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      Exceso de mortalidad, mortalidad por COVID-19 y por otras causas en el año 2020 en Navarra, España Translated title: Excess of mortality and mortality from COVID-19 and other causes of death in 2020 in Navarra, Spain

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          Resumen

          Fundamento:

          El objetivo del estudio fue presentar varios indicadores de mortalidad obtenidos de la base de datos de causas de muerte por edad y sexo de Navarra en 2020: esperanza de vida al nacer, exceso de mortalidad y mortalidad por COVID-19 y por otras causas de muerte.

          Material y métodos:

          Se utilizó un modelo de regresión de Poisson que tiene en cuenta las tendencias temporales en los años previos para estimar las muertes esperadas por sexo y edad en 2020.

          Resultados:

          La esperanza de vida al nacer en 2020 fue de 80,6 años en los hombres y 85,9 años en las mujeres, 1,4 y 1,0 años mas baja, respectivamente, que en 2019. No se observó un exceso de mortalidad por debajo de los 55 años. Las tasas ajustadas de exceso de mortalidad más altas se registraron en los hombres y mujeres de 85 y más años entre los que se concentraron el 61% del exceso de muertes. Los fallecimientos por COVID-19 superaron el número de exceso de muertes estimado. Los mayores de 75 años fueron el subgrupo de población donde se produjeron aproximadamente 9 de cada 10 muertes por COVID-19. Coincidiendo con la pandemia de COVID-19 se produjo un llamativo descenso de las tasas de mortalidad por el grupo de enfermedades donde está incluida la demencia.

          Conclusión:

          La primera y segunda ondas de la pandemia de COVID-19 redujeron la esperanza de vida al nacer a las cifras observadas diez años atrás. El incremento de fallecimientos en 2020 en Navarra es en gran parte atribuible a COVID-19.

          Abstract

          Background:

          In this study, we aimed to present mortality indicators from a database of death causes by age and sex in Navarre (Spain) for 2020: life expectancy at birth, excess mortality, and mortality from COVID-19 and other causes.

          Methods:

          A Poisson regression model, which accounts for temporal trends in the previous years, was used to estimate the expected deaths by sex and age for 2020.

          Results:

          Life expectancy at birth in Navarre for 2020 was 80.6 and 85.9 years for men and women, respectively, 1.4 and 1.0 years lower than in 2019. Deaths in people aged <55 years were similar to those expected. The highest adjusted excess mortality rate occurred among men and women aged ≥85 years, were 61% of excess deaths was concentrated. The estimated number of excess deaths did not exceed the number of reported deaths from COVID-19. In individuals aged >75 years, around 9 out of 10 people died from COVID-19. Coinciding with the COVID-19 pandemic, there was a remarkable decrease in mortality in people affected by diseases where dementia is included.

          Conclusions:

          The first and second waves of the COVID-19 pandemic reduced life expectancy at birth to figures observed ten years ago. The increase in deaths in Navarre for 2020 is largely attributable to COVID-19.

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          Most cited references32

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          A Novel Coronavirus from Patients with Pneumonia in China, 2019

          Summary In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.)
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            Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe

            Following the detection of the new coronavirus1 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its spread outside of China, Europe has experienced large epidemics of coronavirus disease 2019 (COVID-19). In response, many European countries have implemented non-pharmaceutical interventions, such as the closure of schools and national lockdowns. Here we study the effect of major interventions across 11 European countries for the period from the start of the COVID-19 epidemics in February 2020 until 4 May 2020, when lockdowns started to be lifted. Our model calculates backwards from observed deaths to estimate transmission that occurred several weeks previously, allowing for the time lag between infection and death. We use partial pooling of information between countries, with both individual and shared effects on the time-varying reproduction number (Rt). Pooling allows for more information to be used, helps to overcome idiosyncrasies in the data and enables more-timely estimates. Our model relies on fixed estimates of some epidemiological parameters (such as the infection fatality rate), does not include importation or subnational variation and assumes that changes in Rt are an immediate response to interventions rather than gradual changes in behaviour. Amidst the ongoing pandemic, we rely on death data that are incomplete, show systematic biases in reporting and are subject to future consolidation. We estimate that-for all of the countries we consider here-current interventions have been sufficient to drive Rt below 1 (probability Rt < 1.0 is greater than 99%) and achieve control of the epidemic. We estimate that across all 11 countries combined, between 12 and 15 million individuals were infected with SARS-CoV-2 up to 4 May 2020, representing between 3.2% and 4.0% of the population. Our results show that major non-pharmaceutical interventions-and lockdowns in particular-have had a large effect on reducing transmission. Continued intervention should be considered to keep transmission of SARS-CoV-2 under control.
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              Prevalence of SARS-CoV-2 in Spain (ENE-COVID): a nationwide, population-based seroepidemiological study

