Researchers looked at adult sickness and death in 18 countries
Among 289 million adults in 18 European countries, nearly 17 million years of life were lost from 2020-2022 because of the COVID-19 pandemic, according to a new study.
The study, in the open-access journal PLOS Medicine, shows a stark picture of the direct and indirect impacts of the COVID-19 pandemic on both total and disability-free years of life lost, with researchers able to identify different factors at play as the pandemic progressed.
In the study, led by Dr Sara Ahmadi-Abhari of the School of Public Health at Imperial College London, researchers integrated data from multiple sources on the European population aged 35 and older in a computational model. Rates of diseases, such as cardiovascular (heart) disease and dementia, disability, and death were tracked and used to estimate the effect of the pandemic between 2020 and 2022.
Many people who died during the pandemic would probably have lived longer if the pandemic had not happened. The study quantified these 'lost years' and found that in total, 16.8 million years of life were lost due to the pandemic across the 18 European countries surveyed. In addition, more than half of those years would have been lived independently, even among people aged over 80.
In the UK, about 2.3 million years of life were 'lost' in the period of 2020-2022 due to the pandemic, of which 1.5 million, or 70%, would have been lived without disability. Around 1.1 million of those lives lost were among people aged over 80 - more than half of which would have been lived without disability.
There was a similar pattern across European countries. About 3.2 million total years of life were lost in Spain, 2.5 million in Poland, 2.4 million in Germany, 1.8 million in Italy, and 1.1 million in France.
The researchers identified the different factors behind the loss in years of life as the pandemic progressed. The loss in years of life in 2020 was mostly related to COVID-19 deaths and this decreased from 2021 to 2022 along with the rollout of mass vaccination, but lost lives due to non-COVID deaths and to the pandemic's indirect impact on mortality continued to increase from 2020 to 2022 in most countries.
By 2022, over half of the 5 million years of life lost in that year were due to non-COVID deaths.
Of the European total years of 16.8 million lives lost, the research found 3.6-5.3 million were in fact due to non-COVID causes of death and related to the pandemic's indirect impact on mortality.
Dr Sara Ahmadi-Abhari, lead author of the study, said: "Our findings illustrate the pandemic's long-term impact, which extends beyond COVID-19 deaths. While vaccination played an important role in limiting direct losses from the SARS-COV-19 virus, the continuously rising loss of life from other causes shows the broader consequences of the pandemic, possibly arising from disruptions in healthcare."
She added: "The substantial loss in years of life, particularly given more than half would have been lived without disability, underscore the critical need for a comprehensive pandemic preparedness program which could provide both immediate and long-term public health benefits."
The lost years of life differed considerably between countries. Countries with a comparatively lower gross domestic product suffered a greater loss (by population size) in total years of life, and a disproportionately greater loss in disability-free years of life.
However, as might be expected, countries with higher COVID-19 vaccination coverage had fewer years of life lost, independent of the country's gross domestic product (GDP).
As an example, Portugal administered one of the highest average doses of vaccine per adult among the 18 countries and experienced a considerably lower loss in years of life, compared to countries with similar GDP. Yet Switzerland, which compared to countries with similar GDP administered lower average doses of vaccine, experienced a proportionately higher loss in years of life.
"The findings suggest that the pandemic worsened socioeconomic inequalities in premature mortality between countries," the authors say in the paper. "The substantial proportion of years of life lost without disability bring to light an instinctive underestimation of the pandemic's impact, especially on the older population."
Direct and indirect impacts of the COVID-19 pandemic on life expectancy and person-years of life lost with and without disability: A systematic analysis for 18 European countries, 2020–2022 is published in PLoS Med https://doi.org/10.1371/journal.pmed.1004541
