scholarly journals Mortality in Norway and Sweden before and after the Covid-19 outbreak: a cohort study

2020 ◽  
Author(s):  
Frederik E Juul ◽  
Henriette C Jodal ◽  
Ishita Barua ◽  
Erle Refsum ◽  
Ørjan Olsvik ◽  
...  
Keyword(s):  
Excess Mortality ◽  
Mortality Rates ◽  
List Type ◽  
School Closures ◽  
Epidemic Period ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Before And After ◽  
Rate Ratios ◽  
Expected Mortality

AbstractObjectivesNorway and Sweden are similar countries regarding ethnicity, socioeconomics and health care. To combat Covid-19, Norway implemented extensive measures such as school closures and lock-downs, while Sweden has been criticised for relaxed measures against Covid-19. We compared the effect of the different national strategies on all-cause and Covid-19 associated mortality.DesignRetrospective cohort.SettingThe countries Norway and Sweden.ParticipantsAll inhabitants.Main outcome measuresWe calculated weekly mortality rates (MR) with 95% confidence intervals (CI) per 100,000 individuals as well as mortality rate ratios (MRR) comparing the epidemic year (29th July, 2019 to 26th July, 2020) to the four preceding years (July 2015 to July 2019). We also compared Covid-19 associated deaths and mortality rates for the weeks of the epidemic in Norway and Sweden (16th March to 26th July, 2020).ResultsIn Norway, mortality rates were stable during the first three 12-month periods of 2015/16; 2016/17 and 2017/18 (MR 14.8 to 15.1 per 100,000), and slightly lower in the two most recent periods including during epidemic period (2018/19 and 2019/20; 14.5 per 100,000). In Sweden, all-cause mortality was stable during the first three 12-month periods of 2015/16; 2016/17 and 2017/18 (MR 17.2 to 17.5 per 100,000), but lower in the year 2018/19 immediately preceding the epidemic (16.2 per 100,000). Covid-19 associated mortality rates were 0.2 per 100,000 (95%CI 0.1 to 0.4) in Norway and 2.9 (95%CI 1.9 to 3.9) in Sweden. The increase in mortality was confined to individuals in 70 years or older.ConclusionsAll-cause mortality remained unaltered in Norway. In Sweden, the observed increase in all-cause mortality during Covid-19 was partly due to a lower than expected mortality preceding the epidemic and the observed excess mortality, was followed by a lower than expected mortality after the first Covid-19 wave. This may suggest mortality displacement.Strengths and limitations of this studyCompares two similar contries in all aspects but the handling of the Covid-19 epidemicEvaluates the mortality for several years before and during the epidemicProvides a possible explanation of the observed mortality changesDiscusses the socioeconomic effects of the different strategies in the two countriesDoes not evaluate cause-specific mortality

scholarly journals Mortality in Norway and Sweden during the COVID-19 pandemic

2021 ◽  
pp. 140349482110471
Author(s):  
Frederik E. Juul ◽  
Henriette C. Jodal ◽  
Ishita Barua ◽  
Erle Refsum ◽  
Ørjan Olsvik ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Excess Mortality ◽  
Mortality Rates ◽  
Mitigation Measures ◽  
Real World Data ◽  
School Closures ◽  
All Cause Mortality ◽  
Rate Ratios ◽  
Excess Deaths ◽  
Related Mortality

Background: Norway and Sweden are similar countries in terms of socioeconomics and health care. Norway implemented extensive COVID-19 measures, such as school closures and lockdowns, whereas Sweden did not. Aims: To compare mortality in Norway and Sweden, two similar countries with very different mitigation measures against COVID-19. Methods: Using real-world data from national registries, we compared all-cause and COVID-19-related mortality rates with 95% confidence intervals (CI) per 100,000 person-weeks and mortality rate ratios (MRR) comparing the five preceding years (2015–2019) with the pandemic year (2020) in Norway and Sweden. Results: In Norway, all-cause mortality was stable from 2015 to 2019 (mortality rate 14.6–15.1 per 100,000 person-weeks; mean mortality rate 14.9) and was lower in 2020 than from 2015 to 2019 (mortality rate 14.4; MRR 0.97; 95% CI 0.96–0.98). In Sweden, all-cause mortality was stable from 2015 to 2018 (mortality rate 17.0–17.8; mean mortality rate 17.1) and similar to that in 2020 (mortality rate 17.6), but lower in 2019 (mortality rate 16.2). Compared with the years 2015–2019, all-cause mortality in the pandemic year was 3% higher due to the lower rate in 2019 (MRR 1.03; 95% CI 1.02–1.04). Excess mortality was confined to people aged ⩾70 years in Sweden compared with previous years. The COVID-19-associated mortality rates per 100,000 person-weeks during the first wave of the pandemic were 0.3 in Norway and 2.9 in Sweden. Conclusions: All-cause mortality in 2020 decreased in Norway and increased in Sweden compared with previous years. The observed excess deaths in Sweden during the pandemic may, in part, be explained by mortality displacement due to the low all-cause mortality in the previous year.

