Cause-Specific Excess Mortality During the COVID-19 Pandemic (2020–2021) in 12 Countries of the C-MOR Consortium

Beeks V.V. Achilleos S. Quattrocchi A. Pallari C.T. Critselis E. Salameh P. Rahmanian Haghighi M.R. Rodriguez-Llanes J.M. Ambrosio G. Artemiou A. Gabel J. Bennett C.M. Cuthbertson J. Zimmermann C. Schernhammer E.S. Costa A.J.L. de Carvalho L.F. Lobato J.C.P. Athanasiadou M. Critchley J.A. Goldsmith L.P. Kandelaki L. Glushkova N. Davletov K. Semenova Y. Erzen I. Verstiuk O. Alekkou D. Polemitis A. Charalambous A. Demetriou C.A.
June 2024 Springer Science and Business Media B.V.

Journal of Epidemiology and Global Health
2024 #14 Issue 2 337 - 348 pp.

Background: This study investigated cause-specific mortality rates in 12 countries during the COVID-19 pandemic in 2020 and 2021. Methods: We collected weekly cause-specific mortality data from respiratory disease, pneumonia, cardiovascular disease (CVD) and cancer from national vital statistic databases. We calculated excess mortality for respiratory disease (excluding COVID-19 codes), pneumonia, and CVD in 2020 and 2021 by comparing observed weekly against expected mortality based on historical data (2015–2019), accounting for seasonal trends. We used multilevel regression models to investigate the association between country-level pandemic-related variables and cause-specific mortality. Results: Significant reductions in cumulative mortality from respiratory disease and pneumonia were observed in 2020 and/or 2021, except for Georgia, Northern Ireland, Kazakhstan, and Ukraine, which exhibited excess mortality for one or both causes. Australia, Austria, Cyprus, Georgia, and Northern Ireland experienced excess cumulative CVD mortality in 2020 and/or 2021. Australia, Austria, Brazil, Cyprus, Georgia, Northern Ireland, Scotland and Slovenia, experienced increased crude cumulative cancer mortality during 2020 and/or 2021 compared to previous years. Among pandemic-related variables, reported COVID-19 incidence was negatively associated with increased cancer mortality, excess respiratory, (2020) and pneumonia (2021) mortality, and positively associated with respiratory and CVD mortality (2021). Stringency of control measures were negatively associated with excess respiratory disease, CVD, and increased cancer mortality (2021). Conclusions: This study provides evidence of substantial excess mortality from CVD, and notable reductions in respiratory disease and pneumonia in both years across most countries investigated. Our study also highlights the beneficial impact of stringent control measures in mitigating excess mortality from most causes in 2021.

Cancer , Cardiovascular diseases , Cause-specific mortality , COVID-19 , Public health measures , Respiratory tract infections

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Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
PlanAdapt, Berlin, Germany
Department of Cardiology, University of Perugia School of Medicine, Perugia, Italy
Department of Information Technologies, University of Limassol, Limassol, Cyprus
Massachusetts Institute of Technology, Cambridge, MA, United States
School of Health and Social Development, Institute for Health Transformation, Deakin University, Waurn Ponds, Australia
Monash University Disaster Resilience Initiative, Monash University, Melbourne, Australia
Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
Departamento de Epidemiologia do Instituto de Saúde Coletiva, Universidade Federal Fluminense, Niterói, Brazil
Health Monitoring Unit, Cyprus Ministry of Health, 1 Prodromou & 17 Chilonos Street, Nicosia, 1448, Cyprus
Population Health Research Institute, St George’s University of London, London, United Kingdom
Medical Statistics, National Center for Disease Control and Public Health, Tbilisi, Georgia
Health Research Institute, Al-Farabi Kazakh National University, Almaty, Kazakhstan
Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
School of Medicine, Nazarbayev University, Astana, Kazakhstan
School of Public Health, National Institute of Public Health, Ljubljana, Slovenia
Department of Medical Science, University of Nicosia, Nicosia, Cyprus
Department of Psychology, University of Nicosia, Nicosia, Cyprus
University of Nicosia, Nicosia, Cyprus
University of Nicosia Medical School, Nicosia, Cyprus

Department of Primary Care and Population Health
PlanAdapt
Department of Cardiology
Department of Information Technologies
Massachusetts Institute of Technology
School of Health and Social Development
Monash University Disaster Resilience Initiative
Department of Epidemiology
Instituto de Estudos em Saúde Coletiva
Departamento de Epidemiologia do Instituto de Saúde Coletiva
Health Monitoring Unit
Population Health Research Institute
Medical Statistics
Health Research Institute
Asfendiyarov Kazakh National Medical University
School of Medicine
School of Public Health
Department of Medical Science
Department of Psychology
University of Nicosia
University of Nicosia Medical School

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