Lessons from COVID-19 mortality data across countries.
Lessons from COVID-19 mortality data across countries.
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DOI：
10.1097/hjh.0000000000002833
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发表时间：
2021-05-01
影响因子：
4.9
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中科院分区：
文献类型：
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多个在线来源提供了关于COVID-19死亡人数、比率和比例的最新开放获取数据。本文旨在比较和解释国家间死亡率、病死率和全因超额死亡率的趋势。我们使用来自开放数据库（主要是Our World in Data）的数据比较了11个西方国家（奥地利、比利时、加拿大、法国、德国、意大利、荷兰、西班牙、瑞典、英国、美国）的死亡率。比较了死亡率和病死率（两者均包括COVID-19死亡作为分子，因此标记为COVID-19死亡率指标）以及全因超额死亡率（即疫情期间观察到的死亡人数与基于往年同期死亡率的预期死亡人数相比）的国家间趋势。尽管比利时在COVID-19死亡率方面排名第一（可能是由于将死亡归因于COVID-19的最广泛标准），但它并没有在全因超额死亡率方面排名第一。相反，与比利时相比，英国、意大利和西班牙报告的COVID-19死亡率较低（可能是由于COVID-19死亡的定义较窄），但全因超额死亡率较高。德国及奥地利是COVID-19死亡率、病死率及全因超额死亡率持续表现最低的独特国家。COVID-19死亡率指标的国家间异质性在很大程度上可以通过以下因素来解释：将死亡归因于COVID-19的标准不同;年龄/合并症结构不同;识别受SARS-CoV-2感染影响的无症状人群的政策不同。建议将全因超额死亡率作为比较国家的更可靠指标。
Several online sources provide up-to-date open-access data on numbers, rates and proportions of COVID-19 deaths. Our article aims of comparing and interpreting between-country trends of mortality rate, case-fatality and all-cause excess mortality. We used data from open databases (Our World in Data mostly) for comparing mortality of eleven western countries (Austria, Belgium, Canada, France, Germany, Italy, Netherlands, Spain, Sweden, UK, USA). Between-country trends in mortality rate and case-fatality (both including deaths for COVID-19 as numerator and therefore labelled as COVID-19 mortality metrics) and all-cause excess mortality (i.e. observed deaths during the epidemic compared with those expected based on mortality in the same periods of previous years) were compared. Although Belgium ranks first in mortality from COVID-19 (possibly due to the broadest criterion for attributing a death to COVID-19), it does not rank first for all-cause excess mortality. Conversely, compared with Belgium, the UK, Italy and Spain have reported lower COVID-19 mortality (possibly due to the narrower definitions for a COVID-19 death) but higher all-cause excess mortality. Germany and Austria are the unique countries for which COVID-19 mortality, case-fatality and all-cause excess mortality consistently exhibited the lowest rates. Between-country heterogeneity of COVID-19 mortality metrics could be largely explained by differences of criteria for attributing a death to COVID-19; in age/comorbidity structures; in policies for identifying asymptomatic people affected from SARS-CoV-2 infection. All-cause excess mortality is recommended as a more reliable metric for comparing countries.