Temporal dynamics in total excess mortality and COVID-19 deaths in Italian cities
- PDF / 1,052,925 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 2 Downloads / 165 Views
RESEARCH ARTICLE
Open Access
Temporal dynamics in total excess mortality and COVID-19 deaths in Italian cities Paola Michelozzi1, Francesca de’Donato1, Matteo Scortichini1, Patrizio Pezzotti2, Massimo Stafoggia1, Manuela De Sario1* , Giuseppe Costa3, Fiammetta Noccioli1, Flavia Riccardo2, Antonino Bella2, Moreno Demaria3, Pasqualino Rossi4, Silvio Brusaferro2, Giovanni Rezza2 and Marina Davoli1
Abstract Background: Standardized mortality surveillance data, capable of detecting variations in total mortality at population level and not only among the infected, provide an unbiased insight into the impact of epidemics, like COVID-19 (Coronavirus disease). We analysed the temporal trend in total excess mortality and deaths among positive cases of SARS-CoV-2 by geographical area (north and centre-south), age and sex, taking into account the deficit in mortality in previous months. Methods: Data from the Italian rapid mortality surveillance system was used to quantify excess deaths during the epidemic, to estimate the mortality deficit during the previous months and to compare total excess mortality with deaths among positive cases of SARS-CoV-2. Data were stratified by geographical area (north vs centre and south), age and sex. Results: COVID-19 had a greater impact in northern Italian cities among subjects aged 75–84 and 85+ years. COVID-19 deaths accounted for half of total excess mortality in both areas, with differences by age: almost all excess deaths were from COVID-19 among adults, while among the elderly only one third of the excess was coded as COVID-19. When taking into account the mortality deficit in the pre-pandemic period, different trends were observed by area: all excess mortality during COVID-19 was explained by deficit mortality in the centre and south, while only a 16% overlap was estimated in northern cities, with quotas decreasing by age, from 67% in the 15–64 years old to 1% only among subjects 85+ years old. Conclusions: An underestimation of COVID-19 deaths is particularly evident among the elderly. When quantifying the burden in mortality related to COVID-19, it is important to consider seasonal dynamics in mortality. Surveillance data provides an impartial indicator for monitoring the following phases of the epidemic, and may help in the evaluation of mitigation measures adopted. Keywords: Surveillance system, Total excess mortality, COVID-19-related death, Mortality displacement, Demographic factors
* Correspondence: [email protected] 1 Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, via Cristoforo Colombo, 112, 00147 Rome, Italy Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes
Data Loading...
