Impact of the COVID-19 Pandemic on Total and Cause-Specific Mortality in Pavia, Northern Italy
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Odone, A.; Delmonte, D.; Gaetti, G.; Signorelli, C. Doubled mortality rate during the COVID-19 pandemic in Italy: Quantifying what is not captured by surveillance. Public Health 2021, 190, 108–115. [Google Scholar] [CrossRef] [PubMed]
- Odone, A.; Delmonte, D.; Scognamiglio, T.; Signorelli, C. COVID-19 deaths in Lombardy, Italy: Data in context. Lancet Public Health 2020, 5, e310. [Google Scholar] [CrossRef]
- Impatto Dell’epidemia COVID-19 Sulla Mortalità Totale Della Popolazione Residente—Anni 2020–2021 e Gennaio 2022. Available online: https://www.istat.it/it/archivio/266865 (accessed on 20 April 2022).
- Mannucci, P.M.; Nobili, A.; Tettamanti, M.; D’Avanzo, B.; Galbussera, A.A.; Remuzzi, G.; Fortino, I.; Leoni, O.; Harari, S. Impact of the post-COVID-19 condition on health care after the first disease wave in Lombardy. J. Intern. Med. 2022. [Google Scholar] [CrossRef] [PubMed]
- Signorelli, C.; Odone, A.; Gianfredi, V.; Bossi, E.; Bucci, D.; Oradini-Alacreu, A.; Frascella, B.; Capraro, M.; Chiappa, F.; Blandi, L.; et al. The spread of COVID-19 in six western metropolitan regions: A false myth on the excess of mortality in Lombardy and the defense of the city of Milan. Acta Bio Med. 2020, 91, 23–30. [Google Scholar]
- Signorelli, C.; Odone, A. Age-specific COVID-19 case-fatality rate: No evidence of changes over time. Int. J. Public Health 2020, 65, 1435–1436. [Google Scholar] [CrossRef]
- COVID-19 Excess Mortality Collaborators. Estimating excess mortality due to the COVID-19 pandemic: A systematic analysis of COVID-19-related mortality 2020–2021. Lancet 2022, 399, 1513–1536. [Google Scholar] [CrossRef]
- Gianicolo, E.A.L.; Russo, A.; Büchler, B.; Taylor, K.; Stang, A.; Blettner, M. Gender specific excess mortality in Italy during the COVID-19 pandemic accounting for age. Eur. J. Epidemiol. 2021, 36, 213–218. [Google Scholar] [CrossRef]
- Grande, E.; Fedeli, U.; Pappagallo, M.; Crialesi, R.; Marchetti, S.; Minelli, G.; Iavarone, I.; Frova, L.; Onder, G.; Grippo, F. Variation in Cause-Specific Mortality Rates in Italy during the First Wave of the COVID-19 Pandemic: A Study Based on Nationwide Data. Int. J. Environ. Res. Public Health 2022, 19, 805. [Google Scholar] [CrossRef]
- Cerqua, A.; Di Stefano, R.; Letta, M.; Miccoli, S. Local mortality estimates during the COVID-19 pandemic in Italy. J. Popul. Econ. 2021, 34, 1189–1217. [Google Scholar] [CrossRef]
- Alicandro, G.; La Vecchia, C.; Remuzzi, G.; Gerli, A.; Centanni, S. Excess mortality in Italy in 2020 by sex and age groups accounting for demographic changes and temporal trends in mortality. Panminerva Med. 2021. [Google Scholar] [CrossRef]
- Asta, F.; Michelozzi, P.; De Sario, M.; Santelli, E.; Bauleo, L.; Cozzi, I.; Vairo, F.; Davoli, M.; Porta, D. Impact of the COVID-19 epidemic on total and cause-specific mortality in Rome (Italy) in 2020. Epidemiol. Prev. 2022, 46, 59–67. [Google Scholar] [PubMed]
- Blangiardo, M.; Cameletti, M.; Pirani, M.; Corsetti, G.; Battaglini, M.; Baio, G. Estimating weekly excess mortality at sub-national level in Italy during the COVID-19 pandemic. PLoS ONE 2020, 15, e0240286. [Google Scholar] [CrossRef] [PubMed]
- Konstantinoudis, G.; Cameletti, M.; Gómez-Rubio, V.; Gómez, I.L.; Pirani, M.; Baio, G.; Larrauri, A.; Riou, J.; Egger, M.; Vineis, P.; et al. Regional excess mortality during the 2020 COVID-19 pandemic in five European countries. Nat. Commun. 2022, 13, 482. [Google Scholar] [CrossRef] [PubMed]
- Dati COVID-19 Italia—Emergenza Coronavirus: La Risposta Nazionale. Available online: https://github.com/pcm-dpc/COVID-19 (accessed on 18 April 2020).
