Excess mortality during the COVID-19 pandemic and its spatial distribution in the state of Pernambuco, Brazil: an ecological study

• Published in: Epidemiologia e serviços de saúde 2024-01, Vol.33, p.e20231014
• Main Authors: Silva, Letícia Moreira, Silva, Amanda Priscila de Santana Cabral, Galvão, Maria Helena Rodrigues, Silva, Ana Lúcia Andrade da, Maia, Lívia Teixeira de Souza
• Format: Article
• Language: English
• Subjects: Brazil - epidemiology; Cities - epidemiology; COVID-19; COVID-19 - epidemiology; COVID-19 - mortality; Ecological Studies; Excess Mortality; HEALTH CARE SCIENCES & SERVICES; HEALTH POLICY & SERVICES; Humans; INFECTIOUS DISEASES; MEDICINE, GENERAL & INTERNAL; Mortality - trends; Original; Pandemics; Proportional Mortality Ratio; Spatial Analysis
• ISSN: 1679-4974; 2237-9622; 2237-9622
• DOI: 10.1590/S2237-96222024v33e20231014.en

To investigate excess mortality during the COVID-19 pandemic and its spatial distribution in Pernambuco, Brazil. This was an ecological, descriptive and analytical study of deaths, by municipality, recorded on the Mortality Information System, in 2020 and 2021. Excess mortality was measured by comparing observed and expected deaths, the latter estimated by calculating standardized mortality ratio (SMR). SMR and respective confidence intervals (95%CI) were calculated. Spatial analysis was performed by calculating the Global and Local Moran Index. Excess mortality was 20.6% and 27.5%, respectively, in 2020 and 2021, with positive spatial correlation (p-value < 0.05). More populous municipalities (2020: SMR = 1.26; 95%CI 1.24;1.27 and 2021: SMR = 1.34; 95%CI 1.32;1.34), more developed municipalities (2020: SMR = 1.43; 95%CI 1.41;1.44 and 2021: SMR = 1.51;95%CI 1.50;1.53) and municipalities in the Sertão region (2020:SMR = 1.31;95%CI 1.30;1.33 and 2021: SMR = 1.44; 95%CI 1.42;1.46) showed greater excess deaths. Excess mortality coincided with peak periods of COVID-19 transmission.