Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, and CPO-Piedmont, I-28100 Novara, Italy.
Covid19ita Study Group, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, I-35131 Padova, Italy.
Int J Environ Res Public Health. 2020 May 15;17(10):3452. doi: 10.3390/ijerph17103452.
Overall mortality is a relevant indicator of the population burden during an epidemic. It informs on both undiagnosed cases and on the effects of health system disruption. We aimed at evaluating the extent of the total death excess during the COVID-19 epidemic in Italy. Data from 4433 municipalities providing mortality reports until April 15th, 2020 were included for a total of 34.5 million residents from all Italian regions. Data were analyzed by region, sex and age, and compared to expected from 2015-2019. In both genders, overall mortality was stable until February 2020 and abruptly increased from March 1st onwards. Within the municipalities studied, 77,339 deaths were observed in the period between March 1st to April 15th, 2020, in contrast to the 50,822.6 expected. The rate ratio was 1.11 before age 60 and 1.55 afterwards. Both sexes were affected. The excess was greater in the regions most affected by COVID-19 but always exceeded the deaths attributed to COVID-19. The extrapolation to the total Italian population suggests an excess of 45,033 deaths in the study period, while the number of COVID-19 deaths was 21,046. Our paper shows a large death excess during the COVID-19 epidemic in Italy; greater than the number attributed to it. Possible causes included both the undetected cases and the disruption of the Health Service organization. Timely monitoring of overall mortality based on unbiased nationwide data is an essential tool for epidemic control.
总体死亡率是疫情期间人群负担的一个重要指标。它反映了未确诊病例的情况和卫生系统中断的影响。我们旨在评估意大利 COVID-19 疫情期间总死亡人数超额的程度。纳入了截至 2020 年 4 月 15 日提供死亡率报告的 4433 个城市的数据，共计包括意大利所有地区的 3450 万居民。按地区、性别和年龄对数据进行了分析，并与 2015-2019 年的预期进行了比较。在两性中，总体死亡率在 2020 年 2 月之前保持稳定，从 3 月 1 日起急剧上升。在所研究的城市中，2020 年 3 月 1 日至 4 月 15 日期间观察到 77339 例死亡，而预期为 50822.6 例。年龄在 60 岁以下的比率为 1.11，之后为 1.55。两性都受到影响。受 COVID-19 影响最大的地区的超额死亡人数更多，但始终超过归因于 COVID-19 的死亡人数。对意大利总人口的外推表明，在研究期间超额死亡人数为 45033 人，而 COVID-19 死亡人数为 21046 人。我们的论文显示，意大利 COVID-19 疫情期间的死亡人数大量增加；超过归因于 COVID-19 的死亡人数。可能的原因包括未检测到的病例和卫生服务组织的中断。基于无偏全国数据对总体死亡率的及时监测是控制疫情的重要工具。
