Have deaths of despair risen during the COVID-19 pandemic? A rapid systematic review

Abstract

Objective: To systematically review the literature on the impact of the COVID-19 pandemic on deaths of despair (suicide, overdoses and drug-related liver diseases). Methods: Five electronic databases were searched using search terms on deaths of despair and COVID-19. Results: The review of 70 publications included indicates that there is no change or a decline in the suicide rate during the pandemic compared to the pre-pandemic period. Drug-related deaths such as overdose deaths and liver diseases, however, have been increased compared to the pre-pandemic rate. Findings are mainly from middle-high- and high-income countries and data from low-income countries are lacking. Synthesis of data from subgroup analysis indicates that some groups such as Black people, women and younger age groups would be more vulnerable to socioeconomic disruption during the pandemic. Conclusion: Studies included in this review were preliminary and suffered from methodological limitations such as lack of inferential analysis or using provisional data. Further high-quality studies are needed considering the contribution of factors such as disease prevalence, government intervention and environmental characteristics.