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. 2021 Apr 13:27:1609774.
doi: 10.3389/pore.2021.1609774. eCollection 2021.

Different Trends in Excess Mortality in a Central European Country Compared to Main European Regions in the Year of the COVID-19 Pandemic (2020): a Hungarian Analysis

Krisztina Bogos  1 , Zoltan Kiss  2 , Anna Kerpel Fronius  1 , Gabriella Temesi  1 , Jenő Elek  1 , Ildikó Madurka  1 , Zsuzsanna Cselkó  1 , Péter Csányi  1 , Zsolt Abonyi-Tóth  3   4 , György Rokszin  3 , Zsófia Barcza  5 , Judit Moldvay  6   7
Affiliations

Different Trends in Excess Mortality in a Central European Country Compared to Main European Regions in the Year of the COVID-19 Pandemic (2020): a Hungarian Analysis

Krisztina Bogos et al. Pathol Oncol Res. .

Abstract

Objective: This study examined cumulative excess mortality in European countries in the year of the Covid-19 pandemic and characterized the dynamics of the pandemic in different countries, focusing on Hungary and the Central and Eastern European region. Methods: Age-standardized cumulative excess mortality was calculated based on weekly mortality data from the EUROSTAT database, and was compared between 2020 and the 2016-2019 reference period in European countries. Results: Cumulate weekly excess mortality in Hungary was in the negative range until week 44. By week 52, it reached 9,998 excess deaths, corresponding to 7.73% cumulative excess mortality vs. 2016-2019 (p-value = 0.030 vs. 2016-2019). In Q1, only Spain and Italy reported excess mortality compared to the reference period. Significant increases in excess mortality were detected between weeks 13 and 26 in Spain, United Kingdom, Belgium, Netherland and Sweden. Romania and Portugal showed the largest increases in age-standardized cumulative excess mortality in the Q3. The majority of Central and Eastern European countries experienced an outstandingly high impact of the pandemic in Q4 in terms of excess deaths. Hungary ranked 11th in cumulative excess mortality based on the latest available data of from the EUROSTAT database. Conclusion: Hungary experienced a mortality deficit in the first half of 2020 compared to previous years, which was followed by an increase in mortality during the second wave of the COVID-19 pandemic, reaching 7.7% cumulative excess mortality by the end of 2020. The excess was lower than in neighboring countries with similar dynamics of the pandemic.

Keywords: Hungary; age-standardized mortality rate; covid-19 pandemic; cumulative death; excess mortality.

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Conflict of interest statement

Krisztina Bogos, Anna Kerpel Fronius, Gabriella Temesi, Jenő Elek, Ildikó Madurka, Zsuzsanna Cselkó, Péter Csányi are employees of National Korányi Institute of Pulmonology. György Rokszin and Zsolt Abonyi‐Tóth are employees of RxTarget Ltd. Zsófia Barcza is employee of Syntesia Ltd. Zoltan Kiss is a PhD fellow in 2nd Department of Medicine and Nephrological Center of University of Pécs. Judit Moldvay was supported by the Hungarian Brain research Program (grant 2017‐1.2.1‐NKP‐2017‐00002), and the Hungarian NRDI Office (grant K‐129065).

Figures

FIGURE 1
FIGURE 1
All-cause mortality in 2020 in Hungary by weeks compared to mean values from the period of 2016–2019 with 95% prediction intervals, together with the 2016–2019 lower and higher weekly mortality range (light blue range).
FIGURE 2
FIGURE 2
Cumulative all-cause excess mortality in Hungary by weeks in 2020 compared to averages from the reference period (2016–2019).
FIGURE 3
FIGURE 3
Weekly cumulative excess mortality in 2020 in Hungary compared to European regions. European regions are defined as Scandinavian countries for Denmark, Finland, Sweden, Norwegian, Iceland; Baltic countries for Estonia, Latvia, Lithuania; Benelux countries for Belgium, Netherlands, Luxembourg; Western EU countries for Austria, France, Germany, Liechtenstein, Switzerland, United Kingdom; Mediterranean EU countries for Cyprus, Greece, Italy, Malta, Portugal, Spain; Balkan EU countries for Bulgaria, Croatia, Slovenia; Central-Eastern EU countries for Czechia, Hungary, Poland, Romania, Slovakia; V4 countries for Czechia, Hungary, Poland, Slovakia.
FIGURE 4
FIGURE 4
Hungarian age-standardized cumulative excess mortality in 2020 by weeks per 100,000 persons (colored weeks are reference points for Figure 6).
FIGURE 5
FIGURE 5
Age-standardized weekly cumulative excess mortality in 2020 in Hungary compared to selected, neighboring European countries (per 100,000 persons).
FIGURE 6
FIGURE 6
Age-standardized weekly cumulative excess mortality of European countries in 2020 at week 13th, 26th, 39th, and 52th (per 100,000 persons) (in case of United Kingdom, Italy and Greece, latest available week is highlighted in gray at countries name).
See this image and copyright information in PMC

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