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Excess deaths associated with covid-19 pandemic in 2020: age and sex disaggregated time series analysis in 29 high income countries.
Islam, Nazrul; Shkolnikov, Vladimir M; Acosta, Rolando J; Klimkin, Ilya; Kawachi, Ichiro; Irizarry, Rafael A; Alicandro, Gianfranco; Khunti, Kamlesh; Yates, Tom; Jdanov, Dmitri A; White, Martin; Lewington, Sarah; Lacey, Ben.
  • Islam N; Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK nazrul.islam@ndph.ox.ac.uk.
  • Shkolnikov VM; MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
  • Acosta RJ; Max Planck Institute for Demographic Research, Rostock, Germany.
  • Klimkin I; International Laboratory for Population and Health, National Research University Higher School of Economics, Moscow, Russian Federation.
  • Kawachi I; Department of Biostatistics, Harvard T H Chan School of Public, Harvard University, Boston, MA, USA.
  • Irizarry RA; International Laboratory for Population and Health, National Research University Higher School of Economics, Moscow, Russian Federation.
  • Alicandro G; Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA.
  • Khunti K; Department of Biostatistics, Harvard T H Chan School of Public, Harvard University, Boston, MA, USA.
  • Yates T; Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA.
  • Jdanov DA; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
  • White M; Diabetes Research Centre, University of Leicester, Leicester, UK.
  • Lewington S; NIHR Applied Research Collaboration-East Midlands, Leicester General Hospital, Leicester, UK.
  • Lacey B; Diabetes Research Centre, University of Leicester, Leicester, UK.
BMJ ; 373: n1137, 2021 05 19.
Article in English | MEDLINE | ID: covidwho-1236432
Semantic information from SemMedBD (by NLM)
1. Cessation of life ASSOCIATED_WITH COVID-19
Subject
Cessation of life
Predicate
ASSOCIATED_WITH
Object
COVID-19
2. Cessation of life PROCESS_OF Child
Subject
Cessation of life
Predicate
PROCESS_OF
Object
Child
3. Cessation of life ASSOCIATED_WITH COVID-19
Subject
Cessation of life
Predicate
ASSOCIATED_WITH
Object
COVID-19
4. Cessation of life PROCESS_OF Child
Subject
Cessation of life
Predicate
PROCESS_OF
Object
Child
ABSTRACT

OBJECTIVE:

To estimate the direct and indirect effects of the covid-19 pandemic on mortality in 2020 in 29 high income countries with reliable and complete age and sex disaggregated mortality data.

DESIGN:

Time series study of high income countries.

SETTING:

Austria, Belgium, Czech Republic, Denmark, England and Wales, Estonia, Finland, France, Germany, Greece, Hungary, Israel, Italy, Latvia, Lithuania, the Netherlands, New Zealand, Northern Ireland, Norway, Poland, Portugal, Scotland, Slovakia, Slovenia, South Korea, Spain, Sweden, Switzerland, and United States.

PARTICIPANTS:

Mortality data from the Short-term Mortality Fluctuations data series of the Human Mortality Database for 2016-20, harmonised and disaggregated by age and sex.

INTERVENTIONS:

Covid-19 pandemic and associated policy measures. MAIN OUTCOME

MEASURES:

Weekly excess deaths (observed deaths versus expected deaths predicted by model) in 2020, by sex and age (0-14, 15-64, 65-74, 75-84, and ≥85 years), estimated using an over-dispersed Poisson regression model that accounts for temporal trends and seasonal variability in mortality.

RESULTS:

An estimated 979 000 (95% confidence interval 954 000 to 1 001 000) excess deaths occurred in 2020 in the 29 high income countries analysed. All countries had excess deaths in 2020, except New Zealand, Norway, and Denmark. The five countries with the highest absolute number of excess deaths were the US (458 000, 454 000 to 461 000), Italy (89 100, 87 500 to 90 700), England and Wales (85 400, 83 900 to 86 800), Spain (84 100, 82 800 to 85 300), and Poland (60 100, 58 800 to 61 300). New Zealand had lower overall mortality than expected (-2500, -2900 to -2100). In many countries, the estimated number of excess deaths substantially exceeded the number of reported deaths from covid-19. The highest excess death rates (per 100 000) in men were in Lithuania (285, 259 to 311), Poland (191, 184 to 197), Spain (179, 174 to 184), Hungary (174, 161 to 188), and Italy (168, 163 to 173); the highest rates in women were in Lithuania (210, 185 to 234), Spain (180, 175 to 185), Hungary (169, 156 to 182), Slovenia (158, 132 to 184), and Belgium (151, 141 to 162). Little evidence was found of subsequent compensatory reductions following excess mortality.

CONCLUSION:

Approximately one million excess deaths occurred in 2020 in these 29 high income countries. Age standardised excess death rates were higher in men than women in almost all countries. Excess deaths substantially exceeded reported deaths from covid-19 in many countries, indicating that determining the full impact of the pandemic on mortality requires assessment of excess deaths. Many countries had lower deaths than expected in children <15 years. Sex inequality in mortality widened further in most countries in 2020.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Developed Countries / Mortality / COVID-19 Type of study: Prognostic study / Risk factors Limits: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged Country/Region as subject: North America / Asia / Europa Language: English Journal: BMJ Journal subject: Medicine Year: 2021 Document Type: Article Affiliation country: Bmj.n1137

Full text: Available Collection: International databases Database: MEDLINE Main subject: Developed Countries / Mortality / COVID-19 Type of study: Prognostic study / Risk factors Limits: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Infant / Male / Middle aged Country/Region as subject: North America / Asia / Europa Language: English Journal: BMJ Journal subject: Medicine Year: 2021 Document Type: Article Affiliation country: Bmj.n1137