Kepp Kasper P, Björk Jonas, Emilsson Louise, Lallukka Tea
Section of Biophysical and Biomedicinal Chemistry, DTU Chemistry, Technical University of Denmark, Kongens Lyngby, Denmark.
Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden.
SSM Popul Health. 2023 Jun;22:101377. doi: 10.1016/j.ssmph.2023.101377. Epub 2023 Mar 5.
The Nordic countries offer an ideal case study of the COVID-19 pandemic due to their comparability, high data quality, and variable mitigations. We investigated the age- and sex-specific mortality patterns during 2020-2021 for the five Nordic countries and analysed the total age- and sex-adjusted excess deaths, ratios of actual to expected death rates, and age-standardized excess death estimates. We assessed excess deaths using several time periods and sensitivity tests, and 42 sex and age groups. Declining pre-pandemic age-specific death rates reflected improving health demographics. These affect the expected death estimates and should be accounted for in excess mortality models. Denmark had the highest death rates both before and during the pandemic, whereas in 2020 Sweden had the largest mortality increase. The age-standardized mortality of Denmark, Iceland and Norway was lowest in 2020. 2021 was one of the lowest mortality years for all Nordic countries. The total excess deaths in 2020-2021 were dominated by 70-89-year-olds, were not identified in children, and were more pronounced among men than women. Sweden had more excess deaths in 2020 than in 2021, whereas Finland, Norway and Denmark had the opposite. Our study provides new details on Nordic sex- and age-specific mortality during the first two years of the pandemic and shows that several metrics are important to enable a full understanding and comparison of the pandemic mortality.
北欧国家因其可比性、高数据质量和不同的疫情缓解措施，为新冠疫情提供了一个理想的案例研究。我们调查了2020 - 2021年期间五个北欧国家按年龄和性别的死亡率模式，并分析了总体年龄和性别调整后的超额死亡人数、实际死亡率与预期死亡率的比率以及年龄标准化超额死亡估计数。我们使用了几个时间段和敏感性测试以及42个性别和年龄组来评估超额死亡情况。疫情前特定年龄死亡率的下降反映了健康人口结构的改善。这些会影响预期死亡估计数，应在超额死亡率模型中予以考虑。丹麦在疫情前和疫情期间的死亡率最高，而在2020年瑞典的死亡率增幅最大。丹麦、冰岛和挪威的年龄标准化死亡率在2020年最低。2021年是所有北欧国家死亡率最低的年份之一。2020 - 2021年的总超额死亡人数主要集中在70 - 89岁年龄段，儿童中未发现超额死亡情况，男性的超额死亡情况比女性更明显。瑞典2020年的超额死亡人数比2021年多，而芬兰、挪威和丹麦则相反。我们的研究提供了关于疫情头两年北欧按性别和年龄的死亡率的新细节，并表明几个指标对于全面理解和比较疫情死亡率很重要。
