Factors associated with excess all-cause mortality in the first wave of the COVID-19 pandemic in the UK: A time series analysis using the Clinical Practice Research Datalink

PLoS MedicineStrongman H, Carreira H, De Stavola BL, et al. | February 03, 2022


The total effect of the coronavirus disease 2019 (COVID-19) pandemic on mortality is captured by excess mortality which is not influenced by misspecification of cause of death. Researchers herein aimed at delineating the associations of health and demographic factors with excess mortality during, compared with before, the pandemic.

  • For people with individual health and sociodemographic factors, all-cause and excess mortality during Wave 1 of the UK pandemic (5 March to 27 May 2020) was estimated using seasonally adjusted time series models; then the estimates of relative risks of all-cause mortality were determined in people with and without these factors before the pandemic and during Wave 1.

  • People with and without each factor had similar relative risks of all-cause mortality before and during Wave 1 of the pandemic, but there were exceptions.

  • Health-related exceptions included substantially higher risk of death among people with a diagnosis of dementia or learning disabilities, relative to people without these conditions, during Wave 1 compared with it before the pandemic.

  • Non-White ethnicity and living in London were the socioeconomic exceptions; immediate risks of death were lower for these groups before the pandemic compared with White people or people living outside of London, but there were substantially elevated relative risks during Wave 1.

  • This suggests that the risk of death has been dialed up by a similar proportional degree for most people because of COVID-19.

  • From a clinical perspective, pre-pandemic knowledge concerning the relative frailty linked with various conditions can be reasonably applied in the pandemic situation, though further follow-up will be required to verify that the observations generalize beyond Wave 1.

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