Identifying age- and sex-specific COVID-19 mortality trends over time in six countries.

OBJECTIVES: The COVID-19 pandemic is characterized by successive waves that each developed differently over time and through space. We aim to provide an in-depth analysis of the evolution of COVID-19 mortality during 2020 and 2021 in a selection of countries. METHODS: We focus on five European countries and the United States. Using standardized and age-specific mortality rates, we address variations in COVID-19 mortality within and between countries, and demographic characteristics and seasonality patterns. RESULTS: Our results highlight periods of acceleration and deceleration in the pace of COVID-19 mortality, with substantial differences across countries. Periods of stabilization were identified during summer (especially in 2020) among the European countries analyzed but not in the United States. The latter stands out as the study population with the highest COVID-19 mortality at young ages. In general, COVID-19 mortality is highest at old ages, particularly during winter. Compared with women, men have higher COVID-19 mortality rates at most ages and in most seasons. CONCLUSION: There is seasonality in COVID-19 mortality for both sexes at all ages, characterized by higher rates during winter. In 2021, the highest COVID-19 mortality rates continued to be observed at ages 75+, despite vaccinations having targeted those ages specifically.

The demography of COVID-19 deaths database, a gateway to well-documented international data.

National authorities publish COVID-19 death counts, which are extensively re-circulated and compared; but data are generally poorly sourced and documented. Academics and stakeholders need tools to assess data quality and to track data-related discrepancies for comparability over time or across countries. "The Demography of COVID-19 Deaths" database aims at bridging this gap. It provides COVID-19 death counts along with associated documentation, which includes the exact data sources and points out issues of quality and coverage of the data. The database - launched in April 2020 and continuously updated - contains daily cumulative death counts attributable to COVID-19 broken down by sex and age, place and date of occurrence of the death. Data and metadata undergo quality control checks prior to online release. As of mid-December 2021, it covers 21 countries in Europe and beyond. It is open access at a bilingual (English and French) website with content intended for expert users and non-specialists ( https://dc-covid.site.ined.fr/en/ ; figshare: https://doi.org/10.6084/m9.figshare.c.5807027 ). Data and metadata are available for each country separately and pooled over all countries.

Magnitude, change over time, demographic characteristics and geographic distribution of excess deaths among nursing home residents during the first wave of COVID-19 in France: a nationwide cohort study.

BACKGROUND: The objectives were to assess the excess deaths among Nursing Home (NH) residents during the first wave of the COVID-19 pandemic, to determine their part in the total excess deaths and whether there was a mortality displacement. METHODS: We studied a cohort of 494,753 adults in 6,515 NHs in France exposed to COVID-19 pandemic (from 1 March to 31 May 2020) and compared with the 2014-2019 cohorts using data from the French National Health Data System. The main outcome was death. Excess deaths and standardized mortality ratios (SMRs) were estimated. RESULT: There were 13,505 excess deaths. Mortality increased by 43% (SMR: 1.43). The mortality excess was higher among males than females (SMR: 1.51 and 1.38) and decreased with increasing age (SMRs in females: 1.61 in the 60-74 age group, 1.58 for 75-84, 1.41 for 85-94 and 1.31 for 95 or over; males: SMRs: 1.59 for 60-74, 1.69 for 75-84, 1.47 for 85-94 and 1.41 for 95 or over). No mortality displacement effect was observed up until 30 August 2020. By extrapolating to all NH residents nationally (N = 570,003), we estimated that they accounted for 51% of the general population excess deaths (N = 15,114 out of 29,563). CONCLUSION: NH residents accounted for half of the total excess deaths in France during the first wave of the COVID-19 pandemic. The excess death rate was higher among males than females and among younger than older residents.