an extraordinary combination of control measures is needed for halting COVID-19.