Years of life lost to COVID-19 in 20 countries

BACKGROUND: Although the highest burden of COVID-19 mortality is in older age groups, there is considerable burden of premature mortality, including within older age groups who have died as a result of the novel disease. The aim of this work was to calculate years of life lost (YLL) to COVID-19 for countries with age and sex specific COVID-19 death data available and investigate the burden of premature mortality amongst the included countries. A secondary aim was to investigate the underestimation of YLL when using country specific life expectancies instead of global life expectancies. METHODS: This study calculates YLL to COVID-19 for 20 countries to investigate the burden of premature mortality and underestimation of YLL when using country specific life expectancies compared to global. Population statistics and cumulative COVID-19 death data were extracted from the National Institute for Demographic Studies’ Demography of COVID-19 Deaths database. Overall YLL, YLL per 1000, cumulative YLL with age, and peak deaths per 1000 were calculated. RESULTS: USA has the highest overall YLL with 10 289 624 compared to Norway with the lowest YLL of 10 771. When taking into account population size, South Korea has the lowest YLL at 0.55 per 1000 people, with Moldova having the highest at 49.63 per 1000 people. In terms of COVID-19 deaths per 1000 people, South Korea again has the lowest (0.04), but England & Wales have the highest (2.39). The USA, Ukraine, Moldova and Romania have a larger burden of YLL in younger ages. England and Wales had the highest loss to a population category, with 5.78% of those aged 90+ dying of COVID-19. When using local life expectancy instead of global estimates, the burden of YLL was underestimated by as much as 47.9%. CONCLUSIONS: This study highlights that although the higher burden of YLL is with older age groups, some countries have a high burden of YLL in younger age groups that should not be ignored. It also demonstrates that life should be valued across all age groups and geographies, and when making decisions locally, there is value in decision makers comparing local lives to globally optimal values.