Covid-19, non-Covid-19 and excess mortality rates not comparable across countries.
Covid-19, non-Covid-19 and excess mortality rates not comparable across countries.
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DOI：
10.1017/s0950268821001850
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发表时间：
2021-08-02
影响因子：
4.2
通讯作者：
Noah N
中科院分区：
文献类型：
--
作者：
Kelly G;Petti S;Noah N
死亡率数据显示，一些国家死于新冠肺炎的人数多于其他国家，而另一些国家死于新冠肺炎的人数则少于报告的2019年冠状病毒病（COVID-19）死亡率。使用公开数据库，我们将35个国家2020年因新型冠状病毒导致的死亡人数和2015-2020年的所有死亡人数以及经济、健康、人口和政府应对严格指数变量制成表格。2020年的剩余死亡率（RMR）计算为超额死亡率减去报告的2019冠状病毒病死亡率，其中超额死亡为2020年观察到的死亡人数减去2015-2019年的平均数。RMR的差异是不归因于报告的COVID-19的差异。大约有一半的国家的RMR为负数，另一半为正数。一些国家的绝对比率是另一些国家的两倍。在回归分析中，人口密度和女性吸烟者比例与新冠肺炎和超额死亡率呈正相关，而人类发展指数和男性吸烟者比例与两者呈负相关。RMR与任何研究变量无关。研究结果显示，已公布的2019冠状病毒病死亡率数据无法在各国之间进行直接比较。这可能是由于COVID-19死亡报告的差异，此外，为控制大流行而实施的前所未有的公共卫生措施可能增加或减少了其他疾病导致的额外死亡。需要获得关于死因特异性死亡率的进一步数据，以确定剩余死亡率在多大程度上代表非新冠肺炎死亡，并解释各国之间的差异。
Evidence that more people in some countries and fewer in others are dying because of the pandemic, than is reflected by reported coronavirus disease 2019 (Covid-19) mortality rates, is derived from mortality data. Using publicly available databases, deaths attributed to Covid-19 in 2020 and all deaths for the years 2015–2020 were tabulated for 35 countries together with economic, health, demographic and government response stringency index variables. Residual mortality rates (RMR) in 2020 were calculated as excess mortality minus reported mortality rates due to Covid-19 where excess deaths were observed deaths in 2020 minus the average for 2015–2019. Differences in RMR are differences not attributed to reported Covid-19. For about half the countries, RMR's were negative and for half, positive. The absolute rates in some countries were double those in others. In a regression analysis, population density and proportion of female smokers were positively associated with both Covid-19 and excess mortality while the human development index and proportion of male smokers were negatively associated with both. RMR was not associated with any of the investigated variables. The results show that published data on mortality from Covid-19 cannot be directly comparable across countries. This may be due to differences in Covid-19 death reporting and in addition, the unprecedented public health measures implemented to control the pandemic may have produced either increased or reduced excess deaths due to other diseases. Further data on cause-specific mortality is required to determine the extent to which residual mortality represents non-Covid-19 deaths and to explain differences between countries.