Ochoa Sangrador Carlos, Garmendia Leiza José Ramón, Pérez Boillos María José, Pastrana Ara Fernando, Lorenzo Lobato María Del Pilar, Andrés de Llano Jesús María
Servicio de Pediatría, Oficina de Apoyo a la Investigación Clínico-Epidemiológica, Complejo Asistencial de Zamora, Zamora, España.
Dirección General de Sistema de Información, Calidad y Prestación Farmacéutica, Gerencia Regional de Salud de Castilla y León, Sacyl, Valladolid, España.
Gac Sanit. 2021 Sep-Oct;35(5):459-464. doi: 10.1016/j.gaceta.2020.04.009. Epub 2020 May 4.
To estimate the increase in mortality associated with the SARS-CoV-2 coronavirus pandemic in the autonomous community of Castilla y León (Spain).
Ecological study based on population and death data for the months of March 2016 to 2020 in Castilla y León. The general and provincial standardized rates, the relative risks of the year 2020 with respect to previous years and the risks adjusted by sex, periods and province, using Poisson regression, were calculated. Trend analysis was performed using joinpoint linear regression.
An increase in mortality was observed in March 2020 with respect to previous years, with an increase of 39% for men (relative risk [RR]: 1.39; 95% confidence interval [95%CI]: 1.32-1.47) and 28% for women (RR: 1.28; 95%CI: 1.21-1.35). The model predicts excess mortality of 775 deaths. In the trend analysis there is a significant turning point in 2019 in men, globally and for almost all provinces. The increase in mortality is general, although heterogeneous by sex, age group and province.
Although the observed increase in mortality cannot be totally attributed to the disease, it is the best estimate we have of the real impact on deaths directly or indirectly related to it. The number of declared deaths only reaches two thirds of the increase in mortality observed.
评估西班牙卡斯蒂利亚-莱昂自治区与新型冠状病毒肺炎疫情相关的死亡率上升情况。
基于2016年3月至2020年卡斯蒂利亚-莱昂的人口和死亡数据进行生态学研究。计算总体和省级标准化率、2020年相对于前几年的相对风险以及使用泊松回归按性别、时期和省份调整后的风险。使用连接点线性回归进行趋势分析。
观察到2020年3月死亡率相对于前几年有所上升,男性上升39%(相对风险[RR]:1.39;95%置信区间[95%CI]:1.32 - 1.47),女性上升28%(RR:1.28;95%CI:1.21 - 1.35)。该模型预测超额死亡775例。在趋势分析中,2019年男性在总体上以及几乎所有省份都有一个显著的转折点。死亡率上升是普遍现象,尽管在性别、年龄组和省份方面存在差异。
虽然观察到的死亡率上升不能完全归因于该疾病,但这是我们对其直接或间接相关死亡实际影响的最佳估计。申报的死亡人数仅达到观察到的死亡率上升的三分之二。