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Direct and indirect effects of the COVID-19 pandemic on mortality: an individual-level population-scale analysis using linked electronic health records, Wales, United Kingdom, 2016 to 2022
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James D van Oppen ,
Jane Lyons,
Ashley Akbari ,
Gareth Davies ,
Fatemeh Torabi ,
Keith R Abrams ,
Ronan Lyons
Eurosurveillance, Volume: 29, Issue: 50, Start page: 2400085
Swansea University Authors:
Rhiannon Owen , Jane Lyons, Ashley Akbari , Gareth Davies , Fatemeh Torabi , Ronan Lyons
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DOI (Published version): 10.2807/1560-7917.es.2024.29.50.2400085
Abstract
Background: The COVID-19 pandemic resulted in increased mortality directly and indirectly associated with COVID-19. Aim: To assess the impact of the COVID-19 pandemic on all-cause and disease-specific mortality and explore potential health inequalities associated with area-level deprivation in Wales...
| Published in: | Eurosurveillance |
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| ISSN: | 1560-7917 |
| Published: |
European Centre for Disease Control and Prevention (ECDC)
2024
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| Online Access: |
Check full text
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa67163 |
| Abstract: |
Background: The COVID-19 pandemic resulted in increased mortality directly and indirectly associated with COVID-19. Aim: To assess the impact of the COVID-19 pandemic on all-cause and disease-specific mortality and explore potential health inequalities associated with area-level deprivation in Wales. Methods: Two population-based cohort studies were derived from multi-sourced, linked demographic, administrative and electronic health record data from 2016 to 2019 (n = 3,113,319) and 2020 to 2022 (n = 3,571,471). Data were analysed using generalised linear models adjusting for age, sex, area-level deprivation and time at risk. Results: COVID-19 deaths peaked in January 2021 (54.9/100,000 person-months, 95% confidence interval (CI): 52.4–57.5). The pandemic indirectly affected deaths, with higher than expected maximum relative mortality rates (RR) related to cancer (RR: 1.24, 95% CI: 1.13–1.36), infectious diseases (excluding respiratory infections) (RR: 2.09, 95% CI: 1.27– 3.43), circulatory system (RR: 1.41, 95% CI: 1.28–1.56), trauma (RR: 2.04, 95% CI: 1.57– 2.65), digestive system (RR: 1.54, 95% CI: 1.25–1.91), nervous system (RR: 1.63; 95% CI: 1.34–2.00) and mental and behavioural disorders (RR: 1.85, 95% CI: 1.58–2.16). Mortality associated with respiratory diseases (unrelated to COVID-19) were lower than expected (minimum RR: 0.52, 95% CI: 0.45–0.60). All-cause mortality was lower in least deprived communities compared with most deprived (RR: 0.61, 95% CI: 0.60–0.62), and the magnitude of this effect increased during the pandemic. Conclusions: All-cause and disease-specific mortality directly and indirectly associated with COVID-19 increased during the COVID-19 pandemic. Socioeconomic disparities were exacerbated during this time. |
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| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
This work is supported by the Academy of Medical Sciences/the Wellcome Trust/ the Government Department of Business, Energy and Industrial Strategy/the British Heart Foundation/Diabetes UK Springboard Award (SBF006/1122) and the Con-COV team funded by the Medical Research Council (MR/V028367/1). This work was supported by Health Data Research UK, which receives its funding from HDR UK Ltd (HDR-9006) funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Wellcome Trust. This work was supported by the ADR Wales programme of work. The ADR Wales programme of work is aligned to the priority themes as identified in the Welsh Government’s national strategy: Prosperity for All. ADR Wales brings together data science experts at Swansea University Medical School, staff from the Wales Institute of Social and Economic Research, Data and Methods (WISERD) at Cardiff University and specialist teams within the Welsh Government to develop new evidence which supports Prosperity for All by using the SAIL Databank at Swansea University, to link and analyse anonymised data. ADR Wales is part of the Economic and Social Research Council (part of UK Research and Innovation) funded ADR UK (grant ES/S007393/1). The funders have no role in study design or in the collection, analysis, interpretation of data, writing of the report, or decision to submit the article for publication. Researchers are independent of the funders. |
| Issue: |
50 |
| Start Page: |
2400085 |