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Underestimation of COVID-19 mortality during the pandemic

BACKGROUND: There has been considerable international variation in mortality during the COVID-19 pandemic. The objective of this study was to investigate the differences between mortality registered as due to COVID-19 and the excess all-cause mortality reported in countries worldwide during the COVI...

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Autores principales: Kung, Stacey, Doppen, Marjan, Black, Melissa, Braithwaite, Irene, Kearns, Ciléin, Weatherall, Mark, Beasley, Richard, Kearns, Nethmi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Respiratory Society 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7734715/
https://www.ncbi.nlm.nih.gov/pubmed/33614772
http://dx.doi.org/10.1183/23120541.00766-2020
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author Kung, Stacey
Doppen, Marjan
Black, Melissa
Braithwaite, Irene
Kearns, Ciléin
Weatherall, Mark
Beasley, Richard
Kearns, Nethmi
author_facet Kung, Stacey
Doppen, Marjan
Black, Melissa
Braithwaite, Irene
Kearns, Ciléin
Weatherall, Mark
Beasley, Richard
Kearns, Nethmi
author_sort Kung, Stacey
collection PubMed
description BACKGROUND: There has been considerable international variation in mortality during the COVID-19 pandemic. The objective of this study was to investigate the differences between mortality registered as due to COVID-19 and the excess all-cause mortality reported in countries worldwide during the COVID-19 pandemic. METHODS: Ecological analysis of 22 countries compared 5-year historical all-cause mortality, reported all-cause mortality and expected all-cause mortality (calculated as historical mortality plus the reported deaths attributed to COVID-19). Data available from the first week of January 2020 to that most recently available were analysed. RESULTS: Compared to the preceding 5 years, there was an excess of 716 616 deaths, of which 64.3% were attributed to COVID-19. The proportion of deaths registered as COVID-19-related/excess deaths varied markedly between countries, ranging between 30% and 197% in those countries that had an excess of deaths during the period of observation. In most countries where a definite peak in COVID-19-related deaths occurred, the increase in reported all-cause mortality preceded the increase in COVID-19 reported mortality. During the latter period of observation, a few countries reported fewer all-cause deaths than the historical figures. CONCLUSION: The increases in all-cause mortality preceded the increase in COVID-19 mortality in most countries that had definite spikes in COVID-19 mortality. The number of deaths attributed to COVID-19 was underestimated by at least 35%. Together these findings suggest that calculation of excess all-cause mortality is a better predictor of COVID-19 mortality than the reported rates, in those countries experiencing definite increases in mortality.
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spelling pubmed-77347152020-12-15 Underestimation of COVID-19 mortality during the pandemic Kung, Stacey Doppen, Marjan Black, Melissa Braithwaite, Irene Kearns, Ciléin Weatherall, Mark Beasley, Richard Kearns, Nethmi ERJ Open Res Original Articles BACKGROUND: There has been considerable international variation in mortality during the COVID-19 pandemic. The objective of this study was to investigate the differences between mortality registered as due to COVID-19 and the excess all-cause mortality reported in countries worldwide during the COVID-19 pandemic. METHODS: Ecological analysis of 22 countries compared 5-year historical all-cause mortality, reported all-cause mortality and expected all-cause mortality (calculated as historical mortality plus the reported deaths attributed to COVID-19). Data available from the first week of January 2020 to that most recently available were analysed. RESULTS: Compared to the preceding 5 years, there was an excess of 716 616 deaths, of which 64.3% were attributed to COVID-19. The proportion of deaths registered as COVID-19-related/excess deaths varied markedly between countries, ranging between 30% and 197% in those countries that had an excess of deaths during the period of observation. In most countries where a definite peak in COVID-19-related deaths occurred, the increase in reported all-cause mortality preceded the increase in COVID-19 reported mortality. During the latter period of observation, a few countries reported fewer all-cause deaths than the historical figures. CONCLUSION: The increases in all-cause mortality preceded the increase in COVID-19 mortality in most countries that had definite spikes in COVID-19 mortality. The number of deaths attributed to COVID-19 was underestimated by at least 35%. Together these findings suggest that calculation of excess all-cause mortality is a better predictor of COVID-19 mortality than the reported rates, in those countries experiencing definite increases in mortality. European Respiratory Society 2021-02-15 /pmc/articles/PMC7734715/ /pubmed/33614772 http://dx.doi.org/10.1183/23120541.00766-2020 Text en Copyright ©ERS 2021 http://creativecommons.org/licenses/by-nc/4.0/This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.
spellingShingle Original Articles
Kung, Stacey
Doppen, Marjan
Black, Melissa
Braithwaite, Irene
Kearns, Ciléin
Weatherall, Mark
Beasley, Richard
Kearns, Nethmi
Underestimation of COVID-19 mortality during the pandemic
title Underestimation of COVID-19 mortality during the pandemic
title_full Underestimation of COVID-19 mortality during the pandemic
title_fullStr Underestimation of COVID-19 mortality during the pandemic
title_full_unstemmed Underestimation of COVID-19 mortality during the pandemic
title_short Underestimation of COVID-19 mortality during the pandemic
title_sort underestimation of covid-19 mortality during the pandemic
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7734715/
https://www.ncbi.nlm.nih.gov/pubmed/33614772
http://dx.doi.org/10.1183/23120541.00766-2020
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