COVID-19 pandemic has shortened life expectancy in 2020: study

Life expectancy has decreased during the COVID-19 pandemic, with more than 28 million excess life years of life lost in 2020 in 31 countries, according to a study, noting a higher rate in men than women.

In addition, the “[e]xcess years of life lost associated with the COVID-19 pandemic in 2020 were more than five times higher than those associated with the seasonal influenza epidemic in 2015,” the researchers said.

This time series analysis was conducted in 37 upper-middle and high-income countries or regions with reliable and complete mortality data. Annual all-cause mortality data were obtained from the Human Mortality Database for 2005–2020, harmonized and disaggregated by age and sex.

The researchers estimated reduction in life expectancy as the difference between observed and expected life expectancy in 2020 using the Lee-Carter model. Excess years of life lost were estimated as the difference between the observed and expected years of life lost in 2020 using the World Health Organization standard life table.

Except for Taiwan, Norway, and New Zealand, all countries included in the analysis showed a reduction in life expectancy in men and women. No evidence of a change in life expectancy was noted in Denmark, Iceland, and South Korea. [BMJ 2021;375:e066768]

The countries with the highest reduction in life expectancy were as follows: Russia (men: −2.33, 95 percent confidence interval [CI], −2.50 to −2.17; women: −2.14, 95 percent CI, −2.25 to −2.03), the United States (men: −2.27, 95 percent CI, −2.39 to −2.15; women: 95 percent CI, −1.61, −1.70 to −1.51), Bulgaria (men: −1.96, 95 percent CI, −2.11 to −1.81; women: 95 percent CI, −1.37, −1.74 to −1.01), Lithuania (men: −1.83, 95 percent CI, −2.07 to −1.59; women: −1.21, 95 percent CI, −1.36 to −1.05), Chile (men: −1.64, 95 percent CI, −1.97 to −1.32; women: −0.88, 95 percent CI, −1.28 to −0.50), and Spain (men: −1.35, 95 percent CI, −1.53 to −1.18; women: −1.13, 95 percent CI, −1.37 to −0.90).

“Years of life lost in 2020 were higher than expected in all countries except Taiwan, New Zealand, Norway, Iceland, Denmark, and South Korea,” the researchers said.

More than 222 million years of life were lost in 2020 in the remaining 31 countries, which was 28.1 million (95 percent CI, 26.8–29.5) years of life lost more than expected (men: 17.3 million, 95 percent CI, 16.8–17.8; women: 10.8 million, 95 percent CI, 10.4–11.3).

Of note, the highest excess years of life lost per 100,000 population were noted in Bulgaria (men: 7,260, 95 percent CI, 6,820–7,710; women: 3,730, 95 percent CI, 2,740–4,730), Russia (men: 7,020, 95 percent CI, 6,550–7,480; women: 4,760, 95 percent CI, 4,530–4,990), Lithuania (men: 5,430, 95 percent CI, 4,750–6,070; women: 2,640, 95 percent CI, 2,310–2,980), the US (men: 4,350, 95 percent CI, 4,170–4,530; women: 2,430, 95 percent CI, 2,320–2,550), Poland (men: 3,830, 95 percent CI, 3,540–4,120; women: 1,830, 95 percent CI, 1,630–2,040), and Hungary (men: 2,770, 95 percent CI, 2,490–3,040; women: 1,920, 95 percent CI, 1,590–2,240).

“The excess years of life lost were relatively low in people younger than 65 years, except in Russia, Bulgaria, Lithuania, and the US where the excess years of life lost was >2,000 per 100,000,” according to the researchers.

The findings of a comparable or lower than expected years of life lost in Taiwan, Norway, New Zealand, Denmark, Iceland, and South Korea stress the importance of effective viral suppression and elimination policies, as well as targeted and population-based public health policy interventions. [N Engl J Med 2020;383:e56; Med J Aust 2020;213:198-200.e1; JAMA Intern Med 2021;181:913-921; Am J Infect Control 2020;48:1080-1086; Nature 2020;587:536-539]

“A comprehensive pandemic preparedness aimed at more resilient health systems could be key to tackling the impact of future pandemics,” the researchers said. “Quantifying the effects of specific policy interventions on the reduction of premature deaths will help inform future policy intervention.” [Lancet 2020;395:848-850; https://www.oecd.org/coronavirus/policy-responses/a-systemic-resilience-approach-to-dealing-with-covid-19-and-future-shocks-36a5bdfb/]