              Summary Background Spain is one of the European countries most affected by the COVID-19 pandemic. Serological surveys are a valuable tool to assess the extent of the epidemic, given the existence of asymptomatic cases and little access to diagnostic tests. This nationwide population-based study aims to estimate the seroprevalence of SARS-CoV-2 infection in Spain at national and regional level. Methods 35 883 households were selected from municipal rolls using two-stage random sampling stratified by province and municipality size, with all residents invited to participate. From April 27 to May 11, 2020, 61 075 participants (75·1% of all contacted individuals within selected households) answered a questionnaire on history of symptoms compatible with COVID-19 and risk factors, received a point-of-care antibody test, and, if agreed, donated a blood sample for additional testing with a chemiluminescent microparticle immunoassay. Prevalences of IgG antibodies were adjusted using sampling weights and post-stratification to allow for differences in non-response rates based on age group, sex, and census-tract income. Using results for both tests, we calculated a seroprevalence range maximising either specificity (positive for both tests) or sensitivity (positive for either test). Findings Seroprevalence was 5·0% (95% CI 4·7–5·4) by the point-of-care test and 4·6% (4·3–5·0) by immunoassay, with a specificity–sensitivity range of 3·7% (3·3–4·0; both tests positive) to 6·2% (5·8–6·6; either test positive), with no differences by sex and lower seroprevalence in children younger than 10 years ( 10%) and lower in coastal areas (<3%). Seroprevalence among 195 participants with positive PCR more than 14 days before the study visit ranged from 87·6% (81·1–92·1; both tests positive) to 91·8% (86·3–95·3; either test positive). In 7273 individuals with anosmia or at least three symptoms, seroprevalence ranged from 15·3% (13·8–16·8) to 19·3% (17·7–21·0). Around a third of seropositive participants were asymptomatic, ranging from 21·9% (19·1–24·9) to 35·8% (33·1–38·5). Only 19·5% (16·3–23·2) of symptomatic participants who were seropositive by both the point-of-care test and immunoassay reported a previous PCR test. Interpretation The majority of the Spanish population is seronegative to SARS-CoV-2 infection, even in hotspot areas. Most PCR-confirmed cases have detectable antibodies, but a substantial proportion of people with symptoms compatible with COVID-19 did not have a PCR test and at least a third of infections determined by serology were asymptomatic. These results emphasise the need for maintaining public health measures to avoid a new epidemic wave. Funding Spanish Ministry of Health, Institute of Health Carlos III, and Spanish National Health System.
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                Author and article information

                Contributors
                Role: ConceptualizaciónRole: InvestigaciónRole: MetodologíaRole: Administración del proyectoRole: SupervisiónRole: ValidaciónRole: VisualizaciónRole: Redacción - borrador originalRole: Redacción - revisión y edición
                Role: Curación de datosRole: Visualización
                Role: Curación de datosRole: Visualización
                Role: InvestigaciónRole: ValidaciónRole: VisualizaciónRole: Redacción - revisión y edición
                Role: InvestigaciónRole: ValidaciónRole: VisualizaciónRole: Redacción - revisión y edición
                Role: Análisis formalRole: InvestigaciónRole: MetodologíaRole: ValidaciónRole: VisualizaciónRole: Redacción - borrador originalRole: Redacción - revisión y edición
                Journal
                An Sist Sanit Navar
                An Sist Sanit Navar
                assn
                Anales del Sistema Sanitario de Navarra
                Gobierno de Navarra. Departamento de Salud
                1137-6627
                2340-3527
                05 December 2022
                Sep-Dec 2022
                : 45
                : 3
                : e1018
                Affiliations
                [1 ] original Instituto de Salud Pública y Laboral de Navarra. Departamento de Salud. Gobierno de Navarra. Pamplona. España. orgdiv2Instituto de Salud Pública y Laboral de Navarra orgdiv1Departamento de Salud orgnameGobierno de Navarra Pamplona, España
                [2 ] original Instituto de Investigación Sanitaria de Navarra (IdiSNA). Pamplona. España. orgnameInstituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, España
                [3 ] original CIBER de Epidemiología y Salud Pública (CIBERESP). España. orgnameCIBER de Epidemiología y Salud Pública (CIBERESP) España
                Author notes
                [Correspondencia ] Conchi Moreno-Iribas. E-mail: mmorenoi@ 123456cfnavarra.es

                Conflictos de intereses: Los autores declaran no tener conflictos de intereses.

                Financiación: Los autores declaran no haber recibido financiación externa para la realización de este estudio.

                Author information
                http://orcid.org/0000-0001-6537-0131
                http://orcid.org/0000-0001-8434-2013
                http://orcid.org/0000-0001-9242-6364
                http://orcid.org/0000-0002-2331-4542
                Article
                10.23938/ASSN.1018
                10065036
                36468585
                0aad4ce4-7837-4639-9e16-f748946d4704

                Este es un artículo publicado en acceso abierto bajo una licencia Creative Commons

                History
                : 10 February 2022
                : 26 May 2022
                : 09 September 2022
                Page count
                Figures: 3, Tables: 3, Equations: 1, References: 28, Pages: 0
                Categories
                Artículos Originales

                mortalidad,exceso de mortalidad,covid-19,esperanza de vida,mortality,excess of mortality,life expectancy

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