Mortality and Years of Potential Life Lost Due to COVID-19 in Brazil

Abstract

In November 2020, Brazil ranked third in the number of cases of coronavirus disease 2019 (COVID-19) and second in the number of deaths due to the disease. We carried out a descriptive study of deaths, mortality rate, years of potential life lost (YPLL) and excess mortality due to COVID-19, based on SARS-CoV-2 records in SIVEP-Gripe (Ministry of Health of Brazil) from 16 February 2020, to 1 January 2021. In this period, there were 98,025 deaths from COVID-19 in Brazil. Men accounted for 60.5% of the estimated 1.2 million YPLLs. High YPLL averages showed prematurity of deaths. The population aged 45-64 years (both sexes) represented more than 50% of all YPLLs. Risk factors were present in 69.5% of deaths, with heart disease, diabetes and obesity representing the most prevalent comorbidities in both sexes. Indigenous people had the lowest number of deaths and the highest average YPLL. However, in indigenous people, pregnant women and mothers had an average YPLL of over 35 years. The excess mortality for Brazil was estimated at 122,914 deaths (9.2%). The results show that the social impacts of YPLL due to COVID-19 are different depending on gender, race and risk factors. YPLL and excess mortality can be used to guide the prioritization of health interventions, such as prioritization of vaccination, lockdowns, or distribution of facial masks for the most vulnerable populations.

Keywords: COVID-19; excess mortality; years of potential life lost.

Figure A1

Adequacy and adjustment of the SIVEP-Gripe database and selection of death records for COVID-19 in Brazil (2020).

Figure 1

Fatalities and years of potential life lost due to COVID-19 in Brazil (2020) by region and state of residence.

Figure 2

Deaths and years of potential life lost due to COVID-19 in Brazil (2020) by gender and age group.

Figure 3

Fatalities and years of potential life lost in Brazil (2020) due to COVID-19, by gender, race/color, zone residence and risk factor.

Figure 4

Years of potential life lost (YPLL) ratio in Brazil (2020) by sex (A), other respiratory diseases (B), heart disease (C) and land traffic accidents (D). When mortality, by sex or other causes, affects the YPLL equally, the ratio is 1. In charts B–D, values above 1 mean that the YPLL for COVID-19 was higher than for the other causes, the opposite is true for values less than 1. The Brazil-wide ratio is represented by the vertical line on each chart. The names of the states followed by the letters (in parentheses) represent the region of the country in which they are located (n = north, ne = north-east, mw = mid-west, se = south-east and s = south).

Figure 5

Excess mortality in Brazil (2020). Deaths per month compared with upper and lower limits (95% CI) of historical averages in Brazil and its regions.