First year of the pandemic: Years of Life Lost due to COVID-19 in Serbia

Abstract Background The first case of COVID-19 in Serbia was reported on 6th March 2020. Since then, Serbia has registered several epidemic peaks, which have led to a considerable increase in premature mortality. Basic evaluation of COVID-19 premature mortality burden needs to include frequency of COVID-19 deaths among different age-groups. Methods All-cause mortality data disaggregated by age and sex, population estimates and remaining life expectancy for different age-groups were acquired from the Statistical Office of the Republic of Serbia. Years of Life Lost (YLL) due to COVID-19 were calculated for the period from March to December 2020. European Standard Population was used for calculating age-standardized mortality rates. We acknowledge the support from the BoCO-19 - The Burden of Disease due to COVID-19 project coordinated/led by Robert Koch Institute and supported by the WHO Regional Office for Europe. Results In 2020, there were 127,572 YLLs due to COVID-19, with 81,147 of YLLs (63.6%) attributable to men and 46,425 (36.4%) to women. Contribution of COVID-19 to the total all-cause YLL was also higher in men comparing to women: 11.39% and 7.80%, respectively. Three epidemic peaks were observed in 2020, together composing two thirds (65.6%) of total YLLs due to COVID-19. December was the month with the greatest burden, accounting for 45.8% of all YLLs due to COVID-19. Crude YLL rate for COVID-19 was 1849.1 per 100,000, or 1733.5 per 100,000 after standardization. Conclusions Registered COVID-19 deaths accounted for one tenth of total YLLs in Serbia in 2020, with men contributing almost twice as much to that number compared to women. On average, 12.32 YLLs originated from each registered COVID-19 death. Further studies need to assess the impact of the COVID-19 epidemic on avoidable mortality trends in Serbia. Key messages • COVID-19 deaths comprised one tenth of all-cause YLLs, with two-thirds of COVID-19 YLLs attributable to men. • To reduce premature mortality burden, epidemic peaks need to be prevented.


Background:
The first case of COVID-19 in Serbia was reported on 6th March 2020. Since then, Serbia has registered several epidemic peaks, which have led to a considerable increase in premature mortality. Basic evaluation of COVID-19 premature mortality burden needs to include frequency of COVID-19 deaths among different age-groups. Methods: All-cause mortality data disaggregated by age and sex, population estimates and remaining life expectancy for different age-groups were acquired from the Statistical Office of the Republic of Serbia. Years of Life Lost (YLL) due to COVID-19 were calculated for the period from March to December 2020. European Standard Population was used for calculating age-standardized mortality rates. We acknowledge the support from the BoCO-19 -The Burden of Disease due to COVID-19 project coordinated/led by Robert Koch Institute and supported by the WHO Regional Office for Europe.

Results:
In 2020, there were 127,572 YLLs due to COVID-19, with 81,147 of YLLs (63.6%) attributable to men and 46,425 (36.4%) to women. Contribution of COVID-19 to the total allcause YLL was also higher in men comparing to women: 11.39% and 7.80%, respectively. Three epidemic peaks were observed in 2020, together composing two thirds (65.6%) of total YLLs due to COVID-19. December was the month with the greatest burden, accounting for 45.8% of all YLLs due to COVID-19. Crude YLL rate for COVID-19 was 1849.1 per 100,000, or 1733.5 per 100,000 after standardization.

Conclusions:
Registered COVID-19 deaths accounted for one tenth of total YLLs in Serbia in 2020, with men contributing almost twice as much to that number compared to women. On average, 12.32 YLLs originated from each registered COVID-19 death. Further studies need to assess the impact of the COVID-19 epidemic on avoidable mortality trends in Serbia. Key messages: COVID-19 deaths comprised one tenth of all-cause YLLs, with two-thirds of COVID-19 YLLs attributable to men.
To reduce premature mortality burden, epidemic peaks need to be prevented.

Background:
The COVID-19 epidemic and mitigation actions had major impacts on health and healthcare use by the French population. Since 2004, the French public health agency daily collects individual data of visits in the emergency departments (ED) OSCOUR Õ network (94% of national visits in 2022). We aimed to analyse the evolution of non-Covid ED visits from 2020 to March 2022, in order to identify potential indirect impact of the epidemic.

Methods:
The main medical diagnosis (MD) coded in ICD-10 from each ED visit from 2017 to March 2022 was classified into 17 ICD-10 chapters and in 95 disjoint subgroups of pathologies. The observed numbers of ED visits by age group and by chapters/ subgroups were compared to expected numbers, estimated using an overdispersed Poisson regression model based on 2017-2019 data.

Results:
The observed numbers of ED visits for all chapters and for a large part of subgroups were significantly lower than the expected numbers during the three lockdowns in all age groups and progressively returned to the expected level in 2021. A change in the pattern of a limited list of subgroups was observed: ED visits for purpura, chronic blood diseases and neurologic disorders in children decreased during the first lockdown and remained under the expected level until March 2022. Inversely the number of ED visits for mental health and wheezing in children, for pulmonary embolism in adults and for neoplams in the elderly increased and remained over the expected values until 2022. Conclusions: Syndromic ED system was a pillar of the French reactive surveillance of direct and indirect impacts of COVID-19 epidemic. The changes observed for different subgroups of iii434 European Journal of Public Health, Volume 32 Supplement 3, 2022