Magnitude and determinants of excess total, age-specific and sex-specific all-cause mortality in 24 countries worldwide during 2020 and 2021: results on the impact of the COVID-19 pandemic from the CMOR project

Pallari C.Th. Achilleos S. Quattrocchi A. Gabel J. Critselis E. Athanasiadou M. Haghighi M.R.R. Papatheodorou S. Liu T. Artemiou A. Rodriguez-Llanes J.M. Bennett C.M. Zimmermann C. Schernhammer E. Sierra N.B. Ekelson R. Lobato J. Macedo L. Mortensen L.H. Critchley J. Goldsmith L. Denissov G. Le Meur N. Kandelaki L. Athanasakis K. Binyaminy B. Maor T. Stracci F. Ambrosio G. Davletov K. Glushkova N. Martial C. Sun M.C. Hagen T.P. Chong M. Barron M. Łyszczarz B. Erzen I. Gonzalez P.A. Burström B. Pidmurniak N. Verstiuk O. Huang Q. Polemitis A. Charalambous A. Demetriou C.A.
18 April 2024 BMJ Publishing Group

BMJ Global Health
2024 #9 Issue 4

Introduction To examine the impact of the COVID-19 pandemic on mortality, we estimated excess all-cause mortality in 24 countries for 2020 and 2021, overall and stratified by sex and age. Methods Total, age-specific and sex-specific weekly all-cause mortality was collected for 2015–2021 and excess mortality for 2020 and 2021 was calculated by comparing weekly 2020 and 2021 age-standardised mortality rates against expected mortality, estimated based on historical data (2015–2019), accounting for seasonality, and long-term and short-term trends. Age-specific weekly excess mortality was similarly calculated using crude mortality rates. The association of country and pandemic-related variables with excess mortality was investigated using simple and multilevel regression models. Results Excess cumulative mortality for both 2020 and 2021 was found in Austria, Brazil, Belgium, Cyprus, England and Wales, Estonia, France, Georgia, Greece, Israel, Italy, Kazakhstan, Mauritius, Northern Ireland, Norway, Peru, Poland, Slovenia, Spain, Sweden, Ukraine, and the USA. Australia and Denmark experienced excess mortality only in 2021. Mauritius demonstrated a statistically significant decrease in all-cause mortality during both years. Weekly incidence of COVID-19 was significantly positively associated with excess mortality for both years, but the positive association was attenuated in 2021 as percentage of the population fully vaccinated increased. Stringency index of control measures was positively and negatively associated with excess mortality in 2020 and 2021, respectively. Conclusion This study provides evidence of substantial excess mortality in most countries investigated during the first 2 years of the pandemic and suggests that COVID-19 incidence, stringency of control measures and vaccination rates interacted in determining the magnitude of excess mortality.

Text of the article Перейти на текст статьи

Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
Massachusetts Institute of Technology, Cambridge, MA, United States
Health Monitoring Unit, Government of the Republic of Cyprus Ministry of Health, Nicosia, Cyprus
Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, United States
Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, United States
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
School of Information Technologies, University of Limassol, Limassol, Cyprus
European Commission Joint Research Centre, Ispra, Italy
Institute for Health Transformation, Deakin University, Burwood, VIC, Australia
Department of Epidemiology, Medical University of Vienna Center for Public Health, Vienna, Austria
Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
Department of Epidemiology and Biostatistics, Institute of Collective Health (ISC), Federal Fluminense University, Niteroi, Brazil
Institute of Studies in Collective Health (IESC), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
Methods and Analysis Department, Statistics Denmark, Copenhagen, Denmark
Population Health Research Institute, St Georges University of London, London, United Kingdom
Division of Health Services Research and Management, School of Health and Psychological Sciences, University of London, City, London, United Kingdom
Department of Registries, National Institute for Health Development, Tallinn, Estonia
UMR CNRS 6051, INSERM U1309, Ecole des Hautes Etudes en Santé Publique, Rennes, France
Department of Medical Statistics, National Center for Disease Control and Public Health, Tbilisi, Georgia
Laboratory for Health Technology Assessment, University of West Attica, Athens, Greece
Israeli Center of Disease Control, State of Israel Ministry of Health, Ramat Gan, Israel
Department of Medicine, Public Health Section, University of Perugia, School of Medicine, Perugia, Italy
Department of Cardiology, University of Perugia School of Medicine, Perugia, Italy
Rector Administration, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
Department of Epidemiology, Evidence-Based Medicine and Biostatistics, Al-Farabi Kazakh National University, Almaty, Kazakhstan
Department of Medicine, University of Mauritius Faculty of Science, Mauritius, Reduit, Mauritius
Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
Departamento de Ingeniería, Universidad del Pacifico, Lima, Peru
Departamento de Economia, Universidad del Pacifico, Lima, Peru
Department of Health Economics, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
Public Health School, National Institute of Public Health of the Republic of Slovenia, Ljubljana, Slovenia
Unit for Research in Emergency and Disaster, Department of Medicine, University of Oviedo, Oviedo, Spain
Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
Department of Internal Medicine, Bogomolets National Medical University, Kyiv, Ukraine
Department of Medical Sciences, University of Nicosia Medical School, Nicosia, Cyprus
Center for Rural Health Research, College of Public Health, East Tennessee State University, Johnson City, TN, United States
University of Nicosia, Nicosia, Cyprus
University of Nicosia, Medical School, Nicosia, Cyprus

Department of Primary Care and Population Health
Massachusetts Institute of Technology
Health Monitoring Unit
Department of Biostatistics and Epidemiology
Department of Epidemiology
Department of Environmental Health
School of Information Technologies
European Commission Joint Research Centre
Institute for Health Transformation
Department of Epidemiology
Department of Epidemiology and Public Health
Department of Epidemiology and Biostatistics
Institute of Studies in Collective Health (IESC)
Methods and Analysis Department
Population Health Research Institute
Division of Health Services Research and Management
Department of Registries
UMR CNRS 6051
Department of Medical Statistics
Laboratory for Health Technology Assessment
Israeli Center of Disease Control
Department of Medicine
Department of Cardiology
Rector Administration
Department of Epidemiology
Department of Medicine
Department of Health Management and Health Economics
Departamento de Ingeniería
Departamento de Economia
Department of Health Economics
Public Health School
Unit for Research in Emergency and Disaster
Department of Global Public Health
Department of Internal Medicine
Department of Medical Sciences
Center for Rural Health Research
University of Nicosia
University of Nicosia

10 лет помогаем публиковать статьи Международный издатель

Книга Публикация научной статьи Волощук 2026 Book Publication of a scientific article 2026