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. 2024 Mar;57(2):120-127.
doi: 10.3961/jpmph.23.198. Epub 2024 Feb 7.

Excess Deaths During the COVID-19 Pandemic in Southern Iran: Estimating the Absolute Count and Relative Risk Using Ecological Data

Mohammadreza Zakeri  1 , Alireza Mirahmadizadeh  2 , Habibollah Azarbakhsh  3 , Seyed Sina Dehghani  4 , Maryam Janfada  5 , Mohammad Javad Moradian  6 , Leila Moftakhar  3 , Mehdi Sharafi  7 , Alireza Heiran  2
Affiliations

Excess Deaths During the COVID-19 Pandemic in Southern Iran: Estimating the Absolute Count and Relative Risk Using Ecological Data

Mohammadreza Zakeri et al. J Prev Med Public Health. 2024 Mar.

Abstract

Objectives: The coronavirus disease 2019 (COVID-19) pandemic led to increased mortality rates. To assess this impact, this ecological study aimed to estimate the excess death counts in southern Iran.

Methods: The study obtained weekly death counts by linking the National Death Registry and Medical Care Monitoring Center repositories. The P-score was initially estimated using a simple method that involved calculating the difference between the observed and expected death counts. The interrupted time series analysis was then used to calculate the mean relative risk (RR) of death during the first year of the pandemic.

Results: Our study found that there were 5571 excess deaths from all causes (P-score=33.29%) during the first year of the COVID-19 pandemic, with 48.03% of these deaths directly related to COVID-19. The pandemic was found to increase the risk of death from all causes (RR, 1.26; 95% confidence interval [CI], 1.19 to 1.33), as well as in specific age groups such as those aged 35-49 (RR, 1.21; 95% CI, 1.12 to 1.32), 50-64 (RR, 1.38; 95% CI, 1.28 to 1.49), and ≥65 (RR, 1.29; 95% CI, 1.12 to 1.32) years old. Furthermore, there was an increased risk of death from cardiovascular diseases (RR, 1.17; 95% CI, 1.11 to 1.22).

Conclusions: There was a 26% increase in the death count in southern Iran during the COVID-19 pandemic. More than half of these excess deaths were not directly related to COVID-19, but rather other causes, with cardiovascular diseases being a major contributor.

Keywords: COVID-19; Excess mortality; SARS-CoV-2.

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Conflict of interest statement

Conflict of Interest

The authors have no conflicts of interest associated with the material presented in this paper.

Figures

Figure. 1.
Figure. 1.
Expected and observed all-cause death counts during first year of the coronavirus disease 2019 pandemic.
Figure. 2.
Figure. 2.
Interrupted time series plots of (A) the weekly all-cause death count and (B) the weekly death count due to cardiovascular diseases (CVDs) during the first year of the coronavirus disease 2019 pandemic and the preceding 5 years in southern Iran.
See this image and copyright information in PMC

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