Journal of Preventive Medicine and Public Health

  • 제57권2호
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  • Pages.120-127
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  • 2024
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  • 1975-8375(pISSN)
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  • 2233-4521(eISSN)
대한예방의학회 (The Korean Society for Preventive Medicine)
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Excess Deaths During the COVID-19 Pandemic in Southern Iran: Estimating the Absolute Count and Relative Risk Using Ecological Data

  • Mohammadreza Zakeri (Health Policy Research Center, Shiraz University of Medical Sciences) ;
  • Alireza Mirahmadizadeh (Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences) ;
  • Habibollah Azarbakhsh (Student Research Committee, Shiraz University of Medical Sciences) ;
  • Seyed Sina Dehghani (School of Medicine, Shiraz University of Medical Sciences) ;
  • Maryam Janfada (Department of Statistics, Health Vice-Chancellor, Shiraz University of Medical Sciences) ;
  • Mohammad Javad Moradian (Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences) ;
  • Leila Moftakhar (Student Research Committee, Shiraz University of Medical Sciences) ;
  • Mehdi Sharafi (Noncommunicable Diseases Research Center, Fasa University of Medical Sciences) ;
  • Alireza Heiran (Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences)
  • 투고 : 2023.04.23
  • 심사 : 2024.01.05
  • 발행 : 2024.03.31
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초록

Objectives: The coronavirus disease 2019 (COVID-19) pandemic led to increased mortality rates. To assess this impact, this ecological study aimed to estimate the excess death counts in southern Iran. Methods: The study obtained weekly death counts by linking the National Death Registry and Medical Care Monitoring Center repositories. The P-score was initially estimated using a simple method that involved calculating the difference between the observed and expected death counts. The interrupted time series analysis was then used to calculate the mean relative risk (RR) of death during the first year of the pandemic. Results: Our study found that there were 5571 excess deaths from all causes (P-score=33.29%) during the first year of the COVID-19 pandemic, with 48.03% of these deaths directly related to COVID-19. The pandemic was found to increase the risk of death from all causes (RR, 1.26; 95% confidence interval [CI], 1.19 to 1.33), as well as in specific age groups such as those aged 35-49 (RR, 1.21; 95% CI, 1.12 to 1.32), 50-64 (RR, 1.38; 95% CI, 1.28 to 1.49), and ≥65 (RR, 1.29; 95% CI, 1.12 to 1.32) years old. Furthermore, there was an increased risk of death from cardiovascular diseases (RR, 1.17; 95% CI, 1.11 to 1.22). Conclusions: There was a 26% increase in the death count in southern Iran during the COVID-19 pandemic. More than half of these excess deaths were not directly related to COVID-19, but rather other causes, with cardiovascular diseases being a major contributor.

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과제정보

This research project received financial support from the Deputy of Research and Technology at Shiraz University of Medical Sciences, Iran, under grant No. 99-7848.