- Emergency Use ICD Codes for COVID-19 Disease Outbreak. Available online: https://www.who.int/classifications/classification-of-diseases/emergency-use-icd-codes-for-covid-19-disease-outbreak (accessed on 20 April 2022).
- 15° Censimento Della Popolazione e Delle Abitazioni 2011. Available online: https://www.istat.it/it/censimenti-permanenti/censimenti-precedenti/popolazione-e-abitazioni/popolazione-2011 (accessed on 20 April 2022).
- Conti, S.; Ferrara, P.; Mazzaglia, G.; D’Orso, M.I.; Ciampichini, R.; Fornari, C.; Madotto, F.; Magoni, M.; Sampietro, G.; Silenzi, A.; et al. Magnitude and time-course of excess mortality during COVID-19 outbreak: Population-based empirical evidence from highly impacted provinces in northern Italy. ERJ Open Res. 2020, 6, 00458–02020. [Google Scholar] [CrossRef]
- Scortichini, M.; Schneider dos Santos, R.; De’Donato, F.; De Sario, M.; Michelozzi, P.; Davoli, M.; Masselot, P.; Sera, F.; Gasparrini, A. Excess mortality during the COVID-19 outbreak in Italy: A two-stage interrupted time-series analysis. Int. J. Epidemiol. 2020, 49, 1909–1917. [Google Scholar] [CrossRef]
- Levi, M.; Cipriani, F.; Romeo, G.; Balzi, D. Analysis of the excess mortality and factors associated with deaths from COVID-19 versus other causes in Central Tuscany (Italy) in 2020. Epidemiol. Prev. 2021, 45, 496–503. [Google Scholar]
- Amerio, A.; Aguglia, A.; Odone, A.; Gianfredi, V.; Serafini, G.; Signorelli, C.; Amore, M. COVID-19 pandemic impact on mental health of vulnerable populations. Acta Bio Med. 2020, 91, 95–96. [Google Scholar]
- Mantellini, P.; Battisti, F.; Armaroli, P.; Giubilato, P.; Ventura, L.; Zorzi, M.; Battagello, J.; De Bianchi, P.S.; Senore, C.; Zappa, M. Oncological organized screening programmes in the COVID-19 era: An Italian survey on accrued delays, reboot velocity, and diagnostic delay estimates. Epidemiol. Prev. 2021, 44, 344–352. [Google Scholar]
- Xie, Y.; Xu, E.; Bowe, B.; Al-Aly, Z. Long-term cardiovascular outcomes of COVID-19. Nat. Med. 2022, 28, 583–590. [Google Scholar] [CrossRef]
- Woolf, S.H.; Chapman, D.A.; Sabo, R.T.; Zimmerman, E.B. Excess Deaths From COVID-19 and Other Causes in the US, March 1, 2020, to January 2, 2021. JAMA 2021, 325, 1786. [Google Scholar] [CrossRef]
- Rosenbaum, L. Facing COVID-19 in Italy: Ethics, logistics, and therapeutics on the epidemic’s front line. N. Engl. J. Med. 2020, 382, 1873–1875. [Google Scholar] [CrossRef] [PubMed]
- Mohamed, M.O.; Gale, C.P.; Kontopantelis, E.; Doran, T.; de Belder, M.; Asaria, M.; Luscher, T.; Wu, J.; Rashid, M.; Stephenson, C.; et al. Sex Differences in Mortality Rates and Underlying Conditions for COVID-19 Deaths in England and Wales. Mayo Clin. Proc. 2020, 95, 2110–2124. [Google Scholar] [CrossRef] [PubMed]
- Ahmad, F.B.; Anderson, R.N. The Leading Causes of Death in the US for 2020. JAMA 2021, 325, 1829. [Google Scholar] [CrossRef] [PubMed]
