tetano
Editor, Senior Moderator
Eur J Public Health
. 2024 Feb 22:ckae032.
doi: 10.1093/eurpub/ckae032. Online ahead of print. Regional excess mortality in France during COVID-19 pandemic: the first three epidemic periods (March 2020-June 2021)
Marlène Faisant[SUP] 1 [/SUP], Nicolas Vincent[SUP] 1 [/SUP], Bruno Hubert[SUP] 1 [/SUP], Alain Le Tertre[SUP] 1 [/SUP]
Affiliations
Background: This study aimed to describe the mortality excess during the three first epidemic periods of COVID-19 in all regions of France.
Methods: Two complementary approaches were implemented. First, we described the number of death of patients infected with or diagnosed with COVID-19 in health care (HC) and medico-social (MS) institutions. Then, we estimated general all-cause mortality excess (all ages) by comparing the mortality observed with the expected mortality. We used a daily number of death model according to a negative binomial distribution, as a function of the long-term trend in mortality (penalized spline function of time) and its seasonal variation (cyclic spline function). The model provided expected mortality during epidemic periods with a 95% credibility interval. Each region defined three epidemic periods, including the overseas territories.
Results: The two approaches were consistent in the most affected regions but there are major regional disparities that vary according to the epidemic period. There is an east-west gradient in the relative excess of deaths from all-causes during each epidemic period. The deaths observed in HC and MS institutions alone do not explain the excess (or deficit) of mortality in each region and epidemic period.
Conclusion: An analysis by age group according to the two approaches and a comparison of death specific causes could provide a better understanding of these differences. Electronic death registration system (mortality by medical causes) would allow a rapid mortality related estimation to an emerging pathology like Coronavirus Disease-2019 (COVID-19) but is still insufficient for real-time medical causes of death monitoring.
. 2024 Feb 22:ckae032.
doi: 10.1093/eurpub/ckae032. Online ahead of print. Regional excess mortality in France during COVID-19 pandemic: the first three epidemic periods (March 2020-June 2021)
Marlène Faisant[SUP] 1 [/SUP], Nicolas Vincent[SUP] 1 [/SUP], Bruno Hubert[SUP] 1 [/SUP], Alain Le Tertre[SUP] 1 [/SUP]
Affiliations
- PMID: 38390659
- DOI: 10.1093/eurpub/ckae032
Background: This study aimed to describe the mortality excess during the three first epidemic periods of COVID-19 in all regions of France.
Methods: Two complementary approaches were implemented. First, we described the number of death of patients infected with or diagnosed with COVID-19 in health care (HC) and medico-social (MS) institutions. Then, we estimated general all-cause mortality excess (all ages) by comparing the mortality observed with the expected mortality. We used a daily number of death model according to a negative binomial distribution, as a function of the long-term trend in mortality (penalized spline function of time) and its seasonal variation (cyclic spline function). The model provided expected mortality during epidemic periods with a 95% credibility interval. Each region defined three epidemic periods, including the overseas territories.
Results: The two approaches were consistent in the most affected regions but there are major regional disparities that vary according to the epidemic period. There is an east-west gradient in the relative excess of deaths from all-causes during each epidemic period. The deaths observed in HC and MS institutions alone do not explain the excess (or deficit) of mortality in each region and epidemic period.
Conclusion: An analysis by age group according to the two approaches and a comparison of death specific causes could provide a better understanding of these differences. Electronic death registration system (mortality by medical causes) would allow a rapid mortality related estimation to an emerging pathology like Coronavirus Disease-2019 (COVID-19) but is still insufficient for real-time medical causes of death monitoring.