Gianino M M, Savatteri A, Politano G, Nurchis M C, Pascucci D, Damiani G
Department of Public Health and Paediatrics, Università di Torino, Turin, Italy.
Eur Rev Med Pharmacol Sci. 2021 Sep;25(17):5529-5541. doi: 10.26355/eurrev_202109_26665.
The aim of this study is to measure and compare the burden of disease of COVID-19 pandemic in 16 EU/EEA countries through the estimation of Disability-Adjusted Life Years (DALYs) over a long period of time.
The observational study was based on data from ECDC and WHO databases collected from 27 January 2020 to 15 November 2020. In addition to the absolute number of DALYs, a weekly trend of DALYs/100,000 inhabitants was computed for each country to assess the evolution of the pandemic burden over time. A cluster analysis and Kolmogorov-Smirnov (KS) test were performed to allow for a country-to-country comparison.
The total DALYs amount to 4,354 per 100.000 inhabitants. YLLs were accountable for 98% of total DALYs. Italy, Czechia and Sweden had the highest values of DALYs/100,000 while Finland, Estonia and Slovakia had the lowest. The latter three countries differed significantly from the others - in terms of DALYs trend over time - as shown by KS test. The cluster analysis allowed for the identification of three clusters of countries sharing similar trends of DALYs during the assessed period of time. These results show that notable differences were observed among different countries, with most of the disease burden attributable to YLLs.
DALYs have proven to be an effective measure of the burden of disease. Public health and policy actions, as well as demographic, epidemiological and cultural features of each country, may be responsible for the wide variations in the health impact that were observed among the countries analyzed.
本研究旨在通过长期估算伤残调整生命年（DALYs），来衡量和比较16个欧盟/欧洲经济区国家新冠疫情的疾病负担。
这项观察性研究基于2020年1月27日至2020年11月15日期间从欧洲疾病预防控制中心（ECDC）和世界卫生组织（WHO）数据库收集的数据。除了DALYs的绝对数量外，还计算了每个国家每10万居民的DALYs每周趋势，以评估疫情负担随时间的演变。进行了聚类分析和柯尔莫哥洛夫-斯米尔诺夫（KS）检验，以便进行国家间的比较。
每10万居民的DALYs总数为4354。伤残损失生命年（YLLs）占DALYs总数的98%。意大利、捷克和瑞典的每10万居民DALYs值最高，而芬兰、爱沙尼亚和斯洛伐克的该值最低。如KS检验所示，后三个国家在DALYs随时间的趋势方面与其他国家有显著差异。聚类分析有助于识别在评估时间段内DALYs趋势相似的三类国家。这些结果表明，不同国家之间存在显著差异，大部分疾病负担归因于YLLs。
事实证明，DALYs是衡量疾病负担的有效指标。公共卫生和政策行动，以及每个国家的人口、流行病学和文化特征，可能是在所分析国家中观察到的健康影响存在广泛差异的原因。
