Evidence map›Paper›PMID 41644304›Full record

SynthesisEpidemiology and infection2026

Excess mortality in Mainland China after the end of the Zero COVID policy: A systematic review.

Isaac Chun-Hai Fung, Hai Liang, Kelli J Pierce, Alicia N M Kraay, Kin On Kwok, Andrei R Akhmetzhanov, Frank E Baiden, H Juliette T Unwin, Francis B Kengne, Faharudeen Alhassan and 1 more

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Epidemiology and infection, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

11 authors.

Isaac Chun-Hai FungDepartment of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, USA.ORCID https://orcid.org/0000-0001-5496-2529
Hai LiangSchool of Journalism and Communication, The Chinese University of Hong Kong, Hong Kong.
Kelli J PierceDepartment of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, USA.
Alicia N M KraayGates Foundation, USA.
Kin On KwokThe Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong.
Andrei R AkhmetzhanovInstitute of Epidemiology and Preventive Medicine, National Taiwan University College of Public Health, Taiwan.ORCID https://orcid.org/0000-0003-3269-7351
Frank E BaidenOffice of the Dean, University of Health and Allied Sciences School of Public Health, Ghana.
H Juliette T UnwinSchool of Mathematics, The University of Bristol, UK.
Francis B KengneDepartment of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, USA.
Faharudeen AlhassanDepartment of Population Health Sciences, School of Public Health, Georgia State University, USA.
Gerardo ChowellDepartment of Population Health Sciences, School of Public Health, Georgia State University, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

After the Zero COVID policy ended on December 7, 2022, ~90% of mainland Chinese were infected in a COVID-19 wave. This systematic review synthesized research estimating excess mortality during that wave in mainland China. We searched seven databases in May 2024 and updated our search in July-August 2025. Peer-reviewed research (Chinese or English), published since January 1, 2023, estimating excess deaths in the COVID-19 wave post-Zero-COVID was included. Risk of bias was assessed using a modified Newcastle-Ottawa Scale. Two authors independently conducted abstract screening, full-text review, data extraction, and risk-of-bias assessment. Seven articles were included. Two studies analysed the death records of a town and a district in Shanghai, estimating the excess mortality rates of 153.6% and 174.3%, respectively. Using indirect methods, four studies estimated national excess mortality (range: 0.71-1.87 million). Another study estimated excess mortality in Taiyuan. Studies used diverse methods to estimate excess deaths, resulting in widely varying and uncertain estimates. Choice of reference period, seasonality, and other factors affect expected mortality estimates.

Indexed as

COVID-19ChinaHumansPandemicsChinaCOVID-19mortalitySARS-CoV-2vital statistics

Identifiers

PMID41644304
PMCPMC12964144

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.