ArticlePloS one2020
Estimating weekly excess mortality at sub-national level in Italy during the COVID-19 pandemic.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 3 of them syntheses that pooled it.
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Who cites it
44 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Methods Used in the Spatial and Spatiotemporal Analysis of COVID-19 Epidemiology: A Systematic Review.International journal of environmental research and public health · 2022Pooled it
- Coronavirus disease 2019 (COVID-19) excess mortality outcomes associated with pandemic effects study (COPES): A systematic review and meta-analysis.Frontiers in medicine · 2022Pooled it
- Pooled it
- Contrasting pre-vaccine COVID-19 waves in Italy through functional data analysis.Scientific reports · 2025Article
- Investigating the Trend of Mortality, Life Expectancy and Excessive Death with Emphasis on the Role of the COVID-19 Pandemic Period in the Isfahan Province: A Cross-sectional Study of Join Point Regression Analysis 2011-2021.Archives of Iranian medicine · 2025Article
- Spatial Variation in Excess Mortality Across Europe: A Cross-Sectional Study of 561 Regions in 21 Countries.Journal of epidemiology and global health · 2024Article
- Spatial disparities in the mortality burden of the covid-19 pandemic across 569 European regions (2020-2021).Nature communications · 2024Article
- Area-level excess mortality in times of COVID-19 in Switzerland: geographical, socioeconomic and political determinants.European journal of public health · 2024Article
- Bayesian spatio-temporal analysis of the COVID-19 pandemic in Catalonia.Scientific reports · 2024Article
- Article
- COVID-19 could accelerate the decline in recreational hunting: A natural experiment from Northern Italy.PloS one · 2024Article
- Estimating subnational excess mortality in times of pandemic. An application to French départements in 2020.PloS one · 2024Article
- Impact of COVID-19 on mortality in coastal Kenya: a longitudinal open cohort study.Nature communications · 2023Article
- Variation in mortality burden of the COVID-19 pandemic across federal states in Germany.European journal of public health · 2023Article
- Impact of the COVID-19 pandemic on total, sex- and age-specific all-cause mortality in 20 countries worldwide during 2020: results from the C-MOR project.International journal of epidemiology · 2023Article
- The contribution of population age-sex structure to the excess mortality estimates of 2020-2021 in Denmark, Finland, Iceland, Norway, and Sweden.SSM - population health · 2023Article
- The Effect of COVID-19 Pandemic on Overall and Cause-Specific Mortality in Pavia, Northern Italy: Updated Estimates for the Year 2021.International journal of environmental research and public health · 2023Article
- Assessment of Excess Mortality in Italy in 2020-2021 as a Function of Selected Macro-Factors.International journal of environmental research and public health · 2023Article
- Bayesian profile regression to study the ecologic associations of correlated environmental exposures with excess mortality risk during the first year of the Covid-19 epidemic in lombardy, Italy.Environmental research · 2023Article
- The burden of big spaces: Russian regions and cities in the COVID-19 pandemic.Letters in spatial and resource sciences · 2023Article
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Authors and funding
6 authors.
Funding
Abstract
In this study we present the first comprehensive analysis of the spatio-temporal differences in excess mortality during the COVID-19 pandemic in Italy. We used a population-based design on all-cause mortality data, for the 7,904 Italian municipalities. We estimated sex-specific weekly mortality rates for each municipality, based on the first four months of 2016-2019, while adjusting for age, localised temporal trends and the effect of temperature. Then, we predicted all-cause weekly deaths and mortality rates at municipality level for the same period in 2020, based on the modelled spatio-temporal trends. Lombardia showed higher mortality rates than expected from the end of February, with 23,946 (23,013 to 24,786) total excess deaths. North-West and North-East regions showed one week lag, with higher mortality from the beginning of March and 6,942 (6,142 to 7,667) and 8,033 (7,061 to 9,044) total excess deaths respectively. We observed marked geographical differences also at municipality level. For males, the city of Bergamo (Lombardia) showed the largest percent excess, 88.9% (81.9% to 95.2%), at the peak of the pandemic. An excess of 84.2% (73.8% to 93.4%) was also estimated at the same time for males in the city of Pesaro (Central Italy), in stark contrast with the rest of the region, which does not show evidence of excess deaths. We provided a fully probabilistic analysis of excess mortality during the COVID-19 pandemic at sub-national level, suggesting a differential direct and indirect effect in space and time. Our model can be used to help policy-makers target measures locally to contain the burden on the health-care system as well as reducing social and economic consequences. Additionally, this framework can be used for real-time mortality surveillance, continuous monitoring of local temporal trends and to flag where and when mortality rates deviate from the expected range, which might suggest a second wave of the pandemic.
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