OBJECTIVE

Assessment of COVID-19 contribution to the mortality rate of the Russian Federation (RF) in January—June 2020.

MATERIAL AND METHODS

Rosstat data on natural population movement were used. For 2017—2019, monthly (January—June) were calculated the average number of deaths from all causes and compared with 2020. Values of «excessive» number of deaths from all causes were determined. Taking into account that the methodological recommendations of the Ministry of Health of Russia on coding causes of death under conditions of COVID-19 were published only at the end of May 2020, the analysis of COVID-19-related deaths was carried out in May and June 2020 in 24 subjects of the Russian Federation with a population of more than 2 million people, indicating COVID-19: a) as the main cause of death; b) as the cause of death; c) if the virus was identified but had no significant impact on the outcome.

RESULTS

In January—April 2020 in Russia the number of deaths from all causes has decreased compared to the average for the previous 3 years (2017—2019); in May and June 2020. The «excessive» number of deaths was 8.4 and 12.2% respectively. In January 2020. «excessive» number of deaths was recorded in 12 regions, in February — in 24, in March — in 10, in April — in 22, in May — in 43, in June — in 62. The largest number of «excessive» deaths was registered in May and June in Moscow, St. Petersburg, Leningrad and Moscow regions and the Republic of Dagestan (in May). There was no increase in mortality in 3 regions during any of the 6 months. Unstable dynamics was determined in the majority of RF regions, and no region revealed any monthly increase in the number of deaths as compared to the previous 3 years. In general for the Russian Federation the proportion of deaths with any mention of COVID-19 on the medical certificate of death (MSD) in both May and June 2020 was 7.3 and 4.3%, respectively, as the main cause of death, varying significantly in the regions. In May 55.3% of «excessive» deaths and in June 39.7% of cases were due to COVID-19 as the main cause of death (in Moscow 47.5 and 43.5%; in Moscow region 52.2 and 60.4%; in St. Petersburg 50 and 69.3% respectively). In some regions, deaths from COVID-19 were recorded as the main cause of death without an «excessive» number of deaths, while in others the opposite situation was observed. When comparing regions according to the data specified in the MSD, the variability of the fraction of causes of death was revealed: a) from COVID-19 as the main cause of death (with an identified and unidentified virus), b) as the cause contributing to death; c) not affecting the cause of death in the regions under consideration.

CONCLUSIONS

The received results testify to the expressed variability of influence COVID-19 on «excessive mortality» in subjects of the Russian Federation, differences in approaches to definition of a cause of death. Similar data are registered in other countries of the world.