Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark.
Statistical Office of the European Union (Eurostat), Population and Migration Unit, Luxembourg, Luxembourg.
Sci Rep. 2021 Oct 21;11(1):20815. doi: 10.1038/s41598-021-00213-w.
Europe experienced excess mortality from February through June, 2020 due to the COVID-19 pandemic, with more COVID-19-associated deaths in males compared to females. However, a difference in excess mortality among females compared to among males may be a more general phenomenon, and should be investigated in none-COVID-19 situations as well. Based on death counts from Eurostat, separate excess mortalities were estimated for each of the sexes using the EuroMOMO model. Sex-differential excess mortality were expressed as differences in excess mortality incidence rates between the sexes. A general relation between sex-differential and overall excess mortality both during the COVID-19 pandemic and in preceding seasons were investigated. Data from 27 European countries were included, covering the seasons 2016/17 to 2019/20. In periods with increased excess mortality, excess was consistently highest among males. From February through May 2020 male excess mortality was 52.7 (95% PI: 56.29; 49.05) deaths per 100,000 person years higher than for females. Increased male excess mortality compared to female was also observed in the seasons 2016/17 to 2018/19. We found a linear relation between sex-differences in excess mortality and overall excess mortality, i.e., 40 additional deaths among males per 100 excess deaths per 100,000 population. This corresponds to an overall female/male mortality incidence ratio of 0.7. In situations with overall excess mortality, excess mortality increases more for males than females. We suggest that the sex-differences observed during the COVID-19 pandemic reflects a general sex-disparity in excess mortality.
2020 年 2 月至 6 月期间，欧洲因 COVID-19 大流行而出现了超额死亡人数，与女性相比，男性 COVID-19 相关死亡人数更多。然而，女性与男性之间的超额死亡率差异可能是一种更为普遍的现象，因此也应该在非 COVID-19 情况下进行调查。根据来自 Eurostat 的死亡数据，我们使用 EuroMOMO 模型分别估算了每个性别的超额死亡率。男女之间的超额死亡率差异用性别之间超额死亡率发病率的差异来表示。我们研究了 COVID-19 大流行期间以及之前的季节中性别差异超额死亡率与整体超额死亡率之间的一般关系。纳入了来自 27 个欧洲国家的数据，涵盖了 2016/17 年至 2019/20 年的季节。在超额死亡率增加的时期，男性的超额死亡率始终最高。在 2020 年 2 月至 5 月期间，男性的超额死亡率比女性高 52.7（95%置信区间：56.29；49.05）每 10 万人年死亡人数。在 2016/17 年至 2018/19 年的季节中，也观察到男性的超额死亡率高于女性。我们发现性别差异超额死亡率与整体超额死亡率之间存在线性关系，即每 10 万人每年每增加 40 例死亡，男性的死亡率就会增加 1 例。这相当于女性/男性死亡率发病率比为 0.7。在整体超额死亡率的情况下，男性的超额死亡率增加幅度大于女性。我们认为，COVID-19 大流行期间观察到的性别差异反映了超额死亡率方面的普遍性别差异。
