[Description of excess of overall and cause-specific mortality in the Agency for Health Protection of the Metropolitan Area of Milan (Lombardy Region, Northern Italy) in 2020].
EPIDEMIOLOGIA E PREVENZIONE 2022;
46:312-323. [PMID:
36341583 DOI:
10.19191/ep22.5-6.a508.087]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND
as a result of the SARS-CoV-2 pandemic, a generalised mortality excess was recorded in 2020. However, the mortality for COVID-19 cannot fully explain the observed excesses. The analysis of cause-specific mortality could contribute to estimate the direct and indirect effects of the SARS-CoV-2 outbreak and to the monitoring mortality trends.
OBJECTIVES
to describe the impact of the SARS-CoV-2 epidemic in overall and cause-specific mortality in population residing in the Agency for Health Protection (ATS) of Milan. Descriptive analysis of cause-specific mortality within thirty days of SARS-COV-2 infection.
DESIGN
descriptive analysis of overall and cause-specific mortality in the ATS of Milan area in 2020 and comparison with a reference period (2015-2019).
SETTING AND PARTICIPANTS
overall deaths in ATS of Milan in 2020 were collected, using the Local Registry of Causes of Death, and were classified according to the ICD-10 codes.
MAIN OUTCOME MEASURES
total and weekly overall and cause-specific mortality, by age.
RESULTS
in 2020, 44,757 deaths for all causes were observed in people residing in the ATS of Milan with percentage change of 35%. The leading cause of death in 2020 were cardiovascular disease and neoplasm; COVID-19 infection was the third cause. An excess of mortality was observed for most of all causes of deaths. Starting from 40-49-year age group, an increase of mortality was observed; the largest increase was observed in the group 70+ years. The largest increases were observed for endocrine, respiratory, and hypertensive diseases. On the contrary, for neoplasm, infectious (not COVID-19) diseases, traffic-related mortality, and cerebrovascular disease and ictus, a decrease of mortality was observed. The greater mortality increase was observed during the first pandemic wave. The leading cause of death after positive swab was COVID-19 infection, with little variation with age class. Other frequent causes of death were respiratory diseases, cardiovascular diseases, and neoplasm.
CONCLUSIONS
the study showed a generalised increase for most causes of death; observed mortality trends may indicate delay in access to health care system, in diagnosis and treatment.
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