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. 2021 Jul 16:9:669209.
doi: 10.3389/fpubh.2021.669209. eCollection 2021.

Excess Mortality in Italy During the COVID-19 Pandemic: Assessing the Differences Between the First and the Second Wave, Year 2020

Maria Dorrucci  1 , Giada Minelli  2 , Stefano Boros  1 , Valerio Manno  2 , Sabrina Prati  3 , Marco Battaglini  3 , Gianni Corsetti  3 , Xanthi Andrianou  1 , Flavia Riccardo  1 , Massimo Fabiani  1 , Maria Fenicia Vescio  1 , Matteo Spuri  1 , Alberto Mateo Urdiales  1 , Del Manso Martina  1 , Graziano Onder  4 , Patrizio Pezzotti  1 , Antonino Bella  1
Affiliations

Excess Mortality in Italy During the COVID-19 Pandemic: Assessing the Differences Between the First and the Second Wave, Year 2020

Maria Dorrucci et al. Front Public Health. .

Abstract

COVID-19 dramatically influenced mortality worldwide, in Italy as well, the first European country to experience the Sars-Cov2 epidemic. Many countries reported a two-wave pattern of COVID-19 deaths; however, studies comparing the two waves are limited. The objective of the study was to compare all-cause excess mortality between the two waves that occurred during the year 2020 using nationwide data. All-cause excess mortalities were estimated using negative binomial models with time modeled by quadratic splines. The models were also applied to estimate all-cause excess deaths "not directly attributable to COVD-19", i.e., without a previous COVID-19 diagnosis. During the first wave (25th February-31st May), we estimated 52,437 excess deaths (95% CI: 49,213-55,863) and 50,979 (95% CI: 50,333-51,425) during the second phase (10th October-31st December), corresponding to percentage 34.8% (95% CI: 33.8%-35.8%) in the second wave and 31.0% (95%CI: 27.2%-35.4%) in the first. During both waves, all-cause excess deaths percentages were higher in northern regions (59.1% during the first and 42.2% in the second wave), with a significant increase in the rest of Italy (from 6.7% to 27.1%) during the second wave. Males and those aged 80 or over were the most hit groups with an increase in both during the second wave. Excess deaths not directly attributable to COVID-19 decreased during the second phase with respect to the first phase, from 10.8% (95% CI: 9.5%-12.4%) to 7.7% (95% CI: 7.5%-7.9%), respectively. The percentage increase in excess deaths from all causes suggests in Italy a different impact of the SARS-CoV-2 virus during the second wave in 2020. The decrease in excess deaths not directly attributable to COVID-19 may indicate an improvement in the preparedness of the Italian health care services during this second wave, in the detection of COVID-19 diagnoses and/or clinical practice toward the other severe diseases.

Keywords: COVID-19; Italy; excess mortality; mortality from all causes; surveillance.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
All-cause excess deaths during the COVID-19 pandemic by geographical macro-area, Italy - year 2020.
Figure 2
Figure 2
All-cause excess deaths during the COVID-19 pandemic by sex (A) and by age groups (B), Italy - year 2020.
Figure 3
Figure 3
Excess deaths not directly attributable to COVID-19 during the pandemic, Italy - year 2020.
See this image and copyright information in PMC

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