scholarly journals Estimation of Excess Mortality and Years of Life Lost to COVID-19 in Norway and Sweden between March and November 2020

2021 ◽  
Vol 18 (8) ◽  
pp. 3913
Author(s):  
Martin Rypdal ◽  
Kristoffer Rypdal ◽  
Ola Løvsletten ◽  
Sigrunn Holbek Sørbye ◽  
Elinor Ytterstad ◽  
...  
Keyword(s):  
Excess Mortality ◽  
Age Groups ◽  
Years Of Life Lost ◽  
Regressive Model ◽  
Epidemic Period ◽  
All Cause Mortality ◽  
Auto Regressive ◽  
Expected Mortality ◽  
Auto Regressive Model ◽  
Excess Deaths

We estimate the weekly excess all-cause mortality in Norway and Sweden, the years of life lost (YLL) attributed to COVID-19 in Sweden, and the significance of mortality displacement. We computed the expected mortality by taking into account the declining trend and the seasonality in mortality in the two countries over the past 20 years. From the excess mortality in Sweden in 2019/20, we estimated the YLL attributed to COVID-19 using the life expectancy in different age groups. We adjusted this estimate for possible displacement using an auto-regressive model for the year-to-year variations in excess mortality. We found that excess all-cause mortality over the epidemic year, July 2019 to July 2020, was 517 (95%CI = (12, 1074)) in Norway and 4329 [3331, 5325] in Sweden. There were 255 COVID-19 related deaths reported in Norway, and 5741 in Sweden, that year. During the epidemic period of 11 March–11 November, there were 6247 reported COVID-19 deaths and 5517 (4701, 6330) excess deaths in Sweden. We estimated that the number of YLL attributed to COVID-19 in Sweden was 45,850 [13,915, 80,276] without adjusting for mortality displacement and 43,073 (12,160, 85,451) after adjusting for the displacement accounted for by the auto-regressive model. In conclusion, we find good agreement between officially recorded COVID-19 related deaths and all-cause excess deaths in both countries during the first epidemic wave and no significant mortality displacement that can explain those deaths.

scholarly journals EXCESS MORTALITY FROM COVID-19. WEEKLY EXCESS DEATH RATES BY AGE AND SEX FOR SWEDEN AND ITS MOST AFFECTED REGION

2020 ◽  
Author(s):  
Karin Modig ◽  
Anders Ahlbom ◽  
Marcus Ebeling
Keyword(s):  
Causes Of Death ◽  
Excess Mortality ◽  
National Level ◽  
Mortality Rates ◽  
Regional Level ◽  
Death Rates ◽  
Excess Death ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Age And Sex

Abstract Background Sweden has one of the highest numbers of COVID-19 deaths per inhabitant globally. However, absolute death counts can be misleading. Estimating age- and sex-specific mortality rates is necessary in order to account for the underlying population structure. Furthermore, given the difficulty of assigning causes of death, excess all-cause mortality should be estimated to assess the overall burden of the pandemic. Methods By estimating weekly age- and sex-specific death rates during 2020 and during the preceding five years, our aim is to get more accurate estimates of the excess mortality attributed to COVID-19 in Sweden, and in the most affected region Stockholm. Results Eight weeks after Sweden’s first confirmed case, the death rates at all ages above 60 were higher than for previous years. Persons above age 80 were disproportionally more affected, and men suffered greater excess mortality than women in ages up to 75 years. At older ages, the excess mortality was similar for men and women, with up to 1.5 times higher death rates for Sweden and up to 3 times higher for Stockholm. Life expectancy at age 50 declined by less than 1 year for Sweden and 1.5 years for Stockholm compared to 2019. Conclusions The excess mortality has been high in older ages during the pandemic, but it remains to be answered if this is because of age itself being a prognostic factor or a proxy for comorbidity. Only monitoring deaths at a national level may hide the effect of the pandemic on the regional level.

