Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.
Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
BMC Public Health. 2023 Sep 4;23(1):1707. doi: 10.1186/s12889-023-16572-0.
Burden of disease estimates have become important population health metrics over the past decade to measure losses in health. In Belgium, the disease burden caused by COVID-19 has not yet been estimated, although COVID-19 has emerged as one of the most important diseases. Therefore, the current study aims to estimate the direct COVID-19 burden in Belgium, observed despite policy interventions, during 2020 and 2021, and compare it to the burden from other causes.
Disability-adjusted life years (DALYs) are the sum of Years Lived with Disability (YLDs) and Years of Life Lost (YLLs) due to disease. DALYs allow comparing the burden of disease between countries, diseases, and over time. We used the European Burden of Disease Network consensus disease model for COVID-19 to estimate DALYs related to COVID-19. Estimates of person-years for (a) acute non-fatal disease states were calculated from a compartmental model, using Belgian seroprevalence, social contact, hospital, and intensive care admission data, (b) deaths were sourced from the national COVID-19 mortality surveillance, and (c) chronic post-acute disease states were derived from a Belgian cohort study.
In 2020, the total number of COVID-19 related DALYs was estimated at 253,577 [252,541 - 254,739], which is higher than in 2021, when it was 139,281 [136,704 - 142,306]. The observed COVID-19 burden was largely borne by the elderly, and over 90% of the burden was attributable to premature mortality (i.e., YLLs). In younger people, morbidity (i.e., YLD) contributed relatively more to the DALYs, especially in 2021, when vaccination was rolled out. Morbidity was mainly attributable to long-lasting post-acute symptoms.
COVID-19 had a substantial impact on population health in Belgium, especially in 2020, when COVID-19 would have been the main cause of disease burden if all other causes had maintained their 2019 level.
在过去十年中，疾病负担估计已成为衡量健康损失的重要人口健康指标。在比利时，尽管 COVID-19 已成为最重要的疾病之一，但尚未对其造成的疾病负担进行估计。因此，本研究旨在估计 2020 年和 2021 年期间，尽管采取了政策干预措施，但 COVID-19 在比利时造成的直接疾病负担，并将其与其他病因造成的负担进行比较。
残疾调整生命年（DALY）是因疾病导致的伤残生命年（YLD）和早逝生命年（YLL）的总和。DALY 可用于比较不同国家、疾病和不同时间的疾病负担。我们使用欧洲疾病负担网络共识疾病模型来估计与 COVID-19 相关的 DALY。（a）急性非致命疾病状态的人年数是使用比利时血清流行率、社会接触、住院和重症监护入院数据，从一个隔室模型中计算得出的；（b）死亡数据来源于国家 COVID-19 死亡率监测；（c）慢性急性后疾病状态源自一项比利时队列研究。
2020 年，与 COVID-19 相关的 DALY 总数估计为 253577 例[252541-254739]，高于 2021 年的 139281 例[136704-142306]。观察到的 COVID-19 负担主要由老年人承担，超过 90%的负担归因于过早死亡（即 YLL）。在年轻人中，发病率（即 YLD）对 DALY 的贡献相对更大，尤其是在 2021 年疫苗接种推出后。发病率主要归因于长期的急性后症状。
COVID-19 对比利时的人口健康造成了重大影响，尤其是在 2020 年，如果所有其他病因都保持 2019 年的水平，COVID-19 将成为疾病负担的主要原因。
