Department 2, Epidemiology and Health Monitoring, Robert Koch Institute, Berlin; Department 3, Infectious Disease Epidemiology, Robert Koch Institute, Berlin; Department II 1 Environmental Hygiene, German Environment Agency, Berlin.
Dtsch Arztebl Int. 2021 Mar 5;118(9):145-151. doi: 10.3238/arztebl.m2021.0147.
BACKGROUND: The SARS-CoV-2 pandemic presented major challenges to the health sector in 2020. The burden of disease arising from COVID-19 can be expressed as the number of years of life lost to disease or death. For example, death at age 40 involves a loss of far more years of life than death at age 80. METHODS: The disability-adjusted life years (DALY) lost to COVID-19 were calculated as the sum of the years of life lost through death (YLL) and the number of years lived with disability (YLD), on the basis of laboratory-confirmed notifiable cases of SARS-CoV-2 infection in Germany in 2020 (documented as of 18 January 2021). The methodology was based on that used in the Global Burden of Disease Study. Pre-existing diseases do not enter into the determination of YLL; rather, the residual life expectancy that is applied in this calculation corresponds to a mean age-specific level of morbidity. RESULTS: 305 641 years of life were lost to COVID-19 in Germany in 2020. The percentage of DALY lost by persons under 70 was 34.8% in men and 21.0% in women. 99.3% of the COVID-19 disease burden was accounted for by death (YLL). The daily average years of life lost due to death was lower for COVID-19 than for the major non-communicable diseases. Persons who died of COVID-19 lost a mean of 9.6 years of life; those who were under 70 when they died lost a mean of 25.2 years of life. Men lost more years of life than women (11.0 vs. 8.1 years). CONCLUSION: The effects of COVID-19 on public health can be expressed through the burden of disease indicators. This method yields additional information that should be put to use early in the course of future outbreaks.
背景:2020 年,SARS-CoV-2 大流行给卫生部门带来了巨大挑战。由 COVID-19 导致的疾病负担可以用因疾病或死亡而损失的生命年来表示。例如,40 岁死亡涉及的生命损失远远超过 80 岁死亡。
方法:根据 2020 年德国实验室确诊的 SARS-CoV-2 感染病例(截至 2021 年 1 月 18 日记录),计算 COVID-19 导致的残疾调整生命年(DALY)损失,将死亡造成的生命损失年数(YLL)和因残疾而生活的年数(YLD)相加。该方法基于全球疾病负担研究中使用的方法。在确定 YLL 时不考虑先前存在的疾病;相反,在此计算中应用的剩余预期寿命对应于特定年龄的平均发病率水平。
结果:2020 年德国因 COVID-19 损失了 305641 生命年。70 岁以下人群的 DALY 损失百分比为男性 34.8%,女性 21.0%。99.3%的 COVID-19 疾病负担归因于死亡(YLL)。因 COVID-19 死亡的人平均每天损失的生命年数低于主要非传染性疾病。死于 COVID-19 的人平均损失 9.6 年的生命;70 岁以下死亡的人平均损失 25.2 年的生命。男性比女性损失更多的生命年(11.0 年对 8.1 年)。
结论:可以通过疾病负担指标来表达 COVID-19 对公共卫生的影响。这种方法提供了更多信息,应该在未来疫情爆发早期利用这些信息。
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