Excess all-cause mortality and COVID-19-related mortality: a temporal analysis in 22 countries, from January until August 2020

Abstract

Background This study aimed to investigate overall and sex-specific excess all-cause mortality since the inception of the COVID-19 pandemic until August 2020 among 22 countries. Methods Countries reported weekly or monthly all-cause mortality from January 2015 until the end of June or August 2020. Weekly or monthly COVID-19 deaths were reported for 2020. Excess mortality for 2020 was calculated by comparing weekly or monthly 2020 mortality (observed deaths) against a baseline mortality obtained from 2015–2019 data for the same week or month using two methods: (i) difference in observed mortality rates between 2020 and the 2015–2019 average and (ii) difference between observed and expected 2020 deaths. Results Brazil, France, Italy, Spain, Sweden, the UK (England, Wales, Northern Ireland and Scotland) and the USA demonstrated excess all-cause mortality, whereas Australia, Denmark and Georgia experienced a decrease in all-cause mortality. Israel, Ukraine and Ireland demonstrated sex-specific changes in all-cause mortality. Conclusions All-cause mortality up to August 2020 was higher than in previous years in some, but not all, participating countries. Geographical location and seasonality of each country, as well as the prompt application of high-stringency control measures, may explain the observed variability in mortality changes.

Mechanical concordance between left atrium and left atrial appendage in nonvalvular atrial fibrillation: can it be exploited to avoid transesophageal echocardiography prior to electrical cardioversion during Covid-19 pandemic?

“…These findings are particularly relevant during the current Covid-19 pandemic, as TEE carries a heightened risk for spread of coronavirus-2 because it may induce aerosolization of a large amount of virus due to coughing or gagging during the examination [ 7 , 8 ]. Accordingly, the American Society of Echocardiography (ASE) guidelines recommend that TEEs should be avoided to minimize the risk of viral transmission, and suggest alternative imaging modalities, such as off-axis TTE, TTE with ultrasound-enhancing agents, contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI), to rule out LAAT prior to ECV [ 8 , 38 ].…”

“…Current coronavirus disease 2019 (COVID-19) pandemic is heavily affecting all countries worldwide [ 6 ]; as it is due to an airborne virus, TEE is considered a high-risk procedure for the possible transmission of this viral infection [ 7 , 8 ]. Therefore, the American Society of Echocardiography recommends to avoid TEE testing and to use alternative diagnostic tools for LAA imaging whenever possible [ 8 ].…”

Worldwide differences of hospitalization for ST-segment elevation myocardial infarction during COVID-19: A systematic review and meta-analysis

“…To estimate the overall health impact of COVID-19 epidemic, for each country we retrieved (relative to the date of observation of each study) [ [37] , [38] , [39] , [40] , [41] ]: a) number of SARS-CoV-2 positive cases; b) number of COVID-19 deaths; c) SARS-CoV-2 reproduction rate (to estimate time-course and severity of the epidemic); d) “stringency index” of lockdown measures (based on rigorously defined parameters, measured in a comparable way across countries); e) population density; f) gross domestic product/per capita; g) cardiovascular death rate; h) health development index; i) number of hospital beds/1000 inhabitants (see also Supplement).…”

COVID-19 Mortality in Italy Varies by Patient Age, Sex and Pandemic Wave

“…SARS-CoV-2 infection may be asymptomatic or symptomatic, with severity ranging from a few u-like symptoms to severe respiratory manifestations requiring supplemental oxygen and to multi-organ failure [1][2][3]. COVID-19 mortality has been widespread throughout the world, but with considerable temporal and geographical variations [4][5][6][7]. Although the reasons for these differences are not yet fully elucidated, according to a meta-analysis [8] the predictors of mortality of COVID-19 that have been repeatedly observed in different case series from different countries are advanced age, male sex, and pre-existing comorbidities; in addition, some abnormal values of laboratory biomarkers have been associated with poor prognosis.…”

“…The trends of cases and deaths, in most countries, have not been constant over time, but have uctuated, with peaks of incidence called "waves". The rst wave, in Italy and other European countries, began in January 2020 and lasted until summer 2020 [7,11]. Indeed, during the summer there were few cases and deaths, but since the fall the numbers of cases and deaths rose again with subsequent waves [9], due in part to virus variants.…”