Use of all cause mortality to quantify the consequences of covid-19 in Nembro, Lombardy: descriptive study [用全因死亡率量化covid-19的后果，意大利伦巴第内恩布罗：描述性研究]

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BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1835 (Published 14 May 2020)
Cite this as: BMJ 2020;369:m1835

Authors
Marco Piccininni, Jessica L Rohmann, Luca Foresti, Caterina Lurani, Tobias Kurth

Abstract
Objective To quantify the impact of coronavirus disease 2019 (covid-19) on all cause mortality in Nembro, an Italian city severely affected by the covid-19 pandemic.

Design Descriptive study.

Setting Nembro, in the Bergamo province of Lombardy, northern Italy.

Population Residents of Nembro.

Main outcome measures Monthly all cause mortality between January 2012 and April 2020 (data to 11 April), number of confirmed deaths from covid-19 to 11 April 2020, and weekly absolute number of deaths between 1 January and 4 April across recent years by age group and sex.

Results Nembro had 11 505 residents as of 1 January 2020. Monthly all cause mortality between January 2012 and February 2020 fluctuated around 10 per 1000 person years, with a maximum of 21.5 per 1000 person years. In March 2020, monthly all cause mortality reached a peak of 154.4 per 1000 person years. For the first 11 days in April, this rate decreased to 23.0 per 1000 person years. The observed increase in mortality was driven by the number of deaths among older people (≥65 years), especially men. From the outbreak onset until 11 April 2020, only 85 confirmed deaths from covid-19 in Nembro were recorded, corresponding to about half of the 166 deaths from all causes observed in that period.

Conclusions The study findings show how covid-19 can have a considerable impact on the health of a small community. Furthermore, the results suggest that the full implications of the covid-19 pandemic can only be completely understood if, in addition to confirmed deaths related to covid-19, consideration is also given to all cause mortality in a given region and time frame.