| Title: |
Sustained excess all-cause mortality post COVID-19 in 21 countries: an ecological investigation |
| Authors: |
Th. Pallari, Chryso; Achilleos, Souzana; Quattrocchi, Annalisa; Reza Rahmanian Haghighi, Mohammad; Phan, Minh Tam; Artemiou, Andreas; Bennett, Catherine; Cuthbertson, Joseph; Zimmermann, Claudia; Schernhammer, Eva; Vernemmen, Catharina; Nganda Mekogo, Serge; Lobato, Jackeline; Macedo, Laylla; Athanasiadou, Maria; Mortensen, Laust Hvas; Critchley, Julia; Goldsmith, Lucy; Denissov, Gleb; Le Meur, Nolwenn; Kandelaki, Levan; Chikhladze, Nino; Athanasakis, Kostas; Binyaminy, Binyamin; Maor, Tamar; Caruso, Enza; Ambrosio, Giuseppe; Martial, Cyndy; Chan Sun, Marie; Hagen, Terje P; Barron, Manuel; Chong, Mario; Łyszczarz, Błażej; Erzen, Ivan; Cernuda Martínez, José Antonio; Arcos González, Pedro; Burstrom, Bo; Tao, Wenjing; Huang, Qian; Polemitis, Antonis; Charalambous, Andreas; Demetriou, Christiana A |
| Contributors: |
Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus; Universiteit Antwerpen = University of Antwerp; Cyprus University of Technology Limassol; Deakin University Melbourne Burwood; The University of Notre Dame Sydney; Medical University of Vienna = Medizinische Universität Wien (MedUni Vienna); Sciensano Bruxelles; Pasteur Network (Réseau International des Instituts Pasteur); Fluminense Federal University Niterói; Universidade Federal do Rio de Janeiro Brasil = Federal University of Rio de Janeiro Brazil = Université fédérale de Rio de Janeiro Brésil (UFRJ); Health Monitoring Unit, Government of the Republic of Cyprus Ministry of Health, Nicosia, Cyprus; IT University of Copenhagen (ITU); University of London London; National Institute for Health Development, Tallinn, Estonia; Arènes: politique, santé publique, environnement, médias (ARENES); Université de Rennes (UR)-Institut d'Études Politiques IEP - Rennes-École des Hautes Études en Santé Publique (EHESP)-Université de Rennes 2 (UR2)-Centre National de la Recherche Scientifique (CNRS); École des Hautes Études en Santé Publique (EHESP); Recherche sur les services et le management en santé (RSMS); Université de Rennes (UR)-École des Hautes Études en Santé Publique (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS); Département Méthodes quantitatives en santé publique (METIS); Université de Rennes (UR); National Center for Disease Control and Public Health, Head of the Population Registry Division of Department of Medical Statistics, Tbilisi, Georgia; Ivane Javakhishvili Tbilisi State University (TSU); University of West Attica Athens (UNIWA); State of Israel Ministry of Health, Israel Center of Disease Control, Ramat Gan, Israel; Università degli Studi di Perugia = University of Perugia (UNIPG); Demography/Census Unit, Statistics Mauritius, Port Louis, Mauritius; University of Mauritius; University of Oslo (UiO); Universidad Del Pacífico – Ecuador (UPACIFICO); Nicolaus Copernicus University Toruń; Public Health School, National Institute of Public Health, Ljubljana, Slovenia; Universidad de Oviedo = University of Oviedo; Global Public Health, Karolinska Institute, Stockholm, Stockholm, Sweden.; East Tennessee State University (ETSU); University of Nicosia; University of Nicosia Medical School, Nicosia, Cyprus.; This work was supported by the University of Nicosia Medical School (internal funding). The funding source did not have any involvement in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.; Collaboration internationale |
| Source: |
ISSN: 0300-5771. |
| Publisher Information: |
CCSD; Oxford University Press (OUP) |
| Publication Year: |
2025 |
| Collection: |
Archive Ouverte de l'Université Rennes (HAL) |
| Subject Terms: |
excess mortality; governmental control measures; indirect mortality; vaccination; all-cause mortality; COVID-19; [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie |
| Description: |
International audience ; Abstract Background Despite widespread vaccination efforts, significant excess mortality continued in various countries following the COVID-19 pandemic. This study aims to estimate excess mortality during 2022 in 21 countries and regions, and to examine the relationship of governmental control measures and vaccination rates with excess mortality during 2021–2 at an ecological level. Methods Excess mortality for 2022 was estimated by analysing weekly mortality data from January 2020 to December 2022 across 21 countries and regions participating in the C-MOR consortium. This was achieved by comparing the observed age-standardized mortality rates per 100 000 population to a baseline derived from historical data (2015–19). Governmental control measures and vaccination efforts were investigated for their association with weekly excess mortality during 2021–2 in multilevel models with country as a random effect. Results All 21 countries experienced excess mortality in 2022, ranging from 8.6 (Peru) to 116.2 (Georgia) per 100 000 population, noting that rates were not directly comparable across countries. Many countries had higher excess mortality in 2022 compared with previous years. Mauritius showed a significant excess mortality for the first time in 2022. The proportion of COVID-19 deaths relative to total deaths decreased in 2022 for most countries, except Australia. Governmental control measures and vaccinations were associated with reduced excess mortality in 2021 and 2022, respectively. Conclusion The study reveals sustained excess mortality throughout 2022. Excess deaths were mainly non-COVID-19-related, likely due to displaced mortality or to broader long-term impacts of the pandemic response. Governmental control policies and vaccination efforts were associated with lower excess mortality. These findings provide critical insights into pandemic mortality dynamics and emphasize the need for continued vigilance and adaptive public health strategies. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/40492564; PUBMED: 40492564 |
| DOI: |
10.1093/ije/dyaf075 |
| Availability: |
https://ehesp.hal.science/hal-05122484; https://ehesp.hal.science/hal-05122484v1/document; https://ehesp.hal.science/hal-05122484v1/file/dyaf075.pdf; https://doi.org/10.1093/ije/dyaf075 |
| Rights: |
https://creativecommons.org/licenses/by-nc/4.0/ ; info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.9F6B49D0 |
| Database: |
BASE |