Attributed causes of excess mortality during the COVID-19 pandemic in a south Indian city
Abstract Globally, excess deaths during 2020–21 outnumbered documented COVID-19 deaths by 9.5 million, primarily driven by deaths in low- and middle-income countries (LMICs) with limited vital surveillance. Here we unravel the contributions of probable COVID-19 deaths from other changes in mortality...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-06-01
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| Series: | Nature Communications |
| Online Access: | https://doi.org/10.1038/s41467-023-39322-7 |
| _version_ | 1797801324516999168 |
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| author | Joseph A. Lewnard Chandra Mohan B Gagandeep Kang Ramanan Laxminarayan |
| author_facet | Joseph A. Lewnard Chandra Mohan B Gagandeep Kang Ramanan Laxminarayan |
| author_sort | Joseph A. Lewnard |
| collection | DOAJ |
| description | Abstract Globally, excess deaths during 2020–21 outnumbered documented COVID-19 deaths by 9.5 million, primarily driven by deaths in low- and middle-income countries (LMICs) with limited vital surveillance. Here we unravel the contributions of probable COVID-19 deaths from other changes in mortality related to pandemic control measures using medically-certified death registrations from Madurai, India—an urban center with well-functioning vital surveillance. Between March, 2020 and July, 2021, all-cause deaths in Madurai exceeded expected levels by 30% (95% confidence interval: 27–33%). Although driven by deaths attributed to cardiovascular or cerebrovascular conditions, diabetes, senility, and other uncategorized causes, increases in these attributions were restricted to medically-unsupervised deaths, and aligned with surges in confirmed or attributed COVID-19 mortality, likely reflecting mortality among unconfirmed COVID-19 cases. Implementation of lockdown measures was associated with a 7% (0–13%) reduction in all-cause mortality, driven by reductions in deaths attributed to injuries, infectious diseases and maternal conditions, and cirrhosis and other liver conditions, respectively, but offset by a doubling in cancer deaths. Our findings help to account for gaps between documented COVID-19 mortality and excess all-cause mortality during the pandemic in an LMIC setting. |
| first_indexed | 2024-03-13T04:49:45Z |
| format | Article |
| id | doaj.art-af9d1fa0faa0453f97acda1ef71e7854 |
| institution | Directory Open Access Journal |
| issn | 2041-1723 |
| language | English |
| last_indexed | 2024-03-13T04:49:45Z |
| publishDate | 2023-06-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Nature Communications |
| spelling | doaj.art-af9d1fa0faa0453f97acda1ef71e78542023-06-18T11:19:17ZengNature PortfolioNature Communications2041-17232023-06-0114111410.1038/s41467-023-39322-7Attributed causes of excess mortality during the COVID-19 pandemic in a south Indian cityJoseph A. Lewnard0Chandra Mohan B1Gagandeep Kang2Ramanan Laxminarayan3Division of Epidemiology, School of Public Health, University of California, BerkeleyIndian Administrative ServiceChristian Medical CollegeOne Health TrustAbstract Globally, excess deaths during 2020–21 outnumbered documented COVID-19 deaths by 9.5 million, primarily driven by deaths in low- and middle-income countries (LMICs) with limited vital surveillance. Here we unravel the contributions of probable COVID-19 deaths from other changes in mortality related to pandemic control measures using medically-certified death registrations from Madurai, India—an urban center with well-functioning vital surveillance. Between March, 2020 and July, 2021, all-cause deaths in Madurai exceeded expected levels by 30% (95% confidence interval: 27–33%). Although driven by deaths attributed to cardiovascular or cerebrovascular conditions, diabetes, senility, and other uncategorized causes, increases in these attributions were restricted to medically-unsupervised deaths, and aligned with surges in confirmed or attributed COVID-19 mortality, likely reflecting mortality among unconfirmed COVID-19 cases. Implementation of lockdown measures was associated with a 7% (0–13%) reduction in all-cause mortality, driven by reductions in deaths attributed to injuries, infectious diseases and maternal conditions, and cirrhosis and other liver conditions, respectively, but offset by a doubling in cancer deaths. Our findings help to account for gaps between documented COVID-19 mortality and excess all-cause mortality during the pandemic in an LMIC setting.https://doi.org/10.1038/s41467-023-39322-7 |
| spellingShingle | Joseph A. Lewnard Chandra Mohan B Gagandeep Kang Ramanan Laxminarayan Attributed causes of excess mortality during the COVID-19 pandemic in a south Indian city Nature Communications |
| title | Attributed causes of excess mortality during the COVID-19 pandemic in a south Indian city |
| title_full | Attributed causes of excess mortality during the COVID-19 pandemic in a south Indian city |
| title_fullStr | Attributed causes of excess mortality during the COVID-19 pandemic in a south Indian city |
| title_full_unstemmed | Attributed causes of excess mortality during the COVID-19 pandemic in a south Indian city |
| title_short | Attributed causes of excess mortality during the COVID-19 pandemic in a south Indian city |
| title_sort | attributed causes of excess mortality during the covid 19 pandemic in a south indian city |
| url | https://doi.org/10.1038/s41467-023-39322-7 |
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