Impact of the COVID-19 pandemic on total, sex- and age-specific all-cause mortality in 20 countries worldwide during 2020: results from the C-MOR project.

COVID-19 SARS-CoV-2 all-cause mortality excess mortality global impact infection control pandemic

Journal

International journal of epidemiology
ISSN: 1464-3685
Titre abrégé: Int J Epidemiol
Pays: England
ID NLM: 7802871

Informations de publication

Date de publication:
06 06 2023
Historique:
received: 11 03 2022
accepted: 10 08 2022
medline: 8 6 2023
pubmed: 28 8 2022
entrez: 27 8 2022
Statut: ppublish

Résumé

To understand the impact of the COVID-19 pandemic on mortality, this study investigates overall, sex- and age-specific excess all-cause mortality in 20 countries, during 2020. Total, sex- and age-specific weekly all-cause mortality for 2015-2020 was collected from national vital statistics databases. Excess mortality for 2020 was calculated by comparing weekly 2020 observed mortality against expected mortality, estimated from historical data (2015-2019) accounting for seasonality, long- and short-term trends. Crude and age-standardized rates were analysed for total and sex-specific mortality. Austria, Brazil, Cyprus, England and Wales, France, Georgia, Israel, Italy, Northern Ireland, Peru, Scotland, Slovenia, Sweden, and the USA displayed substantial excess age-standardized mortality of varying duration during 2020, while Australia, Denmark, Estonia, Mauritius, Norway, and Ukraine did not. In sex-specific analyses, excess mortality was higher in males than females, except for Slovenia (higher in females) and Cyprus (similar in both sexes). Lastly, for most countries substantial excess mortality was only detectable (Austria, Cyprus, Israel, and Slovenia) or was higher (Brazil, England and Wales, France, Georgia, Italy, Northern Ireland, Sweden, Peru and the USA) in the oldest age group investigated. Peru demonstrated substantial excess mortality even in the <45 age group. This study highlights that excess all-cause mortality during 2020 is context dependent, with specific countries, sex- and age-groups being most affected. As the pandemic continues, tracking excess mortality is important to accurately estimate the true toll of COVID-19, while at the same time investigating the effects of changing contexts, different variants, testing, quarantine, and vaccination strategies.

Sections du résumé

BACKGROUND
To understand the impact of the COVID-19 pandemic on mortality, this study investigates overall, sex- and age-specific excess all-cause mortality in 20 countries, during 2020.
METHODS
Total, sex- and age-specific weekly all-cause mortality for 2015-2020 was collected from national vital statistics databases. Excess mortality for 2020 was calculated by comparing weekly 2020 observed mortality against expected mortality, estimated from historical data (2015-2019) accounting for seasonality, long- and short-term trends. Crude and age-standardized rates were analysed for total and sex-specific mortality.
RESULTS
Austria, Brazil, Cyprus, England and Wales, France, Georgia, Israel, Italy, Northern Ireland, Peru, Scotland, Slovenia, Sweden, and the USA displayed substantial excess age-standardized mortality of varying duration during 2020, while Australia, Denmark, Estonia, Mauritius, Norway, and Ukraine did not. In sex-specific analyses, excess mortality was higher in males than females, except for Slovenia (higher in females) and Cyprus (similar in both sexes). Lastly, for most countries substantial excess mortality was only detectable (Austria, Cyprus, Israel, and Slovenia) or was higher (Brazil, England and Wales, France, Georgia, Italy, Northern Ireland, Sweden, Peru and the USA) in the oldest age group investigated. Peru demonstrated substantial excess mortality even in the <45 age group.
CONCLUSIONS
This study highlights that excess all-cause mortality during 2020 is context dependent, with specific countries, sex- and age-groups being most affected. As the pandemic continues, tracking excess mortality is important to accurately estimate the true toll of COVID-19, while at the same time investigating the effects of changing contexts, different variants, testing, quarantine, and vaccination strategies.

