ArticleCureus2026
All-Cause Excess Mortality During the COVID-19 Pandemic in a Rural Area of North India.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
Introduction COVID-19 pandemic significantly impacted global mortality; however, many deaths were underreported. Excess mortality explains both direct and indirect impacts of the COVID-19 pandemic and therefore provides true and better estimates of pandemic deaths. Objectives The objective of this study was to estimate excess all-cause mortality during the COVID-19 pandemic in a rural area of North India. Methods The study was carried out in the field practice area of the Rural Health Training Centre (RHTC) of a tertiary care hospital in North India. This area covers fifteen villages where home-based comprehensive health care is provided. Age, gender, and month-wise mortality data of these villages (for the years 2015-2023) were extracted from the records. Two models, historical five-year average and negative binomial regression, were used to estimate all-cause excess mortality for the COVID-19 period (January 2020-May 2023) compared with pre-pandemic years (2015-2019). Excess mortality was estimated as the difference between the number of all-cause deaths and baseline expected deaths for each model. Percentage excess mortality (ratio of excess deaths to expected deaths) was calculated. Results Monthly all-cause excess mortality was observed to be higher (exceeding 95% CI upper bounds) during the months of April, May, and August 2021 than expected mortality. May 2021 had the highest excess mortality, consisting of 47 and 43 deaths (223.8%, 167.4%) using historical average and negative binomial regression analysis, respectively. However, it was lower than expected in 2020, 2022, and 2023. Males and adults aged 40-59 years had higher excess mortality. Overall excess mortality was 19 (1.8%), with the year 2021 reporting high excess mortality of 72 (24%). Conclusions Findings indicate significant excess all-cause mortality during the COVID-19 pandemic. The study witnessed high excess mortality across age groups, particularly among 40- to 59-year-old adults and males.
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