- Pirkis, J.; John, A.; Shin, S.; DelPozo-Banos, M.; Arya, V.; Analuisa-Aguilar, P.; Appleby, L.; Arensman, E.; Bantjes, J.; Baran, A.; et al. Suicide trends in the early months of the COVID-19 pandemic: An interrupted time-series analysis of preliminary data from 21 countries. Lancet Psychiatry 2021, 8, 579–588. [Google Scholar] [CrossRef]
- Calderon-Anyosa, R.J.C.; Kaufman, J.S. Impact of COVID-19 lockdown policy on homicide, suicide, and motor vehicle deaths in Peru. Prev. Med. 2021, 143, 106331. [Google Scholar] [CrossRef]
- Barker, T.; Thompson, J.; Corbett, J.; Johal, S.; McNamara, I. Increased 30-day mortality rate in patients admitted with hip fractures during the COVID-19 pandemic in the UK. Eur. J. Trauma Emerg. Surg. 2021, 47, 1327–1334. [Google Scholar] [CrossRef]
- Amerio, A.; Lugo, A.; Stival, C.; Fanucchi, T.; Gorini, G.; Pacifici, R.; Odone, A.; Serafini, G.; Gallus, S. COVID-19 lockdown impact on mental health in a large representative sample of Italian adults. J. Affect. Disord. 2021, 292, 398–404. [Google Scholar] [CrossRef]
- John, A.; Pirkis, J.; Gunnell, D.; Appleby, L.; Morrissey, J. Trends in suicide during the covid-19 pandemic. BMJ 2020, 371, m4352. [Google Scholar] [CrossRef]
- Fernandes, G.A.; Junior, A.P.N.; Azevedo, E.S.G.; Feriani, D.; Franca, E.S.I.L.A.; Caruso, P.; Curado, M.P. Excess mortality by specific causes of deaths in the city of Sao Paulo, Brazil, during the COVID-19 pandemic. PLoS ONE 2021, 16, e0252238. [Google Scholar] [CrossRef]
- Burioni, R.; Odone, A.; Signorelli, C. Lessons from Italy’s policy shift on immunization. Nature 2018, 555, 30. [Google Scholar] [CrossRef] [Green Version]
2015–2019 | 2020 | 2020 vs. 2015–2019 | |||||
---|---|---|---|---|---|---|---|
Average Deaths | ASR | Deaths | ASR | Rate Ratio | 95% CI | ||
Total, all causes of death | 3047.2 | 1027 | 4016 | 1272.6 | 1.24 | 1.20 | 1.28 |
Group of causes | |||||||
COVID-19 | - | - | 859 | 274.9 | - | - | - |
Infectious and parasitic diseases (COVID-19 excluded) | 88 | 29.7 | 121 | 38.5 | 1.30 | 1.06 | 1.59 |
Neoplasms | 1055.6 | 363.3 | 963 | 312.1 | 0.86 | 0.80 | 0.92 |
Malignant neoplasms of lymphoid, haematopoietic and related tissue | 12.4 | 4.2 | 19 | 6.0 | 1.44 | 0.86 | 2.41 |
Endocrinuous, nutritional and metabolic diseases | 101.8 | 34.7 | 119 | 37.8 | 1.09 | 0.89 | 1.33 |
Diabetes mellitus | 80 | 27.3 | 88 | 28.1 | 1.03 | 0.82 | 1.30 |
Mental and behavioral disorders | 74.4 | 24.1 | 121 | 36.1 | 1.50 | 1.22 | 1.84 |
Diseases of the nervous system and sense organs | 129 | 43.3 | 125 | 39.9 | 0.92 | 0.76 | 1.12 |
Dementia and Alzheimer’s | 111.6 | 36.2 | 151 | 45.0 | 1.24 | 1.04 | 1.49 |
Cardiovascular diseases | 951.6 | 315.7 | 913 | 282.1 | 0.89 | 0.83 | 0.96 |
Ischemic heart diseases | 344 | 115.2 | 332 | 105.4 | 0.91 | 0.81 | 1.03 |
Cerebrovascular diseases | 225.4 | 74.2 | 185 | 55.9 | 0.75 | 0.64 | 0.88 |
Diseases of respiratory system | 252.6 | 82.6 | 384 | 118.9 | 1.44 | 1.28 | 1.61 |
Flu virus | 3.6 | 1.2 | 9 | 2.6 | 2.20 | 0.98 | 4.92 |
Pneumonia | 93.4 | 30.6 | 156 | 48.5 | 1.59 | 1.32 | 1.90 |
