Currently, all countries of the world are summing up preliminary results on mortality for 2020. At the same time, there are a large number of problems in determining the underlying cause of death (UCD) in multimorbid pathology in the context of the COVID-19 pandemic when filling out a medical certificate of death (MCC).

OBJECTIVE

To study the impact of the COVID-19 pandemic on preliminary mortality rates in the constituent regions of the Russian Federation.

MATERIAL AND METHODS

The data of Rosstat were used available on 02.02.21. Unstandardized all-cause mortality rates were compared with the averages for similar periods for 2017—2019. for the constituent entities of the Russian Federation. The difference is defined as a percentage of the previous period. The comparison of mortality rates was carried out for the year, as well as from April to December, since it was from April 2020 that Rosstat began to publish data for the constituent entities of the Russian Federation, taking into account the indication in the MSS of the presence of COVID-19 in four groups.

RESULTS

The absolute value of excess deaths was 306.862 cases (or +17% in relation to the average value for 2017—2019). The Republic of Dagestan (+29.7%) and the Chechen Republic (+42.3%) significantly differed from other regions in terms of excess mortality. Only in St. Petersburg, the number of deaths with any mention of COVID-19 exceeded the number of excess deaths in April—December 2020.The regional average share of deaths with COVID-19 as UCD for 2020 was 4.1±2.8% (in April—December 5.3±3.5%); any mention of COVID-19 in the MCC — 6.4±3.3%. The proportion of deaths indicating COVID-19 as UCD from the number of excess deaths for the entire 2020 was 33.9±22.4% (for April—December 30.9±19.9%); with any mention in the MSS — 52.3±22.0% (for April—December 47.4±21.9%; minimum 2.6% in the Republic of Bashkortostan, maximum 98.7% in the Republic of Tyva and 97.7% in Moscow). No correlation was found between excess mortality in 2020 and the proportion of deaths from COVID-19 as PPP.

CONCLUSIONS

The COVID-19 pandemic has led to excess mortality in all regions of the Russian Federation. The causes of excess mortality need to be clarified, there is no evidence of an unambiguous and direct effect of COVID-19 on excess mortality. Clarification of the reasons for regional differences is necessary for the correction of prevention programs and the organization of medical care.