Mortality burden due to COVID-19 in 14 countries or regions in Southeastern Europe and Central Asia

BACKGROUND: Between 2021 and 2023, an international collaboration to estimate the burden of disease due to COVID-19 in 14 countries and regions in Southeastern Europe, the Southern Caucasus and Central Asia was funded by the German Federal Ministry of Health, under its Global Health Protection Programme. As part of the project, the indicators Years of Life Lost (YLL) and Excess Mortality (EM) were estimated in order to compare the mortality burden of COVID-19 across countries and regions. METHODS: Data on COVID-19 deaths, all-cause mortality and population numbers were collected by all partner institutions for the period March 2020 to December 2021. YLL were calculated using standard burden of disease methodology, disaggregated by sex, age and month. EM was calculated in Excel using exponential smoothing, taking trend and seasonality into account. The EM estimates generated were compared to existing estimates published by the WHO, in order to explore similarities or differences. RESULTS: In nearly all countries, YLL rates per 100,000 were higher among men than women, and among those aged 60 and older compared to younger age-groups. YLL rates per 100,000 were also higher in most countries in Southeastern Europe and in the Southern Caucasus as compared to Central Asia. In general, the YLL burden was considerably greater in 2021 compared to 2020. In most countries, the highest YLL rates were seen in the autumn and winter months. However in some countries, peaks were also seen in spring or summer. WHO estimated EM rates were largely in line with our own, except in Ukraine, Türkiye and Azerbaijan, where WHO estimates were substantially higher. CONCLUSIONS: A significant mortality burden due to COVID-19 was observed, particularly in 2021, and among men and older individuals. The disaggregation of data over time facilitates the use of burden of disease metrics in pandemic monitoring, providing an additional tool in response efforts. KEY MESSAGES: • The mortality burden due to COVID-19 was significant in the regions investigated, particularly in 2021. • Data disaggregations over time facilitate the use of burden of disease indicators in pandemic monitoring and response.