Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France.
Department of Data science, Santé Publique France, Saint-Maurice, France.
PLoS One. 2023 Jan 24;18(1):e0280990. doi: 10.1371/journal.pone.0280990. eCollection 2023.
The World Health Organization declared a pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), on March 11, 2020. The standardized approach of disability-adjusted life years (DALYs) allows for quantifying the combined impact of morbidity and mortality of diseases and injuries. The main objective of this study was to estimate the direct impact of COVID-19 in France in 2020, using DALYs to combine the population health impact of infection fatalities, acute symptomatic infections and their post-acute consequences, in 28 days (baseline) up to 140 days, following the initial infection.
National mortality, COVID-19 screening, and hospital admission data were used to calculate DALYs based on the European Burden of Disease Network consensus disease model. Scenario analyses were performed by varying the number of symptomatic cases and duration of symptoms up to a maximum of 140 days, defining COVID-19 deaths using the underlying, and associated, cause of death.
In 2020, the estimated DALYs due to COVID-19 in France were 990 710 (1472 per 100 000), with 99% of burden due to mortality (982 531 years of life lost, YLL) and 1% due to morbidity (8179 years lived with disability, YLD), following the initial infection. The contribution of YLD reached 375%, assuming the duration of 140 days of post-acute consequences of COVID-19. Post-acute consequences contributed to 49% of the total morbidity burden. The contribution of YLD due to acute symptomatic infections among people younger than 70 years was higher (67%) than among people aged 70 years and above (33%). YLL among people aged 70 years and above, contributed to 74% of the total YLL.
COVID-19 had a substantial impact on population health in France in 2020. The majority of population health loss was due to mortality. Men had higher population health loss due to COVID-19 than women. Post-acute consequences of COVID-19 had a large contribution to the YLD component of the disease burden, even when we assume the shortest duration of 28 days, long COVID burden is large. Further research is recommended to assess the impact of health inequalities associated with these estimates.
2020 年 3 月 11 日，世界卫生组织宣布由严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）引起的 2019 年冠状病毒病（COVID-19）大流行。残疾调整生命年（DALYs）的标准化方法可用于量化疾病和伤害的发病率和死亡率的综合影响。本研究的主要目的是使用 DALYs 来结合感染死亡率、急性症状性感染及其急性后后果对 28 天（基线）至初始感染后 140 天的人群健康影响，以估计 2020 年法国 COVID-19 的直接影响。
利用全国死亡率、COVID-19 筛查和住院数据，根据欧洲疾病负担网络共识疾病模型计算 DALYs。通过改变症状病例数和症状持续时间（最长 140 天）进行情景分析，使用潜在和相关死因定义 COVID-19 死亡。
2020 年，法国 COVID-19 导致的估计 DALYs 为 990710（每 10 万人中有 1472 个），99%的负担归因于死亡率（982531 年生命损失，YLL），1%归因于发病率（8179 年残疾生活年，YLD），与初始感染后。假设 COVID-19 急性后后果持续 140 天，YLD 的贡献达到 375%。急性后后果占总发病率负担的 49%。70 岁以下人群急性症状性感染所致 YLD 的贡献较高（67%），而 70 岁及以上人群的 YLD 贡献较低（33%）。70 岁及以上人群的 YLL 占 YLL 总数的 74%。
COVID-19 对 2020 年法国的人群健康产生了重大影响。人群健康损失的主要原因是死亡率。男性因 COVID-19 导致的人群健康损失高于女性。COVID-19 的急性后后果对疾病负担的 YLD 构成部分有很大贡献，即使我们假设最短的 28 天持续时间，长期 COVID 负担也很大。建议进一步研究以评估与这些估计相关的健康不平等的影响。