scholarly journals MO863COMPARISON OF ALL-CAUSE-MORTALITY BEFORE AND AFTER COVID-19 PANDEMIC IN A HEMODIALYSIS CENTER: A SUCCESSFUL PREVENTIVE PROTOCOL

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Vahideh Yavari
Keyword(s):  
Excess Mortality ◽  
Preventive Measures ◽  
Mortality Rates ◽  
Early Referral ◽  
Education Of Patients ◽  
Personnel Screening ◽  
All Cause Mortality ◽  
Before And After ◽  
Spss Software ◽  
Time Frames

Abstract Background and Aims COVID-19 has exerted a lot of pressure and concern on Hemodialysis ward managers. Being successful in patient education and, simultaneously, protecting the personnel and patients with in-time provision of sanitation and prevention protocols are mandatory to survive the pandemic. The aim of this study was to assess the success of our preventive measures in the dialysis center after application of our self-developed protocols. Method Crude and age-adjusted mortality rates of two time frames, i.e. 4th January to 5th December 2019 and the same period in 2020 (before and after the start of pandemic) were compared. The data were processed with SPSS software version 26. Results During 4th January to 5th December 2019, the crude all-cause-morality rate of our hemodialysis center was 20.23% (51 out of 252 patients). Likewise, between 4th January 2020 to 5th December 2020, the crude all-cause-morality rate was 18.25% (46 out of 252 patients). Same result was yielded after age adjustment of the morality rates. Conclusion Tailoring effective and timely preventive measures along with tireless education of patients can control all-cause-mortality and possibly COVID-19 excess mortality rates in dialysis centers. It seems that our preventive protocols which included strict patient and personnel screening, early referral to infectious specialist, clear isolation-sanitation protocols of COVID-19 positive cases and repeated patient and personnel education have been successful in surviving the pandemic till present.

scholarly journals Excess Mortality Attributable to COVID-19 Among Assisted Living Residents

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 58-58
Author(s):  
Kali Thomas ◽  
Wenhan Zhang ◽  
David Dosa ◽  
Paula Carder ◽  
Philip Sloane ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Confidence Intervals ◽  
Assisted Living ◽  
Excess Mortality ◽  
Mortality Rates ◽  
All Cause Mortality ◽  
National Cohort ◽  
Adjusted Incidence Rate ◽  
Rate Ratios ◽  
Adjusted Incidence

Abstract This study examines the excess mortality attributable to COVID-19 among a national cohort of assisted living (AL) residents. To do this, we compare the weekly rate of all-cause mortality during 1/1/20-8/11/20 with the same weeks in 2019 and calculated adjusted incidence rate ratios (IRRs) and 95% confidence intervals (CIs). All-cause mortality rates, nationally, were 14% higher in 2020 compared with 2019 (mean, 2.309 vs. 2.020, respectively, per 1000 residents per week; adjusted IRR, 1.169; 95% CI 1.165-1.173). Among the 10 states with the highest community spread, the excess mortality attributable to COVID-19 was 24% higher, with 2.388 deaths per 1000 residents per week in 2020 during January-August vs 1.928 in 2019 (adjusted IRR, 1.241; 95% CI 1.233-1.250). These results suggest that AL residents suffered excess mortality due to COVID-19.

scholarly journals A first analysis of excess mortality in Switzerland in 2020

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253505
Author(s):  
Isabella Locatelli ◽  
Valentin Rousson
Keyword(s):  
Life Expectancy ◽  
Excess Mortality ◽  
The Elderly ◽  
Mortality Rates ◽  
Loss Of Life ◽  
Key Indicator ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Standardized Mortality Rate ◽  
Official Data

