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. 2023 Sep 4;23(1):1707.
doi: 10.1186/s12889-023-16572-0.

The direct disease burden of COVID-19 in Belgium in 2020 and 2021

Brecht Devleesschauwer #  1   2 , Lander Willem #  3   4 , Jure Jurčević  1 , Pierre Smith  1   5 , Aline Scohy  1 , Grant M A Wyper  6 , Sara Monteiro Pires  7 , Nina Van Goethem  1 , Philippe Beutels  4 , Nicolas Franco  8   9 , Steven Abrams  3   8 , Dieter Van Cauteren  1 , Niko Speybroeck  10 , Niel Hens  4   8 , Robby De Pauw  11   12
Affiliations

The direct disease burden of COVID-19 in Belgium in 2020 and 2021

Brecht Devleesschauwer et al. BMC Public Health. .

Abstract

Background: Burden of disease estimates have become important population health metrics over the past decade to measure losses in health. In Belgium, the disease burden caused by COVID-19 has not yet been estimated, although COVID-19 has emerged as one of the most important diseases. Therefore, the current study aims to estimate the direct COVID-19 burden in Belgium, observed despite policy interventions, during 2020 and 2021, and compare it to the burden from other causes.

Methods: Disability-adjusted life years (DALYs) are the sum of Years Lived with Disability (YLDs) and Years of Life Lost (YLLs) due to disease. DALYs allow comparing the burden of disease between countries, diseases, and over time. We used the European Burden of Disease Network consensus disease model for COVID-19 to estimate DALYs related to COVID-19. Estimates of person-years for (a) acute non-fatal disease states were calculated from a compartmental model, using Belgian seroprevalence, social contact, hospital, and intensive care admission data, (b) deaths were sourced from the national COVID-19 mortality surveillance, and (c) chronic post-acute disease states were derived from a Belgian cohort study.

Results: In 2020, the total number of COVID-19 related DALYs was estimated at 253,577 [252,541 - 254,739], which is higher than in 2021, when it was 139,281 [136,704 - 142,306]. The observed COVID-19 burden was largely borne by the elderly, and over 90% of the burden was attributable to premature mortality (i.e., YLLs). In younger people, morbidity (i.e., YLD) contributed relatively more to the DALYs, especially in 2021, when vaccination was rolled out. Morbidity was mainly attributable to long-lasting post-acute symptoms.

Conclusion: COVID-19 had a substantial impact on population health in Belgium, especially in 2020, when COVID-19 would have been the main cause of disease burden if all other causes had maintained their 2019 level.

Keywords: Burden of disease; COVID-19; Disability-adjusted life years; Years lived with disability; Years of life lost.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Total estimated disease burden of COVID-19 expressed as Disability-Adjusted Life Years (DALYs) per age category for the period 2020–2021. YLLs = Years of Life Lost; YLDs = Years Lived with Disability
See this image and copyright information in PMC

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