2020 年德国的 COVID-19 疾病负担——大流行期间因死亡和疾病而损失的预期寿命。
The COVID-19 Disease Burden in Germany in 2020—Years of Life Lost to Death and Disease Over the Course of the Pandemic.
机构信息
Department 2, Epidemiology and Health Monitoring, Robert Koch Institute, Berlin; Department 3, Infectious Disease Epidemiology, Robert Koch Institute, Berlin; Department II 1 Environmental Hygiene, German Environment Agency, Berlin.
出版信息
Dtsch Arztebl Int. 2021 Mar 5;118(9):145-151. doi: 10.3238/arztebl.m2021.0147.
BACKGROUND
The SARS-CoV-2 pandemic presented major challenges to the health sector in 2020. The burden of disease arising from COVID-19 can be expressed as the number of years of life lost to disease or death. For example, death at age 40 involves a loss of far more years of life than death at age 80.
METHODS
The disability-adjusted life years (DALY) lost to COVID-19 were calculated as the sum of the years of life lost through death (YLL) and the number of years lived with disability (YLD), on the basis of laboratory-confirmed notifiable cases of SARS-CoV-2 infection in Germany in 2020 (documented as of 18 January 2021). The methodology was based on that used in the Global Burden of Disease Study. Pre-existing diseases do not enter into the determination of YLL; rather, the residual life expectancy that is applied in this calculation corresponds to a mean age-specific level of morbidity.
RESULTS
305 641 years of life were lost to COVID-19 in Germany in 2020. The percentage of DALY lost by persons under 70 was 34.8% in men and 21.0% in women. 99.3% of the COVID-19 disease burden was accounted for by death (YLL). The daily average years of life lost due to death was lower for COVID-19 than for the major non-communicable diseases. Persons who died of COVID-19 lost a mean of 9.6 years of life; those who were under 70 when they died lost a mean of 25.2 years of life. Men lost more years of life than women (11.0 vs. 8.1 years).
CONCLUSION
The effects of COVID-19 on public health can be expressed through the burden of disease indicators. This method yields additional information that should be put to use early in the course of future outbreaks.
背景
2020 年，SARS-CoV-2 大流行给卫生部门带来了巨大挑战。由 COVID-19 导致的疾病负担可以用因疾病或死亡而损失的生命年来表示。例如，40 岁死亡涉及的生命损失远远超过 80 岁死亡。
方法
根据 2020 年德国实验室确诊的 SARS-CoV-2 感染病例（截至 2021 年 1 月 18 日记录），计算 COVID-19 导致的残疾调整生命年（DALY）损失，将死亡造成的生命损失年数（YLL）和因残疾而生活的年数（YLD）相加。该方法基于全球疾病负担研究中使用的方法。在确定 YLL 时不考虑先前存在的疾病；相反，在此计算中应用的剩余预期寿命对应于特定年龄的平均发病率水平。
结果
2020 年德国因 COVID-19 损失了 305641 生命年。70 岁以下人群的 DALY 损失百分比为男性 34.8%，女性 21.0%。99.3%的 COVID-19 疾病负担归因于死亡（YLL）。因 COVID-19 死亡的人平均每天损失的生命年数低于主要非传染性疾病。死于 COVID-19 的人平均损失 9.6 年的生命；70 岁以下死亡的人平均损失 25.2 年的生命。男性比女性损失更多的生命年（11.0 年对 8.1 年）。
结论
可以通过疾病负担指标来表达 COVID-19 对公共卫生的影响。这种方法提供了更多信息，应该在未来疫情爆发早期利用这些信息。
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