Effects of the COVID-19 pandemic on life expectancy at birth at the global, regional, and national levels: A joinpoint time-series analysis.

Background: Current estimates indicate that coronavirus disease 2019 (COVID-19) caused 14.9 million excess deaths in 2020 and 2021. Thus, estimating the change in life expectancy at birth due to the COVID-19 pandemic could aid in understanding its impact and implementing public health initiatives. Methods: We collected data on the life expectancy at birth of the combined population between 1990 and 2021 at the global, regional, and national levels from the 2022 Revision of World Population Prospects. In this time series study, we estimated the trend segments, the change of trend years (joinpoints), the annual percentage change (APC) in life expectancy at birth within each trend segment, and the average APC (AAPC) in life expectancy at birth during the full study period using joinpoint regression analysis. Results: The global life expectancy at birth decreased from 72.8 years in 2019 to 71.0 years in 2021, with an annual decrease of 1.2% (95% confidence interval (CI) = 1.0, 1.5) during the 2019-2021 period, despite an overall increasing trend during the entire period from 1990 to 2021 (AAPC = 0.3%; 95% CI = 0.3, 0.4). We observed a significantly increasing trend in life expectancy at birth in all regions and nearly 87.7% (207/236) of the world's countries and areas during the entire period (1990-2021). All continental regions except Africa and Oceania experienced a significant decreasing trend in life expectancy at birth in 2019-2021, with an APC of -1.2% (95% CI = -1.5, -0.9) for Asia, -2.1% (95% CI = -2.7, -1.6) for Latin America and the Caribbean, -1.1% (95% CI = -1.6, -0.6) for Northern America, and -1.4% (95% CI = -1.9, -0.9) for Europe. Among all countries and areas, 107 countries and areas (45.3%) experienced a significant decreasing trend in life expectancy at birth in the most recent time segment, with 77 countries and areas (32.6%) experiencing a significant decreasing trend during the 2019-2021 period. Conclusions: The world experienced a significant decreasing trend in life expectancy at birth in 2019-2021, with a decrease of 1.8 years; all continental regions except Africa and Oceania and 77 countries and areas experienced a significant decreasing trend in life expectancy at birth. These decreasing trends at global, regional, and national levels during the 2019-2021 period reflected the COVID-19 pandemic's direct and indirect adverse effects on life expectancy at birth.