Premature mortality attributable to COVID-19: potential years of life lost in 17 countries around the world, January-August 2020

Abstract

Background: Understanding the impact of the burden of COVID-19 is key to successfully navigating the COVID-19 pandemic. As part of a larger investigation on COVID-19 mortality impact, this study aims to estimate the Potential Years of Life Lost (PYLL) in 17 countries and territories across the world (Australia, Brazil, Cape Verde, Colombia, Cyprus, France, Georgia, Israel, Kazakhstan, Peru, Norway, England & Wales, Scotland, Slovenia, Sweden, Ukraine, and the United States [USA]).

Methods: Age- and sex-specific COVID-19 death numbers from primary national sources were collected by an international research consortium. The study period was established based on the availability of data from the inception of the pandemic to the end of August 2020. The PYLL for each country were computed using 80 years as the maximum life expectancy.

Results: As of August 2020, 442,677 (range: 18-185,083) deaths attributed to COVID-19 were recorded in 17 countries which translated to 4,210,654 (range: 112-1,554,225) PYLL. The average PYLL per death was 8.7 years, with substantial variation ranging from 2.7 years in Australia to 19.3 PYLL in Ukraine. North and South American countries as well as England & Wales, Scotland and Sweden experienced the highest PYLL per 100,000 population; whereas Australia, Slovenia and Georgia experienced the lowest. Overall, males experienced higher PYLL rate and higher PYLL per death than females. In most countries, most of the PYLL were observed for people aged over 60 or 65 years, irrespective of sex. Yet, Brazil, Cape Verde, Colombia, Israel, Peru, Scotland, Ukraine, and the USA concentrated most PYLL in younger age groups.

Conclusions: Our results highlight the role of PYLL as a tool to understand the impact of COVID-19 on demographic groups within and across countries, guiding preventive measures to protect these groups under the ongoing pandemic. Continuous monitoring of PYLL is therefore needed to better understand the burden of COVID-19 in terms of premature mortality.

Keywords: COVID-19; Disease burden; PYLL; Pandemic; Potential years of life lost; SARS-CoV-2.

Fig. 1

PYLL per person death due to COVID-19 in each of the participating countries up to week 35, 2020. The number in brackets following each country name signifies the number of days from the first COVID-19 case in the country to the last date for which numbers of deaths were available. *For Kazakhstan data was available up to week 31, 2020

Fig. 2

Crude and age-standardized PYLL rates (per 100,000 population) per country up to week 35, 2020. The number in brackets following each country name signifies the number of days from the first COVID-19 case in the country to the last date for which numbers of deaths were available. *For Kazakhstan data was available up to week 31, 2020

Fig. 3

Country-specific proportions of a) PYLL and b) deaths for each of three wide age groups, chosen depending on country specific age breakdowns. Countries are presented in decreasing proportion of PYLL or deaths in the youngest age group (under 40 or 45 years of age) *For Kazakhstan data was available up to week 31, 2020

Fig. 4

PYLL per person death by sex and country *For Kazakhstan data was available up to week 31, 2020

Fig. 5

Ratio of male to female a) PYLL rates and b) PYLL per person deaths. Countries where genders were equally affected have ratios closer to the vertical line at 1, while countries where males were more severely affected display points lying to the right of the vertical line

Fig. 6

Scatterplot of the difference in mortality (2020 versus 2015–2019, per 100,000 population) versus PYLL rate (per 100,000 population). The grey lines show the ratio between difference in mortality and PYLL rate in percentage. (Note: Kazakhstan and Peru are not displayed)