Objective To quantify excess all-cause mortality in Switzerland in 2020, a key indicator for assessing direct and indirect consequences of the COVID-19 pandemic. Methods Using official data on deaths in Switzerland, all-cause mortality in 2020 was compared with that of previous years using directly standardized mortality rates, age- and sex-specific mortality rates, and life expectancy. Results The standardized mortality rate was 8.8% higher in 2020 than in 2019, returning to the level observed 5–6 years before, around the year 2015. This increase was greater for men (10.6%) than for women (7.2%) and was statistically significant only for men over 70 years of age, and for women over 75 years of age. The decrease in life expectancy in 2020 compared to 2019 was 0.7%, with a loss of 9.7 months for men and 5.3 months for women. Conclusions There was an excess mortality in Switzerland in 2020, linked to the COVID-19 pandemic. However, as this excess only concerned the elderly, the resulting loss of life expectancy was restricted to a few months, bringing the mortality level back to 2015.

scholarly journals Comparison of Indexes to Measure Comorbidity Burden and Predict All-Cause Mortality in Rheumatoid Arthritis

2021 ◽  
Author(s):  
Yun Ju Huang ◽  
Jung Sheng Chen ◽  
Shue Fen Luo ◽  
Chang Fu Kuo
Keyword(s):  
Rheumatoid Arthritis ◽  
Incidence Rate ◽  
Predictive Ability ◽  
Mortality Rates ◽  
Population Based ◽  
Comorbidity Burden ◽  
All Cause Mortality ◽  
Before And After ◽  
Comorbidity Index ◽  
Rate Ratios

Objectives To examine the comorbidity burden in patients with rheumatoid arthritis (RA) patients using a nationwide population-based cohort by assessing the Charlson Comorbidity Index (CCI), Elixhauser Comorbidity Index (ECI), Multimorbidity Index (MMI), and Rheumatic Disease Comorbidity Index (RDCI) scores and to investigate their predictive ability for all-cause mortality. Methods We identified 24,767 RA patients diagnosed between 1998–2008 in Taiwan and followed up until December 31, 2013. The incidence of comorbidities was estimated in three periods (before, during, and after the diagnostic period). The incidence rate ratios were calculated by comparing during vs. before and after vs. before the diagnostic period. One- and 5-year mortality rates were calculated and discriminated by low and high-score groups and modified models for each index. Results The mean score at diagnosis is 0.8 in CCI, 2.8 in ECI, 0.7 in MMI, and 1.3 in RDCI, and annual percentage changes are 11.0%, 11.3%, 9.7%, and 6.8%, respectively. The incidence of any increase in the comorbidity index is significantly higher in the periods of ‘during’ and ‘after’ the RA diagnosis (incidence rate ratios for different indexes: 1.33-2.77). The mortality rate significantly differs between the high and low-score groups measured by each index (adjusted hazard ratios: 2.5-4.3 for different indexes). CCI is slightly better in the prediction of 1- and 5-year mortality rates. Conclusion Comorbidities are common before and after RA diagnosis, and the rate of accumulation accelerates after RA diagnosis. All four comorbidity indexes are useful to measure the temporal changes and to predict mortality.

scholarly journals Comparison of Indexes to Measure Comorbidity Burden and Predict All-Cause Mortality in Rheumatoid Arthritis

2021 ◽  
Vol 10 (22) ◽  
pp. 5460
Author(s):  
Yun-Ju Huang ◽  
Jung-Sheng Chen ◽  
Shue-Fen Luo ◽  
Chang-Fu Kuo
Keyword(s):  
Rheumatoid Arthritis ◽  
Incidence Rate ◽  
Predictive Ability ◽  
Mortality Rates ◽  
Population Based ◽  
Comorbidity Burden ◽  
All Cause Mortality ◽  
Before And After ◽  
Comorbidity Index ◽  
Rate Ratios

