Beeks Victoria Virginia, Achilleos Souzana, Quattrocchi Annalisa, Pallari Chryso Th, Critselis Elena, Salameh Pascale, Rahmanian Haghighi Mohammad Reza, Rodriguez-Llanes Jose Manuel, Ambrosio Giuseppe, Artemiou Andreas, Gabel John, Bennett Catherine Marie, Cuthbertson Joseph, Zimmermann Claudia, Schernhammer Eva Susanna, Costa Antonio José Leal, de Carvalho Luciana Freire, Lobato Jackeline Christiane Pinto, Athanasiadou Maria, Critchley Julia Alison, Goldsmith Lucy Pollyanna, Kandelaki Levan, Glushkova Natalya, Davletov Kairat, Semenova Yuliya, Erzen Ivan, Verstiuk Olesia, Alekkou Dimos, Polemitis Antonis, Charalambous Andreas, Demetriou Christiana A
Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus.
PlanAdapt, Berlin, Germany.
J Epidemiol Glob Health. 2024 Jun;14(2):337-348. doi: 10.1007/s44197-024-00242-4. Epub 2024 May 22.
This study investigated cause-specific mortality rates in 12 countries during the COVID-19 pandemic in 2020 and 2021.
We collected weekly cause-specific mortality data from respiratory disease, pneumonia, cardiovascular disease (CVD) and cancer from national vital statistic databases. We calculated excess mortality for respiratory disease (excluding COVID-19 codes), pneumonia, and CVD in 2020 and 2021 by comparing observed weekly against expected mortality based on historical data (2015-2019), accounting for seasonal trends. We used multilevel regression models to investigate the association between country-level pandemic-related variables and cause-specific mortality.
Significant reductions in cumulative mortality from respiratory disease and pneumonia were observed in 2020 and/or 2021, except for Georgia, Northern Ireland, Kazakhstan, and Ukraine, which exhibited excess mortality for one or both causes. Australia, Austria, Cyprus, Georgia, and Northern Ireland experienced excess cumulative CVD mortality in 2020 and/or 2021. Australia, Austria, Brazil, Cyprus, Georgia, Northern Ireland, Scotland and Slovenia, experienced increased crude cumulative cancer mortality during 2020 and/or 2021 compared to previous years. Among pandemic-related variables, reported COVID-19 incidence was negatively associated with increased cancer mortality, excess respiratory, (2020) and pneumonia (2021) mortality, and positively associated with respiratory and CVD mortality (2021). Stringency of control measures were negatively associated with excess respiratory disease, CVD, and increased cancer mortality (2021).
This study provides evidence of substantial excess mortality from CVD, and notable reductions in respiratory disease and pneumonia in both years across most countries investigated. Our study also highlights the beneficial impact of stringent control measures in mitigating excess mortality from most causes in 2021.
本研究调查了2020年和2021年新冠疫情期间12个国家特定病因的死亡率。
我们从各国人口动态统计数据库收集了呼吸系统疾病、肺炎、心血管疾病（CVD）和癌症的每周特定病因死亡率数据。我们通过将2020年和2021年观察到的每周死亡率与基于历史数据（2015 - 2019年）的预期死亡率进行比较，并考虑季节性趋势，计算了呼吸系统疾病（不包括新冠代码）、肺炎和CVD的超额死亡率。我们使用多水平回归模型来研究国家层面与疫情相关的变量和特定病因死亡率之间的关联。
在2020年和/或2021年，观察到呼吸系统疾病和肺炎的累积死亡率显著下降，但格鲁吉亚、北爱尔兰、哈萨克斯坦和乌克兰除外，这几个国家在一种或两种病因上出现了超额死亡率。澳大利亚、奥地利、塞浦路斯、格鲁吉亚和北爱尔兰在2020年和/或2021年经历了CVD累积超额死亡率。与前几年相比，澳大利亚、奥地利、巴西、塞浦路斯、格鲁吉亚、北爱尔兰、苏格兰和斯洛文尼亚在2020年和/或2021年的粗累积癌症死亡率有所上升。在与疫情相关的变量中，报告的新冠发病率与癌症死亡率上升、呼吸系统疾病超额死亡率（2020年）和肺炎超额死亡率（2021年）呈负相关，与呼吸系统疾病和CVD死亡率（2021年）呈正相关。防控措施的严格程度与呼吸系统疾病超额死亡率、CVD和癌症死亡率上升（2021年）呈负相关。
本研究提供了证据，表明在所调查的大多数国家中，CVD导致了大量超额死亡率，而呼吸系统疾病和肺炎在这两年中显著下降。我们的研究还强调了严格防控措施在减轻2021年大多数病因导致的超额死亡率方面的有益影响。
