Bureau of Vital Statistics, New York City Department of Health and Mental Hygiene, New York, New York, USA
Bureau of Vital Statistics, New York City Department of Health and Mental Hygiene, New York, New York, USA.
BMJ Open. 2024 Apr 3;14(4):e072441. doi: 10.1136/bmjopen-2023-072441.
Assessing excess deaths from benchmarks across causes of death during the first wave of the COVID-19 pandemic and identifying morbidities most frequently mentioned alongside COVID-19 deaths in the death record.
Descriptive study of death records between 11 March 2020 and 27 July 2020, from the New York City Bureau of Vital Statistics. Mortality counts and percentages were compared with the average for the same calendar period of the previous 2 years. Distributions of morbidities from among forty categories of conditions were generated citywide and by sex, race/ethnicity and four age groups. Causes of death were assumed to follow Poisson processes for Z-score construction.
Within the study period, 46 563 all-cause deaths were reported; 132.9% higher than the average for the same period of the previous 2 years (19 989). Of those 46 563 records, 19 789 (42.5%) report COVID-19 as underlying cause of death. COVID-19 was the most prevalent cause across all demographics, with respiratory conditions (prominently pneumonia), hypertension and diabetes frequently mentioned morbidities. Black non-Hispanics had greater proportions of mentions of pneumonia, hypertension, and diabetes. Hispanics had the largest proportion of COVID-19 deaths (52.9%). Non-COVID-19 excess deaths relative to the previous 2-year averages were widely reported.
Mortality directly due to COVID-19 was accompanied by significant increases across most other causes from their reference averages, potentially suggesting a sizable COVID-19 death undercount. Indirect effects due to COVID-19 may partially account for some increases, but findings are hardly dispositive. Unavailability of vaccines for the time period precludes any impact over excess deaths. Respiratory and cardiometabolic-related conditions were most frequently reported among COVID-19 deaths across demographic characteristics.
评估 COVID-19 大流行第一波期间因各种死因导致的超额死亡人数，并确定在死亡记录中与 COVID-19 死亡一起被频繁提及的合并症。
这是一项对 2020 年 3 月 11 日至 2020 年 7 月 27 日期间来自纽约市生命统计局的死亡记录进行的描述性研究。死亡率计数和百分比与前 2 年同期的平均值进行了比较。在全市范围内以及按性别、种族/族裔和四个年龄组生成了 40 个类别的疾病分布情况。死因假设遵循泊松过程进行 Z 分数构建。
在所研究期间报告了 46563 例全因死亡；比前 2 年同期的平均值高出 132.9%（19989 例）。在这 46563 份记录中，19789 份（42.5%）报告 COVID-19 为根本死因。COVID-19 是所有人群中最常见的原因，呼吸道疾病（突出的是肺炎）、高血压和糖尿病是经常被提及的合并症。非裔西班牙裔黑人的肺炎、高血压和糖尿病提及率更高。西班牙裔的 COVID-19 死亡率最高（52.9%）。与前 2 年平均值相比，非 COVID-19 超额死亡人数广泛报道。
直接归因于 COVID-19 的死亡率伴随着大多数其他原因的死亡率显著上升，这可能表明 COVID-19 死亡人数被低估了很多。由于 COVID-19 导致的间接影响可能部分导致了一些上升，但这些发现还远远不能确定。由于该时期无法获得疫苗，因此对超额死亡人数没有任何影响。在各种人口统计学特征中，与 COVID-19 死亡一起最常报告的是与呼吸道和心血管代谢相关的疾病。
