Excess all-cause mortality and COVID-19-related mortality: a temporal analysis in 22 countries, from January until August 2020

Author:

Achilleos Souzana1ORCID,Quattrocchi Annalisa1ORCID,Gabel John2,Heraclides Alexandros1ORCID,Kolokotroni Ourania1ORCID,Constantinou Constantina3,Pagola Ugarte Maider2,Nicolaou Nicoletta3,Rodriguez-Llanes Jose Manuel4,Bennett Catherine Marie5,Bogatyreva Ekaterina5,Schernhammer Eva6ORCID,Zimmermann Claudia6,Costa Antonio Jose Leal7,Lobato Jackeline Christiane Pinto8,Fernandes Ngibo Mubeta9,Semedo-Aguiar Ana Paula10,Jaramillo Ramirez Gloria Isabel11,Martin Garzon Oscar Dario11,Mortensen Laust Hvas12,Critchley Julia A13,Goldsmith Lucy P13,Denissov Gleb14,Rüütel Kristi15,Le Meur Nolwenn16ORCID,Kandelaki Levan17,Tsiklauri Shorena18,O’Donnell Joan19,Oza Ajay19,Kaufman Zalman20,Zucker Inbar2021,Ambrosio Giuseppe2223,Stracci Fabrizio22,Hagen Terje P24,Erzen Ivan25,Klepac Petra26,Arcos González Pedro27,Fernández Camporro Ángel27,Burström Bo28,Pidmurniak Nataliia29,Verstiuk Olesia29,Huang Qian30,Mehta Neil Kishor31,Polemitis Antonis32,Charalambous Andreas2,Demetriou Christiana A1ORCID

Affiliation:

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

2. University of Nicosia Medical School, Nicosia, Cyprus

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

4. European Commission Joint Research Centre, Ispra, Italy

5. School of Health and Social Development, Deakin University, Melbourne, Australia

6. Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria

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

8. Department of Epidemiology and Biostatistics, Institute of Collective Health (ISC), Fluminense Federal University Niterói, Brazil

9. National Health Observatory, National Institute of Public Health, Praia, Cape Verde

10. Nature, Life and Environment Sciences Department, University Jean Piaget of Cape Verde, Praia, Cape Verde

11. Medicine Faculty, Cooperative University of Colombia, Villavicencio, Colombia

12. Department of Public Health, University of Copenhagen, Methods and Analysis, Statistics Denmark, Copenhagen, Denmark

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

14. Department of Registries, National Institute for Health Development, Tallinn, Estonia

15. Department of Drug and Infectious Diseases Epidemiology, National Institute for Health Development, Tallinn, Estonia

16. University of Rennes, EHESP, REPERES—EA 7449, Rennes, France

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

18. National Statistics Office of Georgia, Tbilisi, Georgia

19. HSE-Health Protection Surveillance Centre, Dublin, Ireland

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

21. Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

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

23. CERICLET- Interdepartmental Center for Clinical and Translational Research, University of Perugia School of Medicine, Perugia, Italy

24. Department of Health Management and Health Economics, University of Oslo, Oslo, Norway

25. Public Health School, National Institute of Public Health, Ljubljana, Slovenia

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

27. Department of Medicine, University of Oviedo, Oviedo, Spain

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

29. Faculty of Medicine, Bogomolets National Medical University, Kyiv, Ukraine

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

31. Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA

32. University of Nicosia, Nicosia, Cyprus

Abstract

Abstract Background This study aimed to investigate overall and sex-specific excess all-cause mortality since the inception of the COVID-19 pandemic until August 2020 among 22 countries. Methods Countries reported weekly or monthly all-cause mortality from January 2015 until the end of June or August 2020. Weekly or monthly COVID-19 deaths were reported for 2020. Excess mortality for 2020 was calculated by comparing weekly or monthly 2020 mortality (observed deaths) against a baseline mortality obtained from 2015–2019 data for the same week or month using two methods: (i) difference in observed mortality rates between 2020 and the 2015–2019 average and (ii) difference between observed and expected 2020 deaths. Results Brazil, France, Italy, Spain, Sweden, the UK (England, Wales, Northern Ireland and Scotland) and the USA demonstrated excess all-cause mortality, whereas Australia, Denmark and Georgia experienced a decrease in all-cause mortality. Israel, Ukraine and Ireland demonstrated sex-specific changes in all-cause mortality. Conclusions All-cause mortality up to August 2020 was higher than in previous years in some, but not all, participating countries. Geographical location and seasonality of each country, as well as the prompt application of high-stringency control measures, may explain the observed variability in mortality changes.

Funder

University of Nicosia Medical School

Publisher

Oxford University Press (OUP)

Subject

General Medicine,Epidemiology

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