Centre for One Health, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab, 141004, India.
Sydney School of Veterinary Science, The University of Sydney, 425 Werombi Road, Camden, 2570 NSW, Australia.
Sci Rep. 2022 Feb 14;12(1):2454. doi: 10.1038/s41598-022-06505-z.
COVID-19 has affected all countries. Its containment represents a unique challenge for India due to a large population (> 1.38 billion) across a wide range of population densities. Assessment of the COVID-19 disease burden is required to put the disease impact into context and support future pandemic policy development. Here, we present the national-level burden of COVID-19 in India in 2020 that accounts for differences across urban and rural regions and across age groups. Input data were collected from official records or published literature. The proportion of excess COVID-19 deaths was estimated using the Institute for Health Metrics and Evaluation, Washington data. Disability-adjusted life years (DALY) due to COVID-19 were estimated in the Indian population in 2020, comprised of years of life lost (YLL) and years lived with disability (YLD). YLL was estimated by multiplying the number of deaths due to COVID-19 by the residual standard life expectancy at the age of death due to the disease. YLD was calculated as a product of the number of incident cases of COVID-19, disease duration and disability weight. Scenario analyses were conducted to account for excess deaths not recorded in the official data and for reported COVID-19 deaths. The direct impact of COVID-19 in 2020 in India was responsible for 14,100,422 (95% uncertainty interval [UI] 14,030,129-14,213,231) DALYs, consisting of 99.2% (95% UI 98.47-99.64%) YLLs and 0.80% (95% UI 0.36-1.53) YLDs. DALYs were higher in urban (56%; 95% UI 56-57%) than rural areas (44%; 95% UI 43.4-43.6) and in men (64%) than women (36%). In absolute terms, the highest DALYs occurred in the 51-60-year-old age group (28%) but the highest DALYs per 100,000 persons were estimated for the 71-80 years old age group (5481; 95% UI 5464-5500 years). There were 4,815,908 (95% UI 4,760,908-4,924,307) DALYs after considering reported COVID-19 deaths only. The DALY estimations have direct and immediate implications not only for public policy in India, but also internationally given that India represents one sixth of the world's population.
新冠疫情已波及所有国家。印度拥有庞大的人口（超过 13.8 亿），人口密度差异显著，因此控制疫情极具挑战。为了解疾病的影响并为未来的大流行政策制定提供参考，有必要对新冠疫情的疾病负担进行评估。本文呈现了 2020 年印度的全国新冠疫情负担，其中考虑了城乡地区和各年龄组之间的差异。输入数据来自官方记录或已发表的文献。超额新冠死亡人数的比例采用华盛顿健康计量评估研究所的数据进行估算。2020 年，印度人口因新冠导致的伤残调整生命年（DALY）包括因疾病死亡导致的预期寿命损失年（YLL）和因病残疾导致的生存年（YLD）。YLL 通过将因新冠死亡的人数乘以疾病死亡时的剩余标准预期寿命来估算。YLD 通过新冠发病例数、疾病持续时间和残疾权重的乘积来计算。我们还进行了情景分析，以考虑官方数据中未记录的超额死亡人数和报告的新冠死亡人数。2020 年，新冠疫情在印度造成的直接影响导致 14100422 个伤残调整生命年（95%置信区间[UI]为 14030129-14213231），其中 99.2%（95% UI 为 98.47-99.64%）为 YLL，0.80%（95% UI 为 0.36-1.53%）为 YLD。城市地区（56%；95% UI 为 56-57%）的 DALY 高于农村地区（44%；95% UI 为 43.4-43.6%），男性（64%）高于女性（36%）。从绝对值来看，51-60 岁年龄组的 DALY 最高（28%），但每 10 万人的 DALY 最高的年龄组为 71-80 岁（5481；95% UI 为 5464-5500 岁）。仅考虑报告的新冠死亡人数时，DALY 为 4815908（95% UI 为 4760908-4924307）。这些估计结果不仅对印度国内的公共政策具有直接和即时的影响，而且鉴于印度占世界人口的六分之一，对国际社会也具有重要意义。
