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Mortality Related to Chronic Obstructive Pulmonary Disease during the COVID-19 Pandemic: An Analysis of Multiple Causes of Death through Different Epidemic Waves in Veneto, Italy

Author

Listed:
  • Ugo Fedeli

    (Epidemiological Department, Azienda Zero, Veneto Region, 35131 Padova, Italy)

  • Claudio Barbiellini Amidei

    (Epidemiological Department, Azienda Zero, Veneto Region, 35131 Padova, Italy)

  • Alessandro Marcon

    (Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy)

  • Veronica Casotto

    (Epidemiological Department, Azienda Zero, Veneto Region, 35131 Padova, Italy)

  • Francesco Grippo

    (Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, 00184 Roma, Italy)

  • Enrico Grande

    (Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, 00184 Roma, Italy)

  • Thomas Gaisl

    (Department of Pulmonology, University Hospital Zurich, 8091 Zurich, Switzerland)

  • Stefano Barco

    (Department of Angiology, University Hospital Zurich, 8091 Zurich, Switzerland
    Center for Thrombosis and Hemostasis, Johannes Gutenberg University Mainz, 55131 Mainz, Germany)

Abstract

Mortality related to chronic obstructive pulmonary disease (COPD) during the COVID-19 pandemic is possibly underestimated by sparse available data. The study aimed to assess the impact of the pandemic on COPD-related mortality by means of time series analyses of causes of death data. We analyzed the death certificates of residents in Veneto (Italy) aged ≥40 years from 2008 to 2020. The age-standardized rates were computed for COPD as the underlying cause of death (UCOD) and as any mention in death certificates (multiple cause of death—MCOD). The annual percent change (APC) in the rates was estimated for the pre-pandemic period. Excess COPD-related mortality in 2020 was estimated by means of Seasonal Autoregressive Integrated Moving Average models. Overall, COPD was mentioned in 7.2% (43,780) of all deaths. From 2008 to 2019, the APC for COPD-related mortality was −4.9% (95% CI −5.5%, −4.2%) in men and −3.1% in women (95% CI −3.8%, −2.5%). In 2020 compared to the 2018–2019 average, the number of deaths from COPD (UCOD) declined by 8%, while COPD-related deaths (MCOD) increased by 14% (95% CI 10–18%), with peaks corresponding to the COVID-19 epidemic waves. Time series analyses confirmed that in 2020, COPD-related mortality increased by 16%. Patients with COPD experienced significant excess mortality during the first year of the pandemic. The decline in COPD mortality as the UCOD is explained by COVID-19 acting as a competing cause, highlighting how an MCOD approach is needed.

Suggested Citation

  • Ugo Fedeli & Claudio Barbiellini Amidei & Alessandro Marcon & Veronica Casotto & Francesco Grippo & Enrico Grande & Thomas Gaisl & Stefano Barco, 2022. "Mortality Related to Chronic Obstructive Pulmonary Disease during the COVID-19 Pandemic: An Analysis of Multiple Causes of Death through Different Epidemic Waves in Veneto, Italy," IJERPH, MDPI, vol. 19(19), pages 1-9, October.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:19:p:12844-:d:935542
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    References listed on IDEAS

    as
    1. Enrico Grande & Ugo Fedeli & Marilena Pappagallo & Roberta Crialesi & Stefano Marchetti & Giada Minelli & Ivano Iavarone & Luisa Frova & Graziano Onder & Francesco Grippo, 2022. "Variation in Cause-Specific Mortality Rates in Italy during the First Wave of the COVID-19 Pandemic: A Study Based on Nationwide Data," IJERPH, MDPI, vol. 19(2), pages 1-13, January.
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    Cited by:

    1. Fihel, Agnieszka & Janick, Anna & Buschner, Andrea & Ustinavičienė, Rūta & Trakienė, Aurelija, 2024. "The Importance of Cause-of-Death Certification for the COVID-19 Burden Assessment: the Case of Central Europe," SocArXiv hy9zn, Center for Open Science.
    2. Claudio Barbiellini Amidei & Ugo Fedeli & Nicola Gennaro & Laura Cestari & Elena Schievano & Manuel Zorzi & Paolo Girardi & Veronica Casotto, 2023. "Estimating Overall and Cause-Specific Excess Mortality during the COVID-19 Pandemic: Methodological Approaches Compared," IJERPH, MDPI, vol. 20(11), pages 1-13, May.

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