Identifiants

pubmed: 36029524
pii: 6678067
doi: 10.1093/ije/dyac170
pmc: PMC9452146
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

664-676

Informations de copyright

© The Author(s) 2022. Published by Oxford University Press on behalf of the International Epidemiological Association.

Auteurs

Christiana A Demetriou (CA)

Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus.

Souzana Achilleos (S)

Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus.

Annalisa Quattrocchi (A)

Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus.

John Gabel (J)

University of Nicosia Medical School, Nicosia, Cyprus.

Elena Critselis (E)

Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus.

Constantina Constantinou (C)

Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus.

Nicoletta Nicolaou (N)

Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus.

Giuseppe Ambrosio (G)

Department of Medicine, University of Perugia School of Medicine, Perugia, Italy.

Catherine M Bennett (CM)

Institute for Health Transformation, Deakin University, Burwood, Australia.

Nolwenn Le Meur (N)

University of Rennes, EHESP, CNRS, Inserm, Arènes-UMR 6051, RSMS-U 1309, Rennes, France.

Julia A Critchley (JA)

Population Health Research Institute, St George's, University of London, London, UK.

Laust Hvas Mortensen (LH)

Department of Methods and Analysis, Statistics Denmark, Copenhagen Oe, Denmark.

Jose Manuel Rodriguez-Llanes (JM)

European Commission Joint Research Centre, Ispra, VA, Italy.

Mario Chong (M)

Departamento de Ingeniería, Universidad del Pacífico, Lima, Peru.

Gleb Denissov (G)

Estonian Causes of Death Registry, National institute for Health Development, Tallinn, Estonia.

Petra Klepac (P)

Department of Communicable Diseases, National Institute of Public Health, Ljubljana, Slovenia.

Lucy P Goldsmith (LP)

Institute for Infection and Immunity, and Population Health Research Institute, St George's, University of London, London, UK.

Antonio José Leal Costa (AJL)

Institute of Studies in Collective Health (IESC), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

Terje P Hagen (TP)

Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway.

Marie Chan Sun (M)

Department of Medicine, Faculty of Medicine and Health Sciences, University of Mauritius, Réduit, Mauritius.

Qian Huang (Q)

Department of Geography, Center for Rural and Primary Healthcare, University of South Carolina, Columbia, SC, USA.

Nataliia Pidmurniak (N)

Department of Medicine, Bogomolets National Medical University, Kyiv, Ukraine.

Inbar Zucker (I)

School of Public Health, Ministry of Health, Ramat Gan, Israel.

Joseph Cuthbertson (J)

Disaster Resilience Initiative, Monash University, Clayton,VIC, Australia.

Bo Burström (B)

Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.

Manuel Barron (M)

Department of Economics, Universidad del Pacifico Av Sanchez Cerro, Lima, Peru.

Ivan Eržen (I)

School of Public Health, National Institute of Public Health, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.

Fabrizio Stracci (F)

Public Health Section, Department of Medicine and Surgery, University of Perugia, Piazza Lucio Severi, Perugia, Italy.

Wilson Calmon (W)

Institute of Mathematics and Statistics, Fluminense Federal University, Niteroi, Brazil.

Cyndy Martial (C)

Department of Demography, Statistics Mauritius, LIC Centre, Port Louis, Mauritius.

Olesia Verstiuk (O)

University of Nicosia Medical School, Nicosia, Cyprus.

Zalman Kaufman (Z)

Israeli Center of Disease Control, Ministry of Health, Ramat Gan, Israel.

Wenjing Tao (W)

Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Department of Molecular Medicine and SURGERY, Karolinska Institutet, Stockholm, Sweden.

Maia Kereselidze (M)

National Center for Disease Control and Public Health, Tbilisi, Georgia.

Nino Chikhladze (N)

Faculty of Medicine, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia.

Antonis Polemitis (A)

University of Nicosia, Nicosia, Cyprus.

Andreas Charalambous (A)

University of Nicosia Medical School, Nicosia, Cyprus.

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