Excess deaths from all causes and by COVID-19 in Brazil in 2020

Alcione Miranda dos Santos; Bruno Feres de Souza; Carolina Abreu de Carvalho; Marcos Adriano Garcia Campos; Bruno Luciano Carneiro Alves de Oliveira; Eduardo Moraes  Diniz; Maria dos Remédios Freitas Carvalho  Branco; Rejane Christine de Sousa  Queiroz; Vitória Abreu de Carvalho; Waleska Regina Machado Araújo; Antônio Augusto Moura da  Silva

doi:10.11606/s1518-8787.2021055004137

Authors

Alcione Miranda dos Santos Universidade Federal do Maranhão. Programa de Pós-Graduação em Saúde Coletiva. São Luís, MA, Brasil https://orcid.org/0000-0001-9711-0182
Bruno Feres de Souza Universidade Federal do Maranhão. Departamento de Engenharia da Computação. São Luís, MA, Brasil https://orcid.org/0000-0003-1997-4983
Carolina Abreu de Carvalho Universidade Federal do Maranhão. Programa de Pós-Graduação em Saúde Coletiva. São Luís, MA, Brasil https://orcid.org/0000-0001-7900-4642
Marcos Adriano Garcia Campos Universidade Federal do Maranhão. Programa de Pós-Graduação em Saúde Coletiva. São Luís, MA, Brasil https://orcid.org/0000-0001-8924-1203
Bruno Luciano Carneiro Alves de Oliveira Universidade Federal do Maranhão. Programa de Pós-Graduação em Saúde Coletiva. São Luís, MA, Brasil https://orcid.org/0000-0001-8053-7972
Eduardo Moraes Diniz Universidade Federal do Maranhão. Departamento de Física. São Luís, MA, Brasil https://orcid.org/0000-0002-6201-1771
Maria dos Remédios Freitas Carvalho Branco Universidade Federal do Maranhão. Programa de Pós-Graduação em Saúde Coletiva. São Luís, MA, Brasil https://orcid.org/0000-0002-3537-0840
Rejane Christine de Sousa Queiroz Universidade Federal do Maranhão. Programa de Pós-Graduação em Saúde Coletiva. São Luís, MA, Brasil https://orcid.org/0000-0003-4019-2011
Vitória Abreu de Carvalho Universidade Federal do Maranhão. Programa de Pós-Graduação em Saúde Coletiva. São Luís, MA, Brasil https://orcid.org/0000-0002-7831-5761
Waleska Regina Machado Araújo Universidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Preventiva, São Paulo, SP, Brasil https://orcid.org/0000-0001-5758-7947
Antônio Augusto Moura da Silva Universidade Federal do Maranhão. Programa de Pós-Graduação em Saúde Coletiva. São Luís, MA, Brasil https://orcid.org/0000-0003-4968-5138

DOI:

https://doi.org/10.11606/s1518-8787.2021055004137

Keywords:

Neoplasms, mortality, Mortality, COVID-19, Cause of Death

Abstract

OBJECTIVE To estimate the 2020 all-cause and COVID-19 excess mortality according to sex, age, race/color, and state, and to compare mortality rates by selected causes with that of the five previous years in Brazil. METHODS Data from the Mortality Information System were used. Expected deaths for 2020 were estimated from 2015 to 2019 data using a negative binomial log-linear model. RESULTS Excess deaths in Brazil in 2020 amounted to 13.7%, and the ratio of excess deaths to COVID-19 deaths was 0.90. Reductions in deaths from cardiovascular diseases (CVD), respiratory diseases, and external causes, and an increase in ill-defined causes were all noted. Excess deaths were also found to be heterogeneous, being higher in the Northern, Center-Western, and Northeastern states. In some states, the number of COVID-19 deaths was lower than that of excess deaths, whereas the opposite occurred in others. Moreover, excess deaths were higher in men aged 20 to 59, and in black, yellow, or indigenous individuals. Meanwhile, excess mortality was lower in women, in individuals aged 80 years or older, and in whites. Additionally, deaths among those aged 0 to 19 were 7.2% lower than expected, with reduction in mortality from respiratory diseases and external causes. There was also a drop in mortality due to external causes in men and in those aged 20 to 39 years. Moreover, reductions in deaths from CVD and neoplasms were noted in some states and groups. CONCLUSION There is evidence of underreporting of COVID-19 deaths and of the possible impact of restrictive measures in the reduction of deaths from external causes and respiratory diseases. The impacts of COVID-19 on mortality were heterogeneous among the states and groups, revealing that regional, demographic, socioeconomic, and racial differences expose individuals in distinct ways to the risk of death from both COVID-19 and other causes.

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Excess deaths from all causes and by COVID-19 in Brazil in 2020

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