Objective

To examine whether the age distribution of COVID-19 deaths and the share of deaths in nursing homes changed in the second versus the first pandemic wave.

Eligible data

We considered all countries that had at least 4000 COVID-19 deaths occurring as of January 14, 2021, at least 200 COVID-19 deaths occurring in each of the two epidemic wave periods; and which had sufficiently detailed information available on the age distribution of these deaths. We also considered countries with data available on COVID-19 deaths of nursing home residents for the two waves.

Main outcome measures

Change in the second wave versus the first wave in the proportion of COVID-19 deaths occurring in people <50 years (“young deaths”) among all COVID-19 deaths and among COVID-19 deaths in people <70 years old; and change in the proportion of COVID-19 deaths in nursing home residents among all COVID-19 deaths.

Results

Data on age distribution were available for 14 eligible countries. Individuals <50 years old had small absolute difference in their share of the total COVID-19 deaths in the two waves across 13 high-income countries (absolute differences 0.0–0.4%). Their proportion was higher in Ukraine, but it decreased markedly in the second wave. The proportion of young deaths was lower in the second versus the first wave (summary prevalence ratio 0.81, 95% CI 0.71–0.92) with large between-country heterogeneity. The proportion of young deaths among deaths <70 years did not differ significantly across the two waves (summary prevalence ratio 0.96, 95% CI 0.86–1.06). Eligible data on nursing home COVID-19 deaths were available for 11 countries. The share of COVID-19 deaths that were accounted by nursing home residents decreased in the second wave significantly and substantially in 8 countries (prevalence ratio estimates: 0.36 to 0.78), remained the same in Denmark and Norway and markedly increased in Australia.

Conclusions

In the examined countries, age distribution of COVID-19 deaths has been fairly similar in the second versus the first wave, but the contribution of COVID-19 deaths in nursing home residents to total fatalities has decreased in most countries in the second wave.

中文翻译：

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第二波与第一波 COVID-19 死亡：年龄分布和疗养院死亡人数的变化

客观的

检查 COVID-19 死亡的年龄分布和疗养院死亡人数的比例在第二波与第一波大流行浪潮中是否发生了变化。

符合条件的数据

我们考虑了截至 2021 年 1 月 14 日至少有 4000 例 COVID-19 死亡的所有国家，在两个流行浪潮时期的每个时期至少有 200 例 COVID-19 死亡；并且有关于这些死亡的年龄分布的足够详细的信息。我们还考虑了拥有关于这两波疗养院居民 COVID-19 死亡数据的国家。

主要观察指标

第二波与第一波相比，发生在 50 岁以下人群（“年轻死亡”）中的 COVID-19 死亡人数占所有 COVID-19 死亡人数和 70 岁以下人群的 COVID-19 死亡人数比例的变化；以及疗养院居民中 COVID-19 死亡人数占所有 COVID-19 死亡人数比例的变化。

结果

14 个符合条件的国家提供了年龄分布数据。在 13 个高收入国家的两波浪潮中，50 岁以下的个体在 COVID-19 总死亡人数中所占比例的绝对差异很小（绝对差异为 0.0-0.4%）。他们的比例在乌克兰较高，但在第二波中明显下降。第二波的年轻人死亡比例低于第一波（汇总流行率 0.81，95% CI 0.71–0.92），国家间存在较大异质性。两次调查中 70 岁以下死亡人数中年轻死亡人数的比例没有显着差异（汇总流行率 0.96，95% CI 0.86–1.06）。11 个国家提供了有关疗养院 COVID-19 死亡的合格数据。

结论

在接受调查的国家中，第二波与第一波的 COVID-19 死亡人数的年龄分布非常相似，但在第二波的大多数国家中，疗养院居民中 COVID-19 死亡人数占总死亡人数的比例有所下降。