Abstract

Background

The COVID-19 pandemic has affected the entire health care system, internationally as well as in Sweden. We aimed to study excess deaths (all death causes, but also COVID-19-related deaths) during the COVID-19 pandemic regarding age, socio-economic status, the situation in nursing homes, and place of death for nursing home residents.

Design

We performed a descriptive regional registry data study using VAL, the Stockholm Regional Council’s central data warehouse, which covers almost all health care use in the county of Stockholm. T tests and chi-square tests were used for comparisons.

Results

Compared with 2016–2019, there were excess deaths in March–May 2020 (p < 0.0001), mainly explained by COVID-19, but in April there were also unexplained excess deaths. Individuals dying from COVID-19 were older than patients dying from other causes (p < 0.0001). There were more patient deaths among people residing in less advantaged socio-economic areas (p < 0.0001). Nursing home residents dying from COVID-19 were more often admitted to acute hospitals than residents dying from other causes (p < 0.0001). Also, the proportion of admissions of nursing home residents dying from other causes increased from April to May 2020 (p < 0.0001).

Conclusions

Dying from COVID-19 mainly affects the elderly, nursing home residents, and persons from less advantaged socio-economic groups. The pandemic has resulted in an increase in acute admissions of dying nursing home residents to acute hospitals.

中文翻译：

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COVID-19导致的过多死亡与年龄和社会经济地位相关。斯德哥尔摩地区的数据库研究

摘要

背景

COVID-19大流行已影响到整个国际医疗体系以及瑞典乃至整个瑞典。我们旨在研究COVID-19大流行期间的过度死亡（所有死亡原因，以及与COVID-19相关的死亡），涉及年龄，社会经济状况，疗养院情况以及疗养院居民的死亡地点。

设计

我们使用斯德哥尔摩区域委员会的中央数据仓库VAL进行了描述性的区域注册表数据研究，该数据覆盖了斯德哥尔摩县几乎所有的医疗保健用途。使用T检验和卡方检验进行比较。

结果

与2016-2019年相比，2020年3月至5月有过多的死亡事件（p  <0.0001），主要由COVID-19解释，但在4月也有无法解释的过度死亡事件。死于COVID-19的患者比死于其他原因的患者大（p  <0.0001）。在经济社会地位较低地区的人们中，有更多的患者死亡（p  <0.0001）。与死于其他原因的居民相比，死于COVID-19的养老院居民更常被送入急诊医院（p  <0.0001）。此外，从2020年4月至2020年5月，因其他原因丧生的疗养院住院病人的比例有所增加（p  <0.0001）。

结论

COVID-19的死亡主要影响老年人，疗养院居民以及社会经济地位较低的人群。大流行导致急性病住院的急诊住院病人增加。