Are COVID-19 age-mortality curves for 2020 flatter in developing countries? Evidence from a cross-sectional observational study of population-level official death counts and excess deaths estimates.
COVID-19
EPIDEMIOLOGY
PUBLIC HEALTH
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
08 11 2022
08 11 2022
Historique:
entrez:
9
11
2022
pubmed:
10
11
2022
medline:
15
11
2022
Statut:
epublish
Résumé
Previous studies have found a pattern of flatter COVID-19 age-mortality curves among low-income and middle-income countries (LMICs) using only official COVID-19 death counts. This study examines this question by comparing the age gradient of COVID-19 mortality in a broad set of countries using both official COVID-19 death counts and excess mortality estimates for 2020. This observational study uses official COVID-19 death counts for 76 countries and excess death estimates for 42 countries. A standardised population analysis was conducted to assess the extent to which variation across countries in the age distribution of COVID-19 deaths was driven by variation in the population age distribution. Officially reported COVID-19 deaths and excess deaths for 2020 for all countries where such data were available in the COVerAGE database and the short-term mortality fluctuations harmonised data series, respectively. A higher share of pandemic-related deaths in 2020 occurred at younger ages in middle-income countries compared with high-income countries. People under age 65 years constituted on average (1) 10% of official deaths and 11 % of excess deaths in high-income countries, (2) 34% of official deaths and 33% of excess deaths in upper-middle-income countries, and (3) 54% of official deaths in LMICs. These contrasting profiles are due only in part to differences in population age structure. These findings are driven by some combination of variation in age patterns of infection rates and infection fatality rates. They indicate that COVID-19 is not just a danger to older people in developing countries, where a large share of victims are people of working age, who are caregivers and breadwinners for their families.
Identifiants
pubmed: 36351719
pii: bmjopen-2022-061589
doi: 10.1136/bmjopen-2022-061589
pmc: PMC9659715
doi:
Types de publication
Observational Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e061589Informations de copyright
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
BMJ Glob Health. 2022 May;7(5):
pubmed: 35618305
Popul Dev Rev. 2022 Jun;48(2):279-302
pubmed: 35600716
Rev Saude Publica. 2021 Oct 29;55:71
pubmed: 34730751
Int J Epidemiol. 2022 Feb 18;51(1):63-74
pubmed: 34564730
Proc Natl Acad Sci U S A. 2020 Jun 23;117(25):13881-13883
pubmed: 32576710
Biometrics. 1986 Dec;42(4):693-734
pubmed: 3814721
Ann Intern Med. 2020 Nov 3;173(9):714-720
pubmed: 32698605
Science. 2020 Jul 24;369(6502):413-422
pubmed: 32532802
Elife. 2021 Jun 30;10:
pubmed: 34190045
Nat Med. 2021 Sep;27(9):1629-1635
pubmed: 34188224
Lancet. 2021 Jul 31;398(10298):391-402
pubmed: 34298000
BMJ Glob Health. 2020 Sep;5(9):
pubmed: 32912856
Proc Natl Acad Sci U S A. 2020 Sep 8;117(36):22035-22041
pubmed: 32820077
Philos Trans R Soc Lond B Biol Sci. 2015 Apr 19;370(1666):
pubmed: 25750242
World Dev. 2022 May;153:105844
pubmed: 35153367
Lancet Infect Dis. 2020 Jun;20(6):669-677
pubmed: 32240634
J R Soc Med. 2020 Sep;113(9):329-334
pubmed: 32910871
Sci Data. 2021 Sep 6;8(1):235
pubmed: 34489477
BMJ. 2021 Nov 3;375:e066768
pubmed: 34732390
Gerontologist. 2021 Jan 21;61(1):71-77
pubmed: 33030209