Objectives: To examine the comorbidity burden in patients with rheumatoid arthritis (RA) patients using a nationwide population-based cohort by assessing the Charlson Comorbidity Index (CCI), Elixhauser Comorbidity Index (ECI), Multimorbidity Index (MMI), and Rheumatic Disease Comorbidity Index (RDCI) scores and to investigate their predictive ability for all-cause mortality. Methods: We identified 24,767 RA patients diagnosed from 1998 to 2008 in Taiwan and followed up until 31 December 2013. The incidence of comorbidities was estimated in three periods (before, during, and after the diagnostic period). The incidence rate ratios were calculated by comparing during vs. before and after vs. before the diagnostic period. One- and 5-year mortality rates were calculated and discriminated by low and high-score groups and modified models for each index. Results: The mean score at diagnosis was 0.8 in CCI, 2.8 in ECI, 0.7 in MMI, and 1.3 in RDCI, and annual percentage changes are 11.0%, 11.3%, 9.7%, and 6.8%, respectively. The incidence of any increase in the comorbidity index was significantly higher in the periods of “during” and “after” the RA diagnosis (incidence rate ratios for different indexes: 1.33–2.77). The mortality rate significantly differed between the high and low-score groups measured by each index (adjusted hazard ratios: 2.5–4.3 for different indexes). CCI was slightly better in the prediction of 1- and 5-year mortality rates. Conclusions: Comorbidities are common before and after RA diagnosis, and the rate of accumulation accelerates after RA diagnosis. All four comorbidity indexes are useful to measure the temporal changes and to predict mortality.

scholarly journals Estimation of Years of Life Lost by Sweden's Relaxed COVID-19 Mitigation Strategy

2020 ◽  
Author(s):  
Martin Rypdal ◽  
Kristoffer Rypdal ◽  
Ola Løvsletten ◽  
Sigrunn Sørbye ◽  
Elinor Ytterstad ◽  
...  
Keyword(s):  
Excess Mortality ◽  
Age Groups ◽  
Years Of Life Lost ◽  
Life Years ◽  
Epidemic Period ◽  
All Cause Mortality ◽  
Auto Regressive ◽  
Life Years Lost ◽  
Expected Mortality ◽  
Auto Regressive Model

Abstract Objective: To estimate the weekly excess all-cause mortality in Norway and Sweden, and to estimate the years of life lost (YLL) attributed to COVID-19 in Sweden and the significance of mortality displacement. Methods: We found expected mortality by taking the declining trend and the seasonality in mortality into account. From the excess mortality in Sweden in 2019/20, we estimated the YLL attributed to COVID-19 using the life expectancy in different age groups. We adjusted this estimate for possible displacement using an auto-regressive model for the year-to-year variations in excess mortality. Results: We found that excess all-cause mortality over the epidemic year (July to July) 2019/20 was 517 (95%CI -12, 1074) in Norway and 4329 (3331, 5325) in Sweden. There were reported 255 COVID-19 related deaths in Norway, and 5741 in Sweden, that year. During the epidemic period March 11 – November 11, there were 6247 reported COVID-19 deaths and 5517 (4701, 6330) excess deaths in Sweden. The estimated number of life-years lost attributed to the more relaxed Swedish strategy was 45850 (13915, 80276) without adjusting for mortality displacement and 43073 (12160, 85451) after adjusting for possible displacement.

scholarly journals A First Analysis of Excess Mortality in Switzerland in 2020

2021 ◽  
Author(s):  
Isabella Locatelli ◽  
Valentin Rousson
Keyword(s):  
Life Expectancy ◽  
Excess Mortality ◽  
The Elderly ◽  
Mortality Rates ◽  
Loss Of Life ◽  
Key Indicator ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Standardized Mortality Rate ◽  
Official Data

AbstractObjectiveTo quantify the excess all-cause mortality in Switzerland in 2020, a key indicator for assessing direct and indirect consequences of the COVID-19 pandemic.MethodsUsing official data on deaths in Switzerland, all-cause mortality in 2020 was compared with that of previous years using directly standardized mortality rates, age- and sex-specific mortality rates, and life expectancy.ResultsThe standardized mortality rate was 8.6% higher in 2020 than in 2019, returning to the level observed 5-6 years ago. This increase was greater for men (10.4%) than for women (7.0%), and was statistically significant only for men over 70 years of age, and for women over 75 years of age. The decrease in life expectancy in 2020 compared to 2019 was about 1%, with a loss of 9.4 months for men and 5.1 months for women.ConclusionsThere was an excess mortality in Switzerland in 2020, linked to the COVID-19 pandemic. However, as this excess only concerned the elderly, the resulting loss of life expectancy was restricted to a few months.

Sign in / Sign up

Export Citation Format

Share Document