COVID-19 death rates by age and sex and the resulting mortality vulnerability of countries and regions in the world

The growing number of series on COVID-19 deaths classified by age and sex, released by national health authorities, has allowed us to compute age and sex patterns of its mortality, based on 183,619 deaths from Western Europe and the USA. We highlight the specific age schedule of COVID-19 mortality and its pronounced excess male mortality and we then apply these COVID-19 death rates to world populations, in 2020. Our results underscore that considerable variations exist between world regions, as concerns the potential impact of COVID-19 mortality, because of their demographic structures. When compared to younger countries in Sub-Saharan Africa, the vulnerability to COVID-19 mortality is shown to be 17 times higher in several industrialized countries of East Asia and Europe. There is a high correlation (r2= .44) between demographic vulnerability to COVID-19 mortality and current COVID-19 death rates. AbstractCOVID-19, mortality, age structures, death rates, Europe, USA. BackgroundThe data available on infection and death rates from COVID-19 have pointed to the elderlys vulnerability to pandemics, especially elderly men. However, current models have not yet incorporated the growing volume of information on deaths by age and sex that is being released by statistical offices and health authorities. These newly available data allow us to examine the specific age and sex patterns of COVID-19 mortality and to estimate the impact of specific demographic structures on potential COVID-19 mortality worldwide. MethodsWe use the data available on May 15, 2020, from the nine countries with the largest series of deaths, disaggregated by age and sex: Belgium, France, Germany, Italy, Netherlands, Spain, Sweden, the UK, and the USA. Using 183,619 deaths (60.2% of all currently estimated COVID-19 deaths), we estimate the sex-specific death rates, by 5-year ranges, for two large death samples: USA and Western Europe. We compare these mortality rates with Gompertz models and with life tables of the worlds population, estimated by the United Nations. We apply these COVID-19 mortality rates by sex and 5-year group to the 2020 age and sex structures of world countries and regions, and obtain an index summarizing the relative magnitude of their potential vulnerability to COVID-19 mortality because of their demographic structures. FindingsCOVID-19 death rates cannot be computed below age 15. COVID-19 death rates from age 15-19 years to 90+ increase by a factor of 3 of every ten years, at a rate that is faster than general mortality. Male mortality from COVID-19 is systematically higher than female mortality, with a peak of excess male mortality occurring among 55-59-year-olds. Age and sex structures show considerable variations across countries, in terms of vulnerability to COVID-19 mortality. It transpires that the youngest countries in Central Africa are 17 times less vulnerable than aging countries, such as Japan. InterpretationWhereas the true intensity of the ongoing COVID-19 pandemic remains underestimated by existing statistics, this unique mortality dataset shows that the regularity of the distribution of COVID deaths by age and sex is in line with the standard Gompertz mortality equation; thus confirming the quality of the first death samples and the unique age and sex patterns of COVID-19 mortality. COVID-19 death rates tend to be negligible below age 15 and cannot be used for analysis. The rate of progression of death rates by age is faster than that of general mortality. This feature places the elderly population in a particularly vulnerable situation compared to younger adults. Male excess mortality from COVID-19 also appears far more pronounced than in general mortality patterns, with men aged 40-59 years being almost 2.5 times more likely to die than women of the same age. Our analysis also points to considerable variations between world regions, as concerns the potential impact of COVID-19 mortality, because of their demographic structures. The COVID-19 structural vulnerability index ranges from .28 in Western or Middle Africa to 2.6 in Southern Europe. There is a high correlation between demographic vulnerability to COVID-19 mortality and current COVID-19 death rates (r2= .44 for 188 countries).