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Excess mortality in Wuhan city and other parts of China during the three months of the covid-19 outbreak: findings from nationwide mortality registries

OBJECTIVE: To assess excess all cause and cause specific mortality during the three months (1 January to 31 March 2020) of the coronavirus disease 2019 (covid-19) outbreak in Wuhan city and other parts of China. DESIGN: Nationwide mortality registries. SETTING: 605 urban districts and rural counties...

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Autores principales: Liu, Jiangmei, Zhang, Lan, Yan, Yaqiong, Zhou, Yuchang, Yin, Peng, Qi, Jinlei, Wang, Lijun, Pan, Jingju, You, Jinling, Yang, Jing, Zhao, Zhenping, Wang, Wei, Liu, Yunning, Lin, Lin, Wu, Jing, Li, Xinhua, Chen, Zhengming, Zhou, Maigeng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group Ltd. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7900645/
https://www.ncbi.nlm.nih.gov/pubmed/33627311
http://dx.doi.org/10.1136/bmj.n415
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author Liu, Jiangmei
Zhang, Lan
Yan, Yaqiong
Zhou, Yuchang
Yin, Peng
Qi, Jinlei
Wang, Lijun
Pan, Jingju
You, Jinling
Yang, Jing
Zhao, Zhenping
Wang, Wei
Liu, Yunning
Lin, Lin
Wu, Jing
Li, Xinhua
Chen, Zhengming
Zhou, Maigeng
author_facet Liu, Jiangmei
Zhang, Lan
Yan, Yaqiong
Zhou, Yuchang
Yin, Peng
Qi, Jinlei
Wang, Lijun
Pan, Jingju
You, Jinling
Yang, Jing
Zhao, Zhenping
Wang, Wei
Liu, Yunning
Lin, Lin
Wu, Jing
Li, Xinhua
Chen, Zhengming
Zhou, Maigeng
author_sort Liu, Jiangmei
collection PubMed
description OBJECTIVE: To assess excess all cause and cause specific mortality during the three months (1 January to 31 March 2020) of the coronavirus disease 2019 (covid-19) outbreak in Wuhan city and other parts of China. DESIGN: Nationwide mortality registries. SETTING: 605 urban districts and rural counties in China’s nationally representative Disease Surveillance Point (DSP) system. PARTICIPANTS: More than 300 million people of all ages. MAIN OUTCOME MEASURES: Observed overall and weekly mortality rates from all cause and cause specific diseases for three months (1 January to 31 March 2020) of the covid-19 outbreak compared with the predicted (or mean rates for 2015-19) in different areas to yield rate ratio. RESULTS: The DSP system recorded 580 819 deaths from January to March 2020. In Wuhan DSP districts (n=3), the observed total mortality rate was 56% (rate ratio 1.56, 95% confidence interval 1.33 to 1.87) higher than the predicted rate (1147 v 735 per 100 000), chiefly as a result of an eightfold increase in deaths from pneumonia (n=1682; 275 v 33 per 100 000; 8.32, 5.19 to 17.02), mainly covid-19 related, but a more modest increase in deaths from certain other diseases, including cardiovascular disease (n=2347; 408 v 316 per 100 000; 1.29, 1.05 to 1.65) and diabetes (n=262; 46 v 25 per 100 000; 1.83, 1.08 to 4.37). In Wuhan city (n=13 districts), 5954 additional (4573 pneumonia) deaths occurred in 2020 compared with 2019, with excess risks greater in central than in suburban districts (50% v 15%). In other parts of Hubei province (n=19 DSP areas), the observed mortality rates from pneumonia and chronic respiratory diseases were non-significantly 28% and 23% lower than the predicted rates, despite excess deaths from covid-19 related pneumonia. Outside Hubei (n=583 DSP areas), the observed total mortality rate was non-significantly lower than the predicted rate (675 v 715 per 100 000), with significantly lower death rates from pneumonia (0.53, 0.46 to 0.63), chronic respiratory diseases (0.82, 0.71 to 0.96), and road traffic incidents (0.77, 0.68 to 0.88). CONCLUSIONS: Except in Wuhan, no increase in overall mortality was found during the three months of the covid-19 outbreak in other parts of China. The lower death rates from certain non-covid-19 related diseases might be attributable to the associated behaviour changes during lockdown.
