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. 2021 May 1;39(5):856-860.
doi: 10.1097/HJH.0000000000002833.

Lessons from COVID-19 mortality data across countries

Giovanni Corrao  1   2 , Federico Rea  1   2 , Gian Carlo Blangiardo  3
Affiliations

Lessons from COVID-19 mortality data across countries

Giovanni Corrao et al. J Hypertens. .

Abstract

Objective: Several online sources provide up-to-date open-access data on numbers, rates and proportions of COVID-19 deaths. Our article aims of comparing and interpreting between-country trends of mortality rate, case-fatality and all-cause excess mortality.

Methods: We used data from open databases (Our World in Data mostly) for comparing mortality of eleven western countries (Austria, Belgium, Canada, France, Germany, Italy, Netherlands, Spain, Sweden, UK, USA). Between-country trends in mortality rate and case-fatality (both including deaths for COVID-19 as numerator and therefore labelled as COVID-19 mortality metrics) and all-cause excess mortality (i.e. observed deaths during the epidemic compared with those expected based on mortality in the same periods of previous years) were compared.

Results: Although Belgium ranks first in mortality from COVID-19 (possibly due to the broadest criterion for attributing a death to COVID-19), it does not rank first for all-cause excess mortality. Conversely, compared with Belgium, the UK, Italy and Spain have reported lower COVID-19 mortality (possibly due to the narrower definitions for a COVID-19 death) but higher all-cause excess mortality. Germany and Austria are the unique countries for which COVID-19 mortality, case-fatality and all-cause excess mortality consistently exhibited the lowest rates.

Conclusion: Between-country heterogeneity of COVID-19 mortality metrics could be largely explained by differences of criteria for attributing a death to COVID-19; in age/comorbidity structures; in policies for identifying asymptomatic people affected from SARS-CoV-2 infection. All-cause excess mortality is recommended as a more reliable metric for comparing countries.

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Conflict of interest statement

G.C. received research support from the European Community (EC), the Italian Agency of Drug (AIFA) and the Italian Ministry of Education, University and Research (MIUR). He took part to a variety of projects that were funded by pharmaceutical companies (i.e. Novartis, GSK, Roche, AMGEN and BMS). He also received honoraria as member of Advisory Board from Roche.

For the remaining authors, none were declared.

G.C. received research support from the European Community (EC), the Italian Agency of Drug (AIFA) and the Italian Ministry of Education, University and Research (MIUR). He took part to a variety of projects that were funded by pharmaceutical companies (i.e. Novartis, GSK, Roche, AMGEN and BMS). He also received honoraria as member of Advisory Board from Roche.

For the remaining authors, none were declared.

Figures

FIGURE 1
FIGURE 1
Relationship between the proportion of asymptomatic patients among reported cases and case-fatality cumulatively observed in regions of Italy. Protezione Civile. Dati COVID-19 Italia (https://github.com/pcm-dpc/COVID-19).
FIGURE 2
FIGURE 2
Weekly trends in all-cause excess mortality in eleven European and North American countries during the first 48 weeks of 2020. The Human Mortality Database (https://www.mortality.org/).
See this image and copyright information in PMC

References

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    1. Our World in Data. Statistics and Research. Coronavirus Pandemic (COVID-19). https://ourworldindata.org/coronavirus [Accessed 26 December 2020].