참고문헌

  1. World Health Organization. WHO COVID-19 dashboard [cited 2023 Dec 31]. Available from: https://data.who.int/dashboards/covid19/cases?n=c
  2. Ciotti M, Angeletti S, Minieri M, Giovannetti M, Benvenuto D, Pascarella S, et al. COVID-19 outbreak: an overview. Chemotherapy 2019;64(5-6):215-223. https://doi.org/10.1159/000507423
  3. Yazdanpanah F, Garg A, Shadman S, Asmarz HY. Literature review of COVID-19, pulmonary and extrapulmonary disease.Am J Med Sci 2021;361(5):567-574. https://doi.org/10.1016/j.amjms.2021.01.023
  4. Desai AD, Lavelle M, Boursiquot BC, Wan EY. Long-term complications of COVID-19. Am J Physiol Cell Physiol 2022;322(1):C1-C11. https://doi.org/10.1152/ajpcell.00375.2021
  5. Ng KH, Kemp R. Understanding and reducing the fear of COVID-19. J Zhejiang Univ Sci B 2020;21(9):752-754. https://doi.org/10.1631/jzus.B2000228
  6. Vardanjani HM, Imanieh MH, Hassani AH, Bagheri-Lankarani K. Public trust in healthcare system and its correlates during the COVID-19 epidemic in Iran. Res Sq [Preprint]. 2020 [cited 2023 Dec 31]. Available from: https://doi.org/10.21203/rs.3.rs-106242/v1
  7. Alotaibi R, Alahmari A, Ababtain I, Altamimi A, Alkhaldi A, Alhelail M, et al. The effect of COVID-19 on the characteristics of adult emergency department visits: a retrospective cohort tertiary hospital experience in Riyadh. J Infect Public Health 2022;15(1):132-137. https://doi.org/10.1016/j.jiph.2021.10.009
  8. Checchi F, Roberts L. Interpreting and using mortality data in humanitarian emergencies; 2005 [cited 2023 Dec 31]. Available from: https://odihpn.org/publication/interpreting-and-usingmortality-data-in-humanitarian-emergencies/
  9. Rossen LM, Branum AM, Ahmad FB, Sutton PD, Anderson RN. Notes from the field: update on excess deaths associated with the COVID-19 pandemic - United States, January 26, 2020-February 27, 2021. MMWR Morb Mortal Wkly Rep 2021;70(15):570-571. https://doi.org/10.15585/mmwr.mm7015a4
  10. Friis NU, Martin-Bertelsen T, Pedersen RK, Nielsen J, Krause TG, Andreasen V, et al. COVID-19 mortality attenuated during widespread Omicron transmission, Denmark, 2020 to 2022. Euro Surveill 2023;28(3):2200547. https://doi.org/10.2807/1560-7917.ES.2023.28.3.2200547
  11. Wang H, Paulson KR, Pease SA, Watson S, Comfort H, Zheng P, et al. Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020-21. Lancet 2022;399(10334):1513-1536. https://doi.org/10.1016/S0140-6736(21)02796-3
  12. Msemburi W, Karlinsky A, Knutson V, Aleshin-Guendel S, Chatterji S, Wakefield J. The WHO estimates of excess mortality associated with the COVID-19 pandemic. Nature 2023;613(7942):130-137. https://doi.org/10.1038/s41586-022-05522-2
  13. Aron J, Muellbauer J. Measuring excess mortality: the case of England during the Covid-19 pandemic. Institute for New Economic Thinking, Oxford Working Paper 11; 2020 [cited 2023 Dec 31]. Available from: https://www.inet.ox.ac.uk/files/revised15.54-18-May-20-Aron-Muellbauer-Revised-INET-Excess-Mortality-article-x.pdf
  14. Dahal S, Luo R, Swahn MH, Chowell G. Geospatial variability in excess death rates during the COVID-19 pandemic in Mexico: examining socio demographic, climate and population health characteristics. Int J Infect Dis 2021;113:347-354. https://doi.org/10.1016/j.ijid.2021.10.024
  15. City Population. FARS Province in Iran; 2023 [cited 2023 Dec 31]. Available from: https://www.citypopulation.de/en/iran/prov/admin/07__f%C4%81rs/
  16. Travis-Lumer Y, Goldberg Y, Levine SZ. Effect size quantification for interrupted time series analysis: implementation in R and analysis for Covid-19 research. Emerg Themes Epidemiol 2022;19(1):9. https://doi.org/10.1186/s12982-022-00118-7
  17. Turner SL, Karahalios A, Forbes AB, Taljaard M, Grimshaw JM, Korevaar E, et al. Creating effective interrupted time series graphs: review and recommendations. Res Synth Methods 2021;12(1):106-117. https://doi.org/10.1002/jrsm.1435
  18. Scortichini M, Schneider Dos Santos R, De' Donato F, De Sario M, Michelozzi P, Davoli M, et al. Excess mortality during the COVID-19 outbreak in Italy: a two-stage interrupted time-series analysis. Int J Epidemiol 2021;49(6):1909-1917. https://doi.org/10.1093/ije/dyaa169
  19. Sandrini M, Andreano A, Murtas R, Tunesi S, Riussi A, Guido D, et al. Assessment of the overall mortality during the COVID-19 outbreak in the provinces of Milan and Lodi (Lombardy Region, Northern Italy). Epidemiol Prev 2020;44(5-6 Suppl 2):244-251. https://doi.org/10.19191/EP20.5-6.S2.124
  20. Sokolski M, Trenson S, Sokolska JM, D'Amario D, Meyer P, Poku NK, et al. Heart failure in COVID-19: the multicentre, multinational PCHF-COVICAV registry. ESC Heart Fail 2021;8(6):4955-4967. https://doi.org/10.1002/ehf2.13549
  21. Farooq S, Tunmore J, Wajid Ali M, Ayub M. Suicide, self-harm and suicidal ideation during COVID-19: a systematic review. Psychiatry Res 2021;306:114228. https://doi.org/10.1016/j.psychres.2021.114228
  22. Raknes G, Strom MS, Sulo G, Overland S, Roelants M, Juliusson PB. Lockdown and non-COVID-19 deaths: cause-specific mortality during the first wave of the 2020 pandemic in Norway: a population-based register study. BMJ Open 2021;11(12): e050525. https://doi.org/10.1136/bmjopen-2021-050525
  23. Oh J, Min J, Kang C, Kim E, Lee JP, Kim H, et al. Excess mortality and the COVID-19 pandemic: causes of death and social inequalities. BMC Public Health 2022;22(1):2293. https://doi.org/10.1186/s12889-022-14785-3
  24. COVID-19 Excess Mortality Collaborators. Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020-21. Lancet 2022;399(10334):1513-1536. https://doi.org/10.1016/S0140-6736(21)02796-3
  25. Kung S, Doppen M, Black M, Braithwaite I, Kearns C, Weatherall M, et al. Underestimation of COVID-19 mortality during the pandemic. ERJ Open Res 2021;7(1):00766-2020. https://doi.org/10.1183/23120541.00766-2020
  26. Han L, Zhao S, Li S, Gu S, Deng X, Yang L, et al. Excess cardiovascular mortality across multiple COVID-19 waves in the United States from March 2020 to March 2022. Nat Cardiovasc Res 2023;2:322-333. https://doi.org/10.1038/s44161-023-00220-2
  27. Mountantonakis SE, Makker P, Saleh M, Coleman KM, Husk G, Jauhar R, et al. Increased inpatient mortality for cardiovascular patients during the first wave of the COVID-19 epidemic in New York. J Am Heart Assoc 2021;10(16):e020255. https://doi.org/10.1161/JAHA.120.020255
  28. World Health Organization. Child mortality (under 5 years);2022 [cited 2023 Dec 31]. Available from: https://www.who.int/news-room/fact-sheets/detail/levels-and-trends-in-childunder-5-mortality-in-2020
  29. Odd D, Stoianova S, Williams T, Fleming P, Luyt K. Child mortality in england during the first 2 years of the COVID-19 pandemic. JAMA Netw Open 2023;6(1):e2249191. https://doi.org/10.1001/jamanetworkopen.2022.49191