Chronic lower respiratory tract diseases | 97 | 31.5 | 119 | 37.0 | 1.17 | 0.96 | 1.44 |
Diseases of the digestive system | 113.6 | 38.3 | 109 | 35.5 | 0.93 | 0.75 | 1.14 |
Diseases of the skin and subcutaneous tissue | 3 | 1 | 4 | 1.2 | 1.14 | 0.38 | 3.45 |
Diseases of the musculoskeletal system and connective tissue | 3.6 | 1.2 | 9 | 2.9 | 2.37 | 1.06 | 5.30 |
Diseases of the genitourinary system | 73 | 23.8 | 65 | 19.3 | 0.81 | 0.62 | 1.06 |
Complications of pregnancy, childbirth and the puerperium | 0 | - | 0 | - | - | - | - |
Certain conditions originating in the perinatal period | 2.6 | 1.1 | 6 | 2.9 | 2.62 | 0.99 | 6.90 |
Congenital malformations, deformations and chromosomal abnormalities | 3.8 | 1.4 | 5 | 1.7 | 1.23 | 0.46 | 3.32 |
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified | 49.4 | 16.6 | 65 | 20.2 | 1.22 | 0.93 | 1.61 |
External causes of mortality | 132.8 | 46.1 | 129 | 42.5 | 0.92 | 0.76 | 1.12 |
Transport accidents | 25.2 | 9.2 | 11 | 4.0 | 0.43 | 0.23 | 0.80 |
Accidental falls | 28.8 | 9.4 | 39 | 12.3 | 1.30 | 0.91 | 1.85 |
Suicide and intentional self-harm | 33.2 | 12.0 | 32 | 10.9 | 0.91 | 0.62 | 1.33 |
2015–2019 | 2020 | 2020 vs. 2015–2019 | |||||
---|---|---|---|---|---|---|---|
Average Deaths | ASR | Deaths | ASR | Rate Ratio | 95% CI | ||
Total, all causes of death | 3591 | 1040.1 | 4771 | 1304.4 | 1.25 | 1.21 | 1.30 |
Group of causes | |||||||
COVID-19 | - | - | 758 | 213.9 | - | - | - |
Infectious and parasitic diseases | 98.4 | 29.3 | 142 | 38.4 | 1.31 | 1.08 | 1.58 |
Neoplasms | 861.6 | 271.6 | 860 | 263.5 | 0.97 | 0.90 | 1.04 |
Malignant neoplasms of lymphoid, haematopoietic and related tissue | 20.4 | 5.9 | 24 | 6.0 | 1.02 | 0.65 | 1.60 |
Endocrinuous, nutritional and metabolic diseases | 128.2 | 37.0 | 150 | 40.6 | 1.10 | 0.92 | 1.31 |
Diabetes mellitus | 93.2 | 26.8 | 111 | 30.3 | 1.13 | 0.92 | 1.40 |
Mental and behavioral disorders | 184.6 | 50.1 | 230 | 57.6 | 1.15 | 0.99 | 1.33 |
Diseases of the nervous system and sense organs | 196.6 | 57.4 | 229 | 65.5 | 1.14 | 0.98 | 1.32 |
Dementia and Alzheimer’s | 282.2 | 77.5 | 331 | 85.1 | 1.10 | 0.97 | 1.24 |
Cardiovascular diseases | 1371.8 | 381.3 | 1419 | 365.0 | 0.96 | 0.90 | 1.01 |
Ischemic heart disease | 312.4 | 88.1 | 288 | 76.9 | 0.87 | 0.77 | 0.99 |
Cerebrovascular disease | 424.8 | 118.2 | 422 | 107.5 | 0.91 | 0.82 | 1.01 |
Diseases of respiratory system | 268.2 | 74.8 | 366 | 97.5 | 1.30 | 1.16 | 1.47 |
Flu virus | 6.4 | 1.8 | 20 | 5.3 | 2.91 | 1.65 | 5.13 |
Pneumonia | 113.8 | 31.2 | 141 | 37.0 | 1.19 | 0.98 | 1.43 |
Chronic lower respiratory tract diseases | 83.8 | 24.0 | 97 | 26.0 | 1.09 | 0.87 | 1.36 |
Diseases of the digestive system | 137.4 | 40.9 | 132 | 35.3 | 0.86 | 0.72 | 1.05 |
Diseases of the skin and subcutaneous tissue | 4.4 | 1.2 | 9 | 2.6 | 2.22 | 1.01 | 4.88 |
Diseases of the musculoskeletal system and connective tissue | 16.2 | 4.7 | 28 | 8.1 | 1.70 | 1.10 | 2.64 |
