Evidence map›Paper›PMID 39527396›Full record

ArticleJournal of epidemiology and global health2024

Excess Mortality and its Determinants During the COVID-19 Pandemic in 21 Countries: An Ecological Study from the C-MOR Project, 2020 and 2021.

Mohammad Reza Rahmanian Haghighi, Chryso Th Pallari, Souzana Achilleos, Annalisa Quattrocchi, John Gabel, Andreas Artemiou, Maria Athanasiadou, Stefania Papatheodorou, Tianyu Liu, José Antonio Cernuda Martínez and 31 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of epidemiology and global health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Paid and unpaid productivity losses across 28 European countries due to excess deaths and COVID-19 deaths from 2020 to 2023.The European journal of health economics : HEPAC : health economics in prevention and care · 2026
    Article
  2. Article
  3. Observational
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

41 authors.

Mohammad Reza Rahmanian HaghighiDepartment of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus.ORCID 0000-0003-3820-4685
Chryso Th PallariDepartment of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus.ORCID 0000-0001-6781-9684
Souzana AchilleosDepartment of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus.
Annalisa QuattrocchiDepartment of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus.
John GabelMassachusetts Institute of Technology, Cambridge, MA, USA.
Andreas ArtemiouDepartment of Information Technologies, University of Limassol, Limassol, Cyprus.
Maria AthanasiadouHealth Monitoring Unit, Government of the Republic of Cyprus Ministry of Health, Nicosia, Cyprus.
Stefania PapatheodorouDepartment of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA.
Tianyu LiuDepartment of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
José Antonio Cernuda MartínezUnit for Research in Emergency and Disaster, University of Oviedo, Oviedo, Spain.
Gleb DenissovDepartment of Registries, National Institute for Health Development, Tallinn, Estonia.
Błażej ŁyszczarzDepartment of Health Economics, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland.
Qian HuangCenter for Rural Health Research, East Tennessee State University, Johnson, TN, USA.
Kostas AthanasakisDepartment of Public Health Policy, University of West Attica, Athens, Greece.
Catherine M BennettInstitute for Health Transformation, Deakin University, Victoria, Australia.
Claudia ZimmermannDepartment of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria.
Wenjing TaoDepartment of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Serge Nganda MekogoEpidemiology of Infectious Diseases, Sciensano, Brussels, Belgium.
Terje P HagenDepartment of Health Management and Health Economics, University of Oslo, Oslo, Norway.
Nolwenn Le MeurCNRS, Inserm, Arènes-UMR 6051, RSMS-U 1309, University of Rennes, EHESP, Rennes, France.
Jackeline Christiane Pinto LobatoEpidemiology, Fluminense Federal University, Niterói, Brazil.
Giuseppe AmbrosioMedicine, University of Perugia, Perugia, Italy.
Ivan ErzenPublic Health School, National Institute of Public Health, Ljubljana, Slovenia.
Binyamin BinyaminyIsrael Center for Disease Control, Ministry of Health, Ramat Gan, Israel.
Julia A CritchleyPopulation Health Research Institute, City St George's, University of London, London, UK.
Lucy P GoldsmithSchool of Health & Psychological Sciences, City St George's, University of London, London, UK.
Olesia VerstiukDepartment of Medical Science, University of Nicosia, Nicosia, Cyprus.
Jideofor Thomas OgbuCenter for Research on the Epidemiology of Disasters, UCLouvain, Brussels, Belgium.
Laust H MortensenDepartment of Public Health, University of Copenhagen, Copenhagen, Denmark.
Levan KandelakiMedical Statistics, National Center for Disease Control and Public Health, Tbilisi, Georgia.
Marcin CzechDepartment of Pharmacoeconomics, Institute of Mother and Child, Warsaw, Poland.
Joseph CutherbertsonMonash University Disaster Resilience Initiative, Monash University, Clayton, Australia.
Eva SchernhammerDepartment of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria.
Catharina VernemmenEpidemiology of Infectious Diseases, Sciensano, Brussels, Belgium.
Antonio José Leal CostaInstituto de Estudos em Saúde Coletiva, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, Brazil.
Tamar MaorIsrael Center of Disease Control, Ministry of Heath, Ramat Gan, Israel.
Dimos AlekkouDepartment of Psychology, University of Nicosia, Nicosia, Cyprus.
Bo BurströmDepartment of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Antonis PolemitisUniversity of Nicosia, Nicosia, Cyprus.
Andreas CharalambousUniversity of Nicosia Medical School, Nicosia, Cyprus.
Christiana A DemetriouDepartment of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus. demetriou.chri@unic.ac.cy.ORCID 0000-0003-4002-2880

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe COVID-19 pandemic overwhelmed health systems, resulting in a surge in excess deaths. This study clustered countries based on excess mortality to understand their response to the pandemic and the influence of various factors on excess mortality within each cluster. MATERIALS AND

methodsThis ecological study is part of the COVID-19 MORtality (C-MOR) Consortium. Mortality data were gathered from 21 countries and were previously used to calculate weekly all-cause excess mortality. Thirty exposure variables were considered in five categories as factors potentially associated with excess mortality: population factors, health care resources, socioeconomic factors, air pollution, and COVID-19 policy. Estimation of Latent Class Linear Mixed Model (LCMM) was used to cluster countries based on response trajectory and Generalized Linear Mixture Model (GLMM) for each cluster was run separately.

resultsUsing LCMM, two clusters were reached. Among 21 countries, Brazil, the USA, Georgia, and Poland were assigned to a separate cluster, with the mean of excess mortality z-score in 2020 and 2021 around 4.4, compared to 1.5 for all other countries assigned to the second cluster. In both clusters the population incidence of COVID-19 had the greatest positive relationship with excess mortality while interactions between the incidence of COVID-19, fully vaccinated people, and stringency index were negatively associated with excess mortality. Moreover, governmental variables (government revenue and government effectiveness) were the most protective against excess mortality.

conclusionThis study highlighted that clustering countries based on excess mortality can provide insights to gain a broader understanding of countries' responses to the pandemic and their effectiveness.

Indexed as

COVID-19PandemicsGlobal HealthHumansMortalitySARS-CoV-2Socioeconomic FactorsCOVID-19Excess mortalityGovernancePublic health measuresVaccination rate

Identifiers

PMID39527396
PMCPMC11652428

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.