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spelling pubmed-79006452021-02-23 Excess mortality in Wuhan city and other parts of China during the three months of the covid-19 outbreak: findings from nationwide mortality registries Liu, Jiangmei Zhang, Lan Yan, Yaqiong Zhou, Yuchang Yin, Peng Qi, Jinlei Wang, Lijun Pan, Jingju You, Jinling Yang, Jing Zhao, Zhenping Wang, Wei Liu, Yunning Lin, Lin Wu, Jing Li, Xinhua Chen, Zhengming Zhou, Maigeng BMJ Research OBJECTIVE: To assess excess all cause and cause specific mortality during the three months (1 January to 31 March 2020) of the coronavirus disease 2019 (covid-19) outbreak in Wuhan city and other parts of China. DESIGN: Nationwide mortality registries. SETTING: 605 urban districts and rural counties in China’s nationally representative Disease Surveillance Point (DSP) system. PARTICIPANTS: More than 300 million people of all ages. MAIN OUTCOME MEASURES: Observed overall and weekly mortality rates from all cause and cause specific diseases for three months (1 January to 31 March 2020) of the covid-19 outbreak compared with the predicted (or mean rates for 2015-19) in different areas to yield rate ratio. RESULTS: The DSP system recorded 580 819 deaths from January to March 2020. In Wuhan DSP districts (n=3), the observed total mortality rate was 56% (rate ratio 1.56, 95% confidence interval 1.33 to 1.87) higher than the predicted rate (1147 v 735 per 100 000), chiefly as a result of an eightfold increase in deaths from pneumonia (n=1682; 275 v 33 per 100 000; 8.32, 5.19 to 17.02), mainly covid-19 related, but a more modest increase in deaths from certain other diseases, including cardiovascular disease (n=2347; 408 v 316 per 100 000; 1.29, 1.05 to 1.65) and diabetes (n=262; 46 v 25 per 100 000; 1.83, 1.08 to 4.37). In Wuhan city (n=13 districts), 5954 additional (4573 pneumonia) deaths occurred in 2020 compared with 2019, with excess risks greater in central than in suburban districts (50% v 15%). In other parts of Hubei province (n=19 DSP areas), the observed mortality rates from pneumonia and chronic respiratory diseases were non-significantly 28% and 23% lower than the predicted rates, despite excess deaths from covid-19 related pneumonia. Outside Hubei (n=583 DSP areas), the observed total mortality rate was non-significantly lower than the predicted rate (675 v 715 per 100 000), with significantly lower death rates from pneumonia (0.53, 0.46 to 0.63), chronic respiratory diseases (0.82, 0.71 to 0.96), and road traffic incidents (0.77, 0.68 to 0.88). CONCLUSIONS: Except in Wuhan, no increase in overall mortality was found during the three months of the covid-19 outbreak in other parts of China. The lower death rates from certain non-covid-19 related diseases might be attributable to the associated behaviour changes during lockdown. BMJ Publishing Group Ltd. 2021-02-24 /pmc/articles/PMC7900645/ /pubmed/33627311 http://dx.doi.org/10.1136/bmj.n415 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/.
spellingShingle Research
Liu, Jiangmei
Zhang, Lan
Yan, Yaqiong
Zhou, Yuchang
Yin, Peng
Qi, Jinlei
Wang, Lijun
Pan, Jingju
You, Jinling
Yang, Jing
Zhao, Zhenping
Wang, Wei
Liu, Yunning
Lin, Lin
Wu, Jing
Li, Xinhua
Chen, Zhengming
Zhou, Maigeng
Excess mortality in Wuhan city and other parts of China during the three months of the covid-19 outbreak: findings from nationwide mortality registries
title Excess mortality in Wuhan city and other parts of China during the three months of the covid-19 outbreak: findings from nationwide mortality registries
title_full Excess mortality in Wuhan city and other parts of China during the three months of the covid-19 outbreak: findings from nationwide mortality registries
title_fullStr Excess mortality in Wuhan city and other parts of China during the three months of the covid-19 outbreak: findings from nationwide mortality registries
title_full_unstemmed Excess mortality in Wuhan city and other parts of China during the three months of the covid-19 outbreak: findings from nationwide mortality registries
title_short Excess mortality in Wuhan city and other parts of China during the three months of the covid-19 outbreak: findings from nationwide mortality registries
title_sort excess mortality in wuhan city and other parts of china during the three months of the covid-19 outbreak: findings from nationwide mortality registries
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7900645/
https://www.ncbi.nlm.nih.gov/pubmed/33627311
http://dx.doi.org/10.1136/bmj.n415
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