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Variation in Cause-Specific Mortality Rates in Italy during the First Wave of the COVID-19 Pandemic: A Study Based on Nationwide Data

Author

Listed:
  • Enrico Grande

    (Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, 00198 Rome, Italy)

  • Ugo Fedeli

    (Epidemiological Department, Azienda Zero, Veneto Region, 35132 Padova, Italy)

  • Marilena Pappagallo

    (Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, 00198 Rome, Italy)

  • Roberta Crialesi

    (Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, 00198 Rome, Italy)

  • Stefano Marchetti

    (Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, 00198 Rome, Italy)

  • Giada Minelli

    (Statistical Service, Istituto Superiore di Sanità, 00161 Rome, Italy)

  • Ivano Iavarone

    (Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy)

  • Luisa Frova

    (Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, 00198 Rome, Italy)

  • Graziano Onder

    (Department of Cardiovascular, Endocrine-Metabolic Diseases and Ageing, Istituto Superiore di Sanità, 00161 Rome, Italy)

  • Francesco Grippo

    (Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, 00198 Rome, Italy)

Abstract

Italy was a country severely hit by the first coronavirus disease 2019 (COVID-19) pandemic wave in early 2020. Mortality studies have focused on the overall excess mortality observed during the pandemic. This paper investigates the cause-specific mortality in Italy from March 2020 to April 2020 and the variation in mortality rates compared with those in 2015–2019 regarding sex, age, and epidemic area. Causes of death were derived from the national cause-of-death register. COVID-19 was the leading cause of death among males and the second leading cause among females. Chronic diseases, such as diabetes and hypertensive, ischemic heart, and cerebrovascular diseases, with decreasing or stable mortality rates in 2015–2019, showed a reversal in the mortality trend. Moreover, mortality due to pneumonia and influenza increased. No increase in neoplasm mortality was observed. Among external causes of death, mortality increased for accidental falls but reduced for transport accidents and suicide. Mortality from causes other than COVID-19 increased similarly in both genders and more at ages 65 years or above. Compared with other areas in Italy, the Lombardy region showed the largest excess in mortality for all leading causes. Underdiagnosis of COVID-19 at the beginning of the pandemic may, to some extent, explain the mortality increase for some causes of death, especially pneumonia and other respiratory diseases.

Suggested Citation

  • Enrico Grande & Ugo Fedeli & Marilena Pappagallo & Roberta Crialesi & Stefano Marchetti & Giada Minelli & Ivano Iavarone & Luisa Frova & Graziano Onder & Francesco Grippo, 2022. "Variation in Cause-Specific Mortality Rates in Italy during the First Wave of the COVID-19 Pandemic: A Study Based on Nationwide Data," IJERPH, MDPI, vol. 19(2), pages 1-13, January.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:2:p:805-:d:722751
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    References listed on IDEAS

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    1. Takanao Tanaka & Shohei Okamoto, 2021. "Increase in suicide following an initial decline during the COVID-19 pandemic in Japan," Nature Human Behaviour, Nature, vol. 5(2), pages 229-238, February.
    2. David Morgan & Junya Ino & Gabriel Di Paolantonio & Fabrice Murtin, 2020. "Excess mortality: Measuring the direct and indirect impact of COVID-19," OECD Health Working Papers 122, OECD Publishing.
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    1. Paola Bertuccio & Pietro Perotti & Giansanto Mosconi & Simona Dalle Carbonare & Federica Manzoni & Lorenza Boschetti & Stefano Marguati & Paolo Paraluppi & Lorenzo Blandi & Leandro Gentile & Maddalena, 2023. "The Effect of COVID-19 Pandemic on Overall and Cause-Specific Mortality in Pavia, Northern Italy: Updated Estimates for the Year 2021," IJERPH, MDPI, vol. 20(8), pages 1-10, April.
    2. Marinella Bertolotti & Marta Betti & Fabio Giacchero & Chiara Grasso & Genny Franceschetti & Margherita Carotenuto & Anna Odone & Guglielmo Pacileo & Daniela Ferrante & Antonio Maconi, 2022. "Long-Term Survival among Patients Hospitalized for COVID-19 during the First Three Epidemic Waves: An Observational Study in a Northern Italy Hospital," IJERPH, MDPI, vol. 19(22), pages 1-11, November.
    3. Giacomo Pietro Vigezzi & Paola Bertuccio & Andrea Amerio & Cristina Bosetti & Davide Gori & Luca Cavalieri d’Oro & Licia Iacoviello & David Stuckler & Alberto Zucchi & Silvano Gallus & Anna Odone & Lo, 2022. "Older Adults’ Access to Care during the COVID-19 Pandemic: Results from the LOckdown and LifeSTyles (LOST) in Lombardia Project," IJERPH, MDPI, vol. 19(18), pages 1-14, September.
    4. Pietro Perotti & Paola Bertuccio & Stefano Cacitti & Silvia Deandrea & Lorenza Boschetti & Simona Dalle Carbonare & Stefano Marguati & Simona Migliazza & Eleonora Porzio & Simona Riboli & Ennio Cadum , 2022. "Impact of the COVID-19 Pandemic on Total and Cause-Specific Mortality in Pavia, Northern Italy," IJERPH, MDPI, vol. 19(11), pages 1-10, May.
    5. Graziella Bonanno & Marino De Luca, 2025. "Unravelling Myths: A Difference-In-Differences Analysis of Post-Vaccination Mortality in Italy During COVID-19," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 176(3), pages 1137-1177, February.
    6. Ugo Fedeli & Claudio Barbiellini Amidei & Alessandro Marcon & Veronica Casotto & Francesco Grippo & Enrico Grande & Thomas Gaisl & Stefano Barco, 2022. "Mortality Related to Chronic Obstructive Pulmonary Disease during the COVID-19 Pandemic: An Analysis of Multiple Causes of Death through Different Epidemic Waves in Veneto, Italy," IJERPH, MDPI, vol. 19(19), pages 1-9, October.

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