背景:这项研究调查了2020年和2021年COVID-19大流行期间12个国家的特定原因死亡率。
方法:我们每周收集呼吸道疾病的特定原因死亡率数据,肺炎,来自国家重要统计数据库的心血管疾病(CVD)和癌症。我们计算了呼吸系统疾病的超额死亡率(不包括COVID-19代码),肺炎,2020年和2021年的CVD,根据历史数据(2015-2019年)将每周观察到的死亡率与预期死亡率进行比较,考虑季节性趋势。我们使用多水平回归模型来调查国家一级大流行相关变量与特定原因死亡率之间的关系。
结果:在2020年和/或2021年观察到呼吸道疾病和肺炎的累积死亡率显着降低,格鲁吉亚除外,北爱尔兰,哈萨克斯坦,乌克兰,表现出一种或两种原因的超额死亡率。澳大利亚,奥地利,塞浦路斯,格鲁吉亚,北爱尔兰在2020年和/或2021年经历了超过累积的CVD死亡率。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,与前几年相比,2020年和/或2021年期间经历了粗累积癌症死亡率的增加。在与大流行相关的变量中,报告的COVID-19发病率与癌症死亡率增加呈负相关,呼吸过度,(2020年)和肺炎(2021年)死亡率,与呼吸和心血管疾病死亡率呈正相关(2021年)。严格的控制措施与过度呼吸道疾病呈负相关,CVD,癌症死亡率增加(2021年)。
结论:这项研究提供了心血管疾病导致大量超额死亡率的证据,在这两年中,大多数被调查国家的呼吸道疾病和肺炎都显著减少。我们的研究还强调了严格的控制措施在减少2021年大多数原因导致的超额死亡率方面的有益影响。
BACKGROUND: This study investigated cause-specific mortality rates in 12 countries during the COVID-19 pandemic in 2020 and 2021.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: 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.