Australia's health report gives insight into COVID 19 severity--ten years of life lost per infection

From the Australia's health 2020 report section on coronavirus disease there is an interesting discussion of how COVID infection shaves more than 10 years off people's lives. This is indicated by the estimate of years of life lost to people suffering from Covid 19 provided in the report, as presented below:

Age at death

The median age at death for COVID-19 was 80 years, which is slightly lower than that

for all causes of death in 2018 (81 years). It is also somewhat lower than many other

leading causes of death that commonly occur in older age. Compared with the top 7

leading causes of death occurring in 2018, as well as suicide (12th), pneumonia (14th)

and influenza (90th) (Table S2.1), the median age at death for COVID-19 was:

• lower than the 3 leading causes of death—coronary heart disease (CHD) (84 years),

dementia (88) and stroke (86)—and pneumonia (89) and influenza (82)

• similar to diabetes (81) and chronic obstructive pulmonary disease (COPD) (80)

• higher than bowel cancer (77), lung cancer (73) and suicide (44).

Another way to examine the impact of age at death is to measure years of life lost

(YLL), which counts the number of years between the age at death and life expectancy

at that age. There has been speculation that YLL are low for COVID-19, which would

indicate that some people dying from the disease did not have a long life expectancy

prior to developing COVID-19, largely due to being older or having comorbidities that

put them at higher risk of the severe effects of disease. 

A study using Italian and UK

data shed some light on this, showing that average YLL per person was 14 for men

and 12 for women (Hanlon et al. 2020). The authors also produced modelled estimates

adjusting for comorbidities, which showed that the presence of comorbidities did not

greatly decrease the estimates, reducing average YLL to 13 for men and 11 for women.

Preliminary calculations for Australia (not adjusted for comorbidity) using similar

methods to the European paper shows average YLL per person was 17 years for men

and 14 for women (including deaths up to 31 May). These higher estimates in Australia

indicate a lower proportion of deaths in older people, possibly due to fewer outbreaks

in aged care facilities than have occurred in other countries (COVID-19 NIRSTd). Using

methods similar to Australia’s usual approach for calculating YLL (which uses a different

reference life table) results in preliminary estimates of average YLL per person of 14

and 11 for males and females respectively. 

Corresponding estimates for 2015 for the 5 leading causes of death in Australia are: CHD (14 for males, 8 for females), dementia (9 and 7), stroke (11 and 8), lung cancer (17 and 18) and COPD (13 and 12) (AIHW 2019).

This shows that those dying from COVID-19 lost more years of their expected life span

than most other major causes of death. This suggests there is a strong possibility

that the COVID-19 deaths were among people that, on average, would not have been

expected to die soon, particularly when taken alongside the Hanlon et al. (2020) finding

that comorbidity did not greatly reduce YLL.

Hanlon P, Chadwick F, Shah A, Wood R, Minton J, McCartney G, et al. 2020. COVID-19 – exploring the implications of long-term condition type and extent of multimorbidity on years of life
lost: a modelling study (pre-print). Wellcome Open Research, 5:75
( DOI: 10.12688/wellcomeopenres.15849.1 )



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