Underestimation of COVID-19 mortality during the pandemic.
Journal
ERJ open research
ISSN: 2312-0541
Titre abrégé: ERJ Open Res
Pays: England
ID NLM: 101671641
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
20
10
2020
accepted:
25
11
2020
entrez:
22
2
2021
pubmed:
23
2
2021
medline:
23
2
2021
Statut:
epublish
Résumé
There has been considerable international variation in mortality during the COVID-19 pandemic. The objective of this study was to investigate the differences between mortality registered as due to COVID-19 and the excess all-cause mortality reported in countries worldwide during the COVID-19 pandemic. Ecological analysis of 22 countries compared 5-year historical all-cause mortality, reported all-cause mortality and expected all-cause mortality (calculated as historical mortality plus the reported deaths attributed to COVID-19). Data available from the first week of January 2020 to that most recently available were analysed. Compared to the preceding 5 years, there was an excess of 716 616 deaths, of which 64.3% were attributed to COVID-19. The proportion of deaths registered as COVID-19-related/excess deaths varied markedly between countries, ranging between 30% and 197% in those countries that had an excess of deaths during the period of observation. In most countries where a definite peak in COVID-19-related deaths occurred, the increase in reported all-cause mortality preceded the increase in COVID-19 reported mortality. During the latter period of observation, a few countries reported fewer all-cause deaths than the historical figures. The increases in all-cause mortality preceded the increase in COVID-19 mortality in most countries that had definite spikes in COVID-19 mortality. The number of deaths attributed to COVID-19 was underestimated by at least 35%. Together these findings suggest that calculation of excess all-cause mortality is a better predictor of COVID-19 mortality than the reported rates, in those countries experiencing definite increases in mortality.
Sections du résumé
BACKGROUND
BACKGROUND
There has been considerable international variation in mortality during the COVID-19 pandemic. The objective of this study was to investigate the differences between mortality registered as due to COVID-19 and the excess all-cause mortality reported in countries worldwide during the COVID-19 pandemic.
METHODS
METHODS
Ecological analysis of 22 countries compared 5-year historical all-cause mortality, reported all-cause mortality and expected all-cause mortality (calculated as historical mortality plus the reported deaths attributed to COVID-19). Data available from the first week of January 2020 to that most recently available were analysed.
RESULTS
RESULTS
Compared to the preceding 5 years, there was an excess of 716 616 deaths, of which 64.3% were attributed to COVID-19. The proportion of deaths registered as COVID-19-related/excess deaths varied markedly between countries, ranging between 30% and 197% in those countries that had an excess of deaths during the period of observation. In most countries where a definite peak in COVID-19-related deaths occurred, the increase in reported all-cause mortality preceded the increase in COVID-19 reported mortality. During the latter period of observation, a few countries reported fewer all-cause deaths than the historical figures.
CONCLUSION
CONCLUSIONS
The increases in all-cause mortality preceded the increase in COVID-19 mortality in most countries that had definite spikes in COVID-19 mortality. The number of deaths attributed to COVID-19 was underestimated by at least 35%. Together these findings suggest that calculation of excess all-cause mortality is a better predictor of COVID-19 mortality than the reported rates, in those countries experiencing definite increases in mortality.
Identifiants
pubmed: 33614772
doi: 10.1183/23120541.00766-2020
pii: 00766-2020
pmc: PMC7734715
pii:
doi:
Types de publication
Journal Article
Langues
eng
Informations de copyright
Copyright ©ERS 2021.
Déclaration de conflit d'intérêts
Conflict of interest: S. Kung has nothing to disclose. Conflict of interest: M. Doppen has nothing to disclose. Conflict of interest: M. Black has nothing to disclose. Conflict of interest: I. Braithwaite has nothing to disclose. Conflict of interest: C. Kearns has nothing to disclose. Conflict of interest: M. Weatherall has nothing to disclose. Conflict of interest: R. Beasley has nothing to disclose. Conflict of interest: N. Kearns has nothing to disclose.
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