Comparison of fatalities due to COVID-19 and other nonexternal causes during the first five pandemic waves : Results from multiple cause of death statistics in Bavaria.

Vergleich zwischen COVID-19-bedingten und anderen natürlichen Todesfällen während der ersten fünf Pandemiewellen : Ergebnisse der multikausalen Todesursachenstatistik in Bayern.

Comorbidities Mortality Preexisting diseases SARS-CoV-2 Wave-specific causes of death

Journal

Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz

ISSN: 1437-1588

Titre abrégé: Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz

Pays: Germany

ID NLM: 101181368

Informations de publication

Date de publication:
16 Jul 2024

Historique:

received: 14 09 2023

accepted: 06 06 2024

medline: 16 7 2024

pubmed: 16 7 2024

entrez: 16 7 2024

Statut: aheadofprint

Résumé

Older age is a risk factor for a fatal course of SARS-CoV‑2 infection, possibly due to comorbidities whose exact role in this context, however, is not yet well understood. In this paper, the characteristics and comorbidities of persons who had died of COVID-19 in Bavaria by July 2022 are shown and compared with the characteristics of other fatalities during the pandemic. Based on data from multiple cause of death statistics, odds ratios for dying from COVID-19 (compared to dying from other nonexternal causes of death) were calculated by using logistic regression models, stratified by age, sex, and pandemic waves. In Bavaria, a total of 24,479 persons (6.5% of all deaths) officially died from COVID-19 between March 2020 and July 2022. In addition to increasing age and male sex, preexisting diseases and comorbidities such as obesity, degenerative diseases of the nervous system, dementia, renal insufficiency, chronic lower respiratory diseases, and diabetes mellitus were significantly associated with COVID-19-related deaths. Dementia was mainly associated with increased COVID-19 mortality during the first and second waves, while obesity was strongly associated during the fourth wave. The frequency of specific comorbidities in COVID-19 deaths varied over the course of the pandemic. This suggests that wave-specific results also need to be interpreted against the background of circulating virus variants, changing immunisation levels, and nonpharmaceutical interventions in place at the time. HINTERGRUND: Ein höheres Alter stellt einen Risikofaktor für einen tödlichen Verlauf einer SARS-CoV-2-Infektion dar, möglicherweise bedingt durch Komorbiditäten, deren genaue Rolle in diesem Kontext jedoch noch nicht gut verstanden ist. Im vorliegenden Beitrag werden Charakteristika sowie Komorbiditäten der bis Juli 2022 in Bayern an COVID-19 Verstorbenen im Pandemieverlauf aufgezeigt und mit den Merkmalen anderer Verstorbener verglichen. Basierend auf Daten der amtlichen Todesursachenstatistik wurden mit Hilfe logistischer Regressionsmodelle Odds-Ratios für das Versterben an COVID-19 (im Vergleich zum Versterben an anderen natürlichen Todesursachen) stratifiziert nach Alter, Geschlecht und Pandemiewellen berechnet. In Bayern verstarben von März 2020 bis Juli 2022 offiziell insgesamt 24.479 Personen (6,5 % aller Sterbefälle) an COVID-19. Neben zunehmendem Alter und männlichem Geschlecht waren Vor- und Begleiterkrankungen wie Adipositas, degenerative Erkrankungen des Nervensystems, Demenz, Niereninsuffizienz, chronische Erkrankungen der unteren Atemwege und Diabetes mellitus signifikant mit COVID-19-bedingtem Versterben assoziiert. Demenz war hauptsächlich in der ersten und zweiten Welle, Adipositas besonders stark während der vierten Welle mit erhöhter COVID-19-Sterblichkeit assoziiert. Die Häufigkeit bestimmter Komorbiditäten bei Personen, die an COVID-19 verstorben sind, variierte im Pandemieverlauf. Dies deutet darauf hin, dass wellenspezifische Ergebnisse auch vor dem Hintergrund zirkulierender Virusvarianten, sich verändernder Immunisierungsgrade und der zum jeweiligen Zeitpunkt geltenden Schutzmaßnahmen interpretiert werden müssen.

Sections du résumé

BACKGROUND BACKGROUND

METHODS METHODS

Based on data from multiple cause of death statistics, odds ratios for dying from COVID-19 (compared to dying from other nonexternal causes of death) were calculated by using logistic regression models, stratified by age, sex, and pandemic waves.

RESULTS RESULTS

In Bavaria, a total of 24,479 persons (6.5% of all deaths) officially died from COVID-19 between March 2020 and July 2022. In addition to increasing age and male sex, preexisting diseases and comorbidities such as obesity, degenerative diseases of the nervous system, dementia, renal insufficiency, chronic lower respiratory diseases, and diabetes mellitus were significantly associated with COVID-19-related deaths. Dementia was mainly associated with increased COVID-19 mortality during the first and second waves, while obesity was strongly associated during the fourth wave.

DISCUSSION CONCLUSIONS

The frequency of specific comorbidities in COVID-19 deaths varied over the course of the pandemic. This suggests that wave-specific results also need to be interpreted against the background of circulating virus variants, changing immunisation levels, and nonpharmaceutical interventions in place at the time.

ZUSAMMENFASSUNG UNASSIGNED

HINTERGRUND: Ein höheres Alter stellt einen Risikofaktor für einen tödlichen Verlauf einer SARS-CoV-2-Infektion dar, möglicherweise bedingt durch Komorbiditäten, deren genaue Rolle in diesem Kontext jedoch noch nicht gut verstanden ist. Im vorliegenden Beitrag werden Charakteristika sowie Komorbiditäten der bis Juli 2022 in Bayern an COVID-19 Verstorbenen im Pandemieverlauf aufgezeigt und mit den Merkmalen anderer Verstorbener verglichen.

METHODEN METHODS

Basierend auf Daten der amtlichen Todesursachenstatistik wurden mit Hilfe logistischer Regressionsmodelle Odds-Ratios für das Versterben an COVID-19 (im Vergleich zum Versterben an anderen natürlichen Todesursachen) stratifiziert nach Alter, Geschlecht und Pandemiewellen berechnet.

ERGEBNISSE UNASSIGNED

In Bayern verstarben von März 2020 bis Juli 2022 offiziell insgesamt 24.479 Personen (6,5 % aller Sterbefälle) an COVID-19. Neben zunehmendem Alter und männlichem Geschlecht waren Vor- und Begleiterkrankungen wie Adipositas, degenerative Erkrankungen des Nervensystems, Demenz, Niereninsuffizienz, chronische Erkrankungen der unteren Atemwege und Diabetes mellitus signifikant mit COVID-19-bedingtem Versterben assoziiert. Demenz war hauptsächlich in der ersten und zweiten Welle, Adipositas besonders stark während der vierten Welle mit erhöhter COVID-19-Sterblichkeit assoziiert.

DISKUSSION CONCLUSIONS

Die Häufigkeit bestimmter Komorbiditäten bei Personen, die an COVID-19 verstorben sind, variierte im Pandemieverlauf. Dies deutet darauf hin, dass wellenspezifische Ergebnisse auch vor dem Hintergrund zirkulierender Virusvarianten, sich verändernder Immunisierungsgrade und der zum jeweiligen Zeitpunkt geltenden Schutzmaßnahmen interpretiert werden müssen.

Autres résumés

Type: Publisher (ger)

Identifiants

DOI: 10.1007/s00103-024-03914-5 PMID: 39012367

pubmed: 39012367

doi: 10.1007/s00103-024-03914-5

pii: 10.1007/s00103-024-03914-5

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Informations de copyright

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