Excess all-cause mortality during the COVID-19 pandemic in Europe – preliminary pooled estimates from the EuroMOMO network, March to April 2020

Vestergaard, Lasse S; Nielsen, Jens; Richter, Lukáš; Schmid, Daniela; Bustos, Natalia; Braeye, Toon; Denissov, Gleb; Veideman, Tatjana; Luomala, Oskari; Möttönen, Teemu; Fouillet, Anne; Caserio-Schönemann, Céline; Heiden, Matthias an der; Uphoff, Helmut; Lytras, Theodore; Gkolfinopoulou, Kassiani; Páldy, Anna; Domegan, Lisa; O’Donnell, Joan; Donato, F. De; Noccioli, Fiammetta; Hoffmann, Patrick; Velez, Telma; England, Kathleen; Asten, Liselotte van; White, Richard A.; Tønnessen, Ragnhild; Silva, Susana Pereira; Rodrigues, Ana Paula; Larrauri, Amparo; Delgado-Sanz, Concha; Ahmed, Farah; Galanis, Ilias; Junker, Christoph; Perisa, Damir; Sinnathamby, Mary; Andrews, Nick; O’Doherty, Mark G.; Marquess, Diogo F. P.; Kennedy, Sharon; Olsen, Sonja J.; Pebody, Richard; Krause, Tyra Grove; Mølbak, Kåre

doi:10.2807/1560-7917.es.2020.25.26.2001214

Cited by 207 publications

(211 citation statements)

References 10 publications

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“…That Danish mortality is currently not in excess, is confirmed by EuroMOMO, who show that mortality in Denmark has not exceeded 4 Z-scores above expected deaths during the outbreak [ 20 ]. A recent publication from the EuroMOMO group mentions Denmark as one of the European countries with little or no excess mortality [ 29 ]. It appears that government policies towards social distancing and changes in individual behaviour were timely in Denmark.…”

Section: Discussionmentioning

confidence: 99%

National all-cause mortality during the COVID-19 pandemic: a Danish registry-based study

et al. 2020

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Denmark implemented early widespread social distancing to reduce pressure on the healthcare system from the coronavirus disease 2019 (COVID-19) pandemic, with the aims to reduce mortality. Unintended consequences might be delays in treatment for other diseases and subsequent mortality. We examined national all-cause mortality comparing weeks 1–27 in 2020 and 2015–2019. This registry-based study used Danish national registry data until 5 July 2020. We examined all-cause mortality rates among all deaths recorded from 2015 to 2020 and among chronic conditions (cardiovascular (cardiac & circulatory), chronic pulmonary, chronic kidney disease, cancer, and diabetes), comparing each week in 2020 to weeks in 2015–2019. In 2020, there were 28,363 deaths in weeks 1–27 (30 December 2019–5 July 2020), the mean deaths in 2015–2019 were 28,630 deaths (standard deviation 784). Compared to previous years, the mortality rate in weeks 3–10 of 2020 was low, peaking in week 14 (17.6 per 100,000 persons in week 9, 19.9 per 100,000 in week 14). Comorbidity prevalence among deceased individuals was similar in 2020 and 2015–2019: 71.1% of all deceased had a prior cardiovascular diagnosis, 30.0% of all deceased had a prior cardiac diagnosis. There were 493 deaths with COVID-19 in weeks 11–27, (59.8% male), and 75.1% had a prior cardiovascular diagnosis. Weekly mortality rates for pre-existing chronic conditions peaked in week 14, and then declined. During the COVID-19 pandemic, due to timely lockdown measures, the mortality rate in Denmark has not increased compared to the mortality rates in the same period during 2015–2019. Electronic supplementary material The online version of this article (10.1007/s10654-020-00680-x) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

National all-cause mortality during the COVID-19 pandemic: a Danish registry-based study

et al. 2020

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“…Severity of an epidemic can also be measured by excess mortality. Excess mortality due to COVID-19 has been reported from a number of regions, e.g., 24 nations from Europe with 185,000 excess deaths in the first 18 weeks of 2020 [30]. No excess mortality, but a signal of COVID mortality can be seen in German weekly deaths, a week signal for Germany (Fig.…”

