ArticleBMJ (Clinical research ed.)2021
Effects of covid-19 pandemic on life expectancy and premature mortality in 2020: time series analysis in 37 countries.
Article in BMJ (Clinical research ed.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 111 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
111 citing papers in PubMed, 3 syntheses or guidelines pooled it, 247 citations in OpenAlex.
- COVID-19 Disease and Economic Burden to Healthcare Systems in Adults in Six Latin American Countries Before Nationwide Vaccination Program: Ministry of Health Database Assessment and Literature Review.International journal of environmental research and public health · 2025Pooled it
- Disability-adjusted life years (DALYs) based COVID-19 health impact assessment: a systematic review.BMC public health · 2023Pooled it
- The burden of premature mortality from cardiovascular diseases: A systematic review of years of life lost.PloS one · 2023Pooled it
- Prediction of intensive care admission and hospital mortality in COVID-19 patients using demographics and baseline laboratory data.Clinics (Sao Paulo, Brazil) · 2023Trial
- Dynamic properties of an SARS-CoV-2 epidemic model via stochastic PINNs.Infectious Disease Modelling · 2026Article
- Environmental Quality, Renewable Energy, and Life Expectancy in Gulf Cooperation Council Countries.International journal of environmental research and public health · 2026Article
- Evaluating Premature Mortality in Bangladesh During the COVID-19 Pandemic: A Comparative Analysis of Absolute and Relative Measures.Public health challenges · 2026Article
- Excess Mortality as the Primary Mediator of COVID-19's Impact on Life Expectancy in Europe: A Multilevel Longitudinal Analysis of Regional Disparities.Medicina (Kaunas, Lithuania) · 2026Article
- Long-term negative divergence in mortality at ages 25-49 years between the United Kingdom and 21 peer countries between 1990 and 2019.European journal of epidemiology · 2026Article
- Article
- Inequality in life expectancy losses by education in Finland during COVID-19 pandemic.International journal for equity in health · 2026Article
- Slowdown in mortality improvements and trends in lifespan inequality across high-income countries: the role of changing causes of death, 2010-2021.European journal of public health · 2026Article
- SARS-CoV-2 infection in lung transplant recipients: a single-center retrospective study in Japan.Surgery today · 2026Article
- Widening East-West inequality in life expectancy in Europe during the COVID-19 pandemic: An international comparative study.PloS one · 2026Article
- Article
- Acute SARS-CoV-2 infection.Nature reviews. Disease primers · 2025Review
- Inequities in mortality and potential years of life lost (PYLL) in greater Santiago, Chile, during and after the COVID-19 pandemic.International journal for equity in health · 2025Article
- The impact of the COVID-19 pandemic on all-cause mortality and life expectancy in northern Ghana: findings from the Navrongo Health and Demographic Surveillance System.Population health metrics · 2025Article
- Impact of adjustment for differential testing by age and sex on apparent epidemiology of SARS-CoV- 2 infection in Ontario, Canada.BMC infectious diseases · 2025Article
- The impact of non-pharmaceutical interventions on COVID-19 transmission and its effect on life expectancy in two European regions.BMC public health · 2025Article
51 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 5 institutions in 4 countries.
Funding
Abstract
objectiveTo estimate the changes in life expectancy and years of life lost in 2020 associated with the covid-19 pandemic.
designTime series analysis.
setting37 upper-middle and high income countries or regions with reliable and complete mortality data.
participantsAnnual all cause mortality data from the Human Mortality Database for 2005-20, harmonised and disaggregated by age and sex.
main outcome measuresReduction in life expectancy was estimated as the difference between observed and expected life expectancy in 2020 using the Lee-Carter model. Excess years of life lost were estimated as the difference between the observed and expected years of life lost in 2020 using the World Health Organization standard life table.
resultsReduction in life expectancy in men and women was observed in all the countries studied except New Zealand, Taiwan, and Norway, where there was a gain in life expectancy in 2020. No evidence was found of a change in life expectancy in Denmark, Iceland, and South Korea. The highest reduction in life expectancy was observed in Russia (men: -2.33, 95% confidence interval -2.50 to -2.17; women: -2.14, -2.25 to -2.03), the United States (men: -2.27, -2.39 to -2.15; women: -1.61, -1.70 to -1.51), Bulgaria (men: -1.96, -2.11 to -1.81; women: -1.37, -1.74 to -1.01), Lithuania (men: -1.83, -2.07 to -1.59; women: -1.21, -1.36 to -1.05), Chile (men: -1.64, -1.97 to -1.32; women: -0.88, -1.28 to -0.50), and Spain (men: -1.35, -1.53 to -1.18; women: -1.13, -1.37 to -0.90). Years of life lost in 2020 were higher than expected in all countries except Taiwan, New Zealand, Norway, Iceland, Denmark, and South Korea. In the remaining 31 countries, more than 222 million years of life were lost in 2020, which is 28.1 million (95% confidence interval 26.8m to 29.5m) years of life lost more than expected (17.3 million (16.8m to 17.8m) in men and 10.8 million (10.4m to 11.3m) in women). The highest excess years of life lost per 100 000 population were observed in Bulgaria (men: 7260, 95% confidence interval 6820 to 7710; women: 3730, 2740 to 4730), Russia (men: 7020, 6550 to 7480; women: 4760, 4530 to 4990), Lithuania (men: 5430, 4750 to 6070; women: 2640, 2310 to 2980), the US (men: 4350, 4170 to 4530; women: 2430, 2320 to 2550), Poland (men: 3830, 3540 to 4120; women: 1830, 1630 to 2040), and Hungary (men: 2770, 2490 to 3040; women: 1920, 1590 to 2240). The excess years of life lost were relatively low in people younger than 65 years, except in Russia, Bulgaria, Lithuania, and the US where the excess years of life lost was >2000 per 100 000.
conclusionMore than 28 million excess years of life were lost in 2020 in 31 countries, with a higher rate in men than women. Excess years of life lost associated with the covid-19 pandemic in 2020 were more than five times higher than those associated with the seasonal influenza epidemic in 2015.
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