Department of Pathophysiology and Transplantaersità degli Studi di Milano, Cystic Fibrosis Centre, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy.
Med Lav. 2021 Dec 23;112(6):414-421. doi: 10.23749/mdl.v112i6.12601.
Italy was severely hit by the Covid-19 pandemic with an excess of around 90,000 total deaths in 2020. Comparable data in 2021 are needed for monitoring the effects of the interventions adopted to control its spread and reduce the burden. This study estimates the excess mortality in Italy in the first eight months of 2021, with a focus on the working age population.
Excess mortality was estimated as difference between the number of registered deaths and the expected deaths. Expected deaths in March-December 2020 and January-August 2021 were estimated separately by sex, through an over-dispersed Poisson regression model using mortality and population data for the period 2011-2019 (before the Covid-19 outbreak). The models included terms for calendar year, age group, a smooth function of week of the year and the natural logarithm of the population as offset term. Results: In the first eight months of 2021, we estimated 34,599 excess deaths (+7.9% of the expected deaths), of these 3667 were among individuals of working age (25-64 years). In this age group, mortality was 8.2% higher than expected with higher excesses among men (2972 deaths, +10.7%) than women (695 deaths, +4.1%).
The excess deaths in the first eight months of 2021 account for about one third of that registered in 2020. Current data indicate that around 5000 excess deaths are expected by the end of the year, leading to a total excess for 2021 of around 40 thousand deaths. Despite the absence of influenza in January-March 2021, a relevant excess was also observed among the working age population.
意大利在 2020 年受到 COVID-19 疫情的严重打击，总死亡人数超过 9 万。需要 2021 年的可比数据来监测为控制其传播和减轻负担而采取的干预措施的效果。本研究估计了 2021 年前八个月意大利的超额死亡率，重点关注工作年龄人口。
超额死亡率估计为登记死亡人数与预期死亡人数之间的差异。2020 年 3 月至 12 月和 2021 年 1 月至 8 月的预期死亡人数分别按性别进行估计，通过使用 2011-2019 年（COVID-19 爆发前）的死亡率和人口数据的过分散泊松回归模型进行估计。该模型包括日历年度、年龄组、当年周的平滑函数以及人口自然对数作为偏移项的项。
在 2021 年前八个月，我们估计有 34599 人超额死亡（占预期死亡人数的 7.9%），其中 3667 人属于工作年龄（25-64 岁）。在这个年龄组中，死亡率比预期高出 8.2%，男性（2972 人，+10.7%）的超额死亡人数高于女性（695 人，+4.1%）。
2021 年前八个月的超额死亡人数约占 2020 年登记死亡人数的三分之一。目前的数据表明，到今年年底预计将有 5000 人超额死亡，导致 2021 年总超额死亡人数约为 4 万。尽管 2021 年 1 月至 3 月没有流感，但工作年龄人群的超额死亡人数也明显增加。
