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.
Highlights
COVID-19 probably already existed during the autumn of 2019, the outbreak in Wuhan, China was formally announced by the WHO in December 2019
We aimed to study excess deaths during the COVID-19 pandemic, with special reference to age, socio-economic status, and the situation in nursing homes
An additional finding was that nursing home residents dying from COVID-19 were more often admitted to hospitals than residents dying from other causes
Summary
COVID-19 probably already existed during the autumn of 2019, the outbreak in Wuhan, China was formally announced by the WHO in December 2019. Regarding the Stockholm region, patients from less affluent areas seemed to already be overrepresented among deaths at the beginning of the pandemic, and there were alarming early reports stating that individuals from certain non-European backgrounds were overrepresented among the deceased. This was confirmed in a study where deaths in 2020 were compared with deaths in 2016–2019, month by month [3]. 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
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