Section: How Deadly Is Sars-cov-2?mentioning

confidence: 96%

Epidemiology of SARS-CoV-2

et al. 2020

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Purpose SARS-CoV-2 is a recently emerged ß-coronavirus. Here we present the current knowledge on its epidemiologic features. Methods Non-systematic review. Results SARS-CoV-2 replicates in the upper and lower respiratory tract. It is mainly transmitted by droplets and aerosols from asymptomatic and symptomatic infected subjects. The consensus estimate for the basis reproduction number (R0) is between 2 and 3, and the median incubation period is 5.7 (range 2–14) days. Similar to SARS and MERS, superspreading events have been reported, the dispersion parameter (kappa) is estimated at 0.1. Most infections are uncomplicated, and 5–10% of patients are hospitalized, mainly due to pneumonia with severe inflammation. Complications are respiratory and multiorgan failure; risk factors for complicated disease are higher age, hypertension, diabetes, chronic cardiovascular, chronic pulmonary disease and immunodeficiency. Nosocomial and infections in medical personnel have been reported. Drastic reductions of social contacts have been implemented in many countries with outbreaks of SARS-CoV-2, leading to rapid reductions. Most interventions have used bundles, but which of the measures have been more or less effective is still unknown. The current estimate for the infection’s fatality rate is 0.5–1%. Using current models of age-dependent infection fatality rates, upper and lower limits for the attack rate in Germany can be estimated between 0.4 and 1.6%, lower than in most European countries. Conclusions Despite a rapid worldwide spread, attack rates have been low in most regions, demonstrating the efficacy of control measures.

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“…The pandemic of novel coronavirus disease 2019 (Covid-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has impacted healthcare systems across the world, and much research has been done regarding the underlying mechanisms of the disease (1), the clinical presentation of affected patients (2,3), prevention and treatment methodologies (4,5), and the impact on populationlevel health (6). Prehospital care providers play an important role in initiating disease isolation precautions and are instrumental in preventing contagion at ambulance receiving facilities.…”

Section: Introductionmentioning

confidence: 99%

Prehospital Identification of Covid-19: An Observational Study

Spangler

Blomberg

Smékal

2020

Preprint

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Background The novel coronavirus disease 2019 (Covid-19) pandemic has affected prehospital care systems across the world, but the prehospital presentation of affected patients and the extent to which prehospital care providers are able to identify them is not well characterized. In this study, we describe the presentation of Covid-19 patients in a Swedish prehospital care system, and asses the predictive value of Covid-19 suspicion as documented by dispatch and ambulance nurses.Methods Data for all patients with dispatch, ambulance, and hospital records between January 1 - August 31, 2020 were extracted. A descriptive statistical analysis of patients with and without hospital-confirmed Covid-19 was performed. In a subset of records beginning from April 14, we assessed the sensitivity and specificity of documented Covid-19 suspicion in dispatch and ambulance patient care records.Results A total of 11 894 prehospital records were included, of which 481 had a primary hospital diagnosis code related to-, or positive test results for Covid-19. Covid-19-positive patients had considerably worse outcomes than patients with negative test results, with 30-day mortality rates of 24% vs 11%, but lower levels of prehospital acuity (e.g. emergent transport rates of 14% vs 22%). About half (46%) of Covid-19-positive patients presented to dispatchers with primary complaints typically associated with Covid-19. 6 776 of records were included in the assessment of predictive value. Sensitivity was 76% (95% CI 71 - 80) and 82% (78 - 86) for dispatch and ambulance suspicion respectively, while specificities were 86% (85 - 87) and 78% (77 - 79).Conclusions While prehospital suspicion was strongly indicative of hospital-confirmed Covid-19, based on the sensitivity identified in this study, prehospital suspicion should not be relied upon as a single factor to rule out the need for isolation precautions. The data provided may be used to develop improved guidelines for identifying Covid-19 patients in the prehospital setting.

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Excess all-cause mortality during the COVID-19 pandemic in Europe – preliminary pooled estimates from the EuroMOMO network, March to April 2020

Cited by 207 publications

References 10 publications

National all-cause mortality during the COVID-19 pandemic: a Danish registry-based study

National all-cause mortality during the COVID-19 pandemic: a Danish registry-based study

Epidemiology of SARS-CoV-2

Prehospital Identification of Covid-19: An Observational Study

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