Tadbiri Hooman, Moradi-Lakeh Maziar, Naghavi Mohsen
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2020 Jul 15;34:80. doi: 10.34171/mjiri.34.80. eCollection 2020.
Iran reported its first COVID-19 deaths on February 19, 2020 and announced 1284 deaths with a laboratory-confirmed SARS-CoV-2 infection by March 19, 2020 (end of the winter 1398 SH). We estimated all-cause excess mortality, compared to the historical trends, to obtain an indirect estimate of COVID-19-related deaths. We assembled time series of the seasonal number of all-cause mortalities from March 21, 2013 (spring of 1392 SH) to March 19, 2020 (winter 1398 SH) for each province of Iran and nationwide with the vital statistics data from the National Organization for Civil Registration (NOCR). We estimated the expected seasonal mortality and excess mortality (the difference between the number of registered and expected deaths). Moreover, we reviewed the provincial number of confirmed cases of COVID-19 to assess their association with excess deaths. The results of our analysis showed around 7507 (95% CI: 3,350 - 11,664) and 5180 (95% CI: 1,023 - 9,337) all-cause excess mortality in fall and winter, respectively. There were 3778 excess deaths occurred in Qom, Gilan, Mazandaran, and Golestan provinces in the winter, all among the COVID-19 epicenters based on the number of confirmed cases. We think most of the excess deaths in the winter were related to COVID-19. Also, we think the influenza epidemic might have been the main reason for the excess mortality in the fall and parts of excess deaths in the winter of 1398 SH. Moreover, a review of all available clinical and paraclinical records and through analyses of the surveillance data for severe acute respiratory infections (SARI) can help to obtain a more accurate estimate of COVID-19 mortality.
伊朗于2020年2月19日报告了首例新冠病毒死亡病例，并于2020年3月19日（伊朗历1398年冬季末）宣布有1284例死亡病例，其感染经实验室确诊为严重急性呼吸综合征冠状病毒2（SARS-CoV-2）。我们通过与历史趋势相比较，估算了全因超额死亡率，以间接估计与新冠病毒相关的死亡人数。我们利用来自国家民事登记组织（NOCR）的人口动态统计数据，汇编了2013年3月21日（伊朗历1392年春季）至2020年3月（伊朗历1398年冬季）伊朗各省及全国季节性全因死亡人数的时间序列。我们估算了预期季节性死亡率和超额死亡率（登记死亡人数与预期死亡人数之差）。此外，我们还审查了各省新冠病毒确诊病例数，以评估其与超额死亡的关联。我们的分析结果显示，秋季和冬季的全因超额死亡率分别约为7507例（95%置信区间：3350 - 11664）和5180例（95%置信区间：1023 - 9337）。冬季，库姆省、吉兰省、马赞德兰省和戈勒斯坦省出现了3778例超额死亡病例，根据确诊病例数，这些省份均位于新冠病毒疫情中心。我们认为冬季的大多数超额死亡与新冠病毒有关。此外，我们认为流感疫情可能是秋季超额死亡率以及伊朗历1398年冬季部分超额死亡的主要原因。此外，审查所有可用的临床和辅助临床记录，并通过分析严重急性呼吸道感染（SARI）监测数据，有助于更准确地估算新冠病毒死亡率。