Diseases of the genitourinary system | 83.2 | 23.6 | 92 | 24.0 | 1.02 | 0.81 | 1.28 |
Complications of pregnancy, childbirth and the puerperium | 0 | - | 0 | - | - | - | - |
Certain conditions originating in the perinatal period | 2.6 | 1.0 | 3 | 1.2 | 1.20 | 0.34 | 4.25 |
Congenital malformations, deformations and chromosomal abnormalities | 2.4 | 0.9 | 4 | 1.3 | 1.53 | 0.48 | 4.91 |
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified | 100.8 | 27.7 | 182 | 44.3 | 1.60 | 1.35 | 1.90 |
External causes of mortality | 114.2 | 32.8 | 143 | 39.7 | 1.21 | 1.01 | 1.46 |
Transport accidents | 6.4 | 2.2 | 9 | 3.2 | 1.43 | 0.68 | 3.0 |
Accidental falls | 36.6 | 10.3 | 24 | 6.7 | 0.65 | 0.43 | 1.01 |
Suicide and intentional self-harm | 9.6 | 3.3 | 9 | 3.3 | 1.0 | 0.49 | 2.03 |
Men | Women | |||||
---|---|---|---|---|---|---|
COVID-19 | Neoplasms | Cardiovascular Diseases | COVID-19 | Neoplasms | Cardiovascular Diseases | |
50–64 years old | ||||||
ASR 2015–2019 | - | 259.2 | 122.4 | - | 206.4 | 40.4 |
ASR 2020 | 111.1 | 199.8 | 113.5 | 53.9 | 177.6 | 42.8 |
Deaths 2020 | 66 | 120 | 68 | 32 | 109 | 26 |
Rate ratio (95% CI) | 0.77 (0.65–0.92) | 0.93 (0.72–10.2) | 0.86 (0.71–1.05) | 1.06 (0.69–1.63) | ||
65–79 years old | ||||||
ASR 2015–2019 | - | 1119.4 | 603 | - | 595.4 | 298.2 |
ASR 2020 | 792.8 | 952.2 | 604 | 313.1 | 580.4 | 300.7 |
Deaths 2020 | 318 | 385 | 242 | 146 | 272 | 140 |
Rate ratio (95% CI) | 0.85 (0.77–0.94) | 1.00 (0.84–1.19) | 0.98 (0.86–1.11) | 1.01 (0.83–1.22) | ||
≥80 years old | ||||||
ASR 2015–2019 | - | 3136.8 | 5086.2 | - | 1486.7 | 3888.1 |
ASR 2020 | 3137 | 2931.2 | 4224.4 | 1808.3 | 1445.1 | 3673.8 |
Deaths 2020 | 468 | 441 | 587 | 576 | 446 | 1247 |
Rate ratio (95% CI) | 0.93 (0.84–1.04) | 0.83 (0.76–0.91) | 0.97 (0.88–1.08) | 0.95 (0.89–1.00) |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Perotti, P.; Bertuccio, P.; Cacitti, S.; Deandrea, S.; Boschetti, L.; Dalle Carbonare, S.; Marguati, S.; Migliazza, S.; Porzio, E.; Riboli, S.; et al. Impact of the COVID-19 Pandemic on Total and Cause-Specific Mortality in Pavia, Northern Italy. Int. J. Environ. Res. Public Health 2022, 19, 6498. https://doi.org/10.3390/ijerph19116498
Perotti P, Bertuccio P, Cacitti S, Deandrea S, Boschetti L, Dalle Carbonare S, Marguati S, Migliazza S, Porzio E, Riboli S, et al. Impact of the COVID-19 Pandemic on Total and Cause-Specific Mortality in Pavia, Northern Italy. International Journal of Environmental Research and Public Health. 2022; 19(11):6498. https://doi.org/10.3390/ijerph19116498
Chicago/Turabian StylePerotti, Pietro, Paola Bertuccio, Stefano Cacitti, Silvia Deandrea, Lorenza Boschetti, Simona Dalle Carbonare, Stefano Marguati, Simona Migliazza, Eleonora Porzio, Simona Riboli, and et al. 2022. "Impact of the COVID-19 Pandemic on Total and Cause-Specific Mortality in Pavia, Northern Italy" International Journal of Environmental Research and Public Health 19, no. 11: 6498. https://doi.org/10.3390/ijerph19116498