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Original Article
Excess mortality in older adults and cumulative excess mortality across all ages during the COVID-19 pandemic in the 20 countries with the highest mortality rates worldwide
Chiranjib Chakraborty, Manojit Bhattacharya, Sang-Soo Lee
Osong Public Health Res Perspect. 2025;16(1):42-58.   Published online February 13, 2025
DOI: https://doi.org/10.24171/j.phrp.2024.0186
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Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Objectives
Mortality statistics during the coronavirus disease 2019 (COVID-19) pandemic are crucial for the allocation of medical care resources and public health decision-making. This study was initiated to investigate the excess mortality among older adults during the pandemic. Our research focuses on 2 primary areas. First, we analyzed the cumulative excess mortality across all age groups to assess the global impact and specifically examined the top 20 countries with the highest mortality rates during the pandemic. Second, we explored excess deaths among older adults by categorizing data from the years 2020 and 2021 into age groups: 65–74, 75–84, and above 85.
Methods
We analyzed data from the top 20 countries with the highest mortality rates globally, focusing on 3 components: all-cause mortality means, expected deaths mean, and excess deaths mean for both older men and women.
Results
Although excess mortality is higher among older men and women across all 3 age groups (65–74, 75–84, and >85), the highest mean excess mortality was observed in women over the age of 85.
Conclusion
The results indicate that the severe acute respiratory syndrome coronavirus 2 virus had a disproportionately intense impact on older women. We developed 2 types of statistical models using the data: a binomial distribution model and a correlation coefficient model, both considering the mean excess deaths in older men and women across these 3 age groups. Estimating the excess mortality among older adults will aid in the formulation of healthcare policies for this demographic.

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