All-Cause Excess Mortality During the COVID-19 Pandemic in a Rural Area of North India.
- 1Community Medicine, Dayanand Medical College and Hospital, Ludhiana, IND.
- 2Biostatistics, Community Medicine, Dayanand Medical College and Hospital, Ludhiana, IND.
Abstract
Introduction COVID-19 pandemic significantly impacted global mortality; however, many deaths were underreported. Excess mortality explains both direct and indirect impacts of the COVID-19 pandemic and therefore provides true and better estimates of pandemic deaths. Objectives The objective of this study was to estimate excess all-cause mortality during the COVID-19 pandemic in a rural area of North India. Methods The study was carried out in the field practice area of the Rural Health Training Centre (RHTC) of a tertiary care hospital in North India. This area covers fifteen villages where home-based comprehensive health care is provided. Age, gender, and month-wise mortality data of these villages (for the years 2015-2023) were extracted from the records. Two models, historical five-year average and negative binomial regression, were used to estimate all-cause excess mortality for the COVID-19 period (January 2020-May 2023) compared with pre-pandemic years (2015-2019). Excess mortality was estimated as the difference between the number of all-cause deaths and baseline expected deaths for each model. Percentage excess mortality (ratio of excess deaths to expected deaths) was calculated. Results Monthly all-cause excess mortality was observed to be higher (exceeding 95% CI upper bounds) during the months of April, May, and August 2021 than expected mortality. May 2021 had the highest excess mortality, consisting of 47 and 43 deaths (223.8%, 167.4%) using historical average and negative binomial regression analysis, respectively. However, it was lower than expected in 2020, 2022, and 2023. Males and adults aged 40-59 years had higher excess mortality. Overall excess mortality was 19 (1.8%), with the year 2021 reporting high excess mortality of 72 (24%). Conclusions Findings indicate significant excess all-cause mortality during the COVID-19 pandemic. The study witnessed high excess mortality across age groups, particularly among 40- to 59-year-old adults and males.
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BibTeX
@article{satija2026allcause,
title = {{All-Cause Excess Mortality During the COVID-19 Pandemic in a Rural Area of North India.}},
author = {Mahesh Satija and Anurag Chaudhary and Pranjl Sharma and Surinder P Singh and Nishant Sharma and Sarit Sharma and Sangeeta Girdhar and Vikram K Gupta and Priya Bansal},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.116525},
url = {https://europepmc.org/article/MED/42899133},
note = {CC BY},
}
RIS
TY - JOUR
TI - All-Cause Excess Mortality During the COVID-19 Pandemic in a Rural Area of North India.
AU - Mahesh Satija
AU - Anurag Chaudhary
AU - Pranjl Sharma
AU - Surinder P Singh
AU - Nishant Sharma
AU - Sarit Sharma
AU - Sangeeta Girdhar
AU - Vikram K Gupta
AU - Priya Bansal
PY - 2026
DA - 2026/09/19
JO - Cureus
DO - 10.7759/cureus.116525
UR - https://europepmc.org/article/MED/42899133
AB - Introduction COVID-19 pandemic significantly impacted global mortality; however, many deaths were underreported. Excess mortality explains both direct and indirect impacts of the COVID-19 pandemic and therefore provides true and better estimates of pandemic deaths. Objectives The objective of this study was to estimate excess all-cause mortality during the COVID-19 pandemic in a rural area of North India. Methods The study was carried out in the field practice area of the Rural Health Training Centre (RHTC) of a tertiary care hospital in North India. This area covers fifteen villages where home-based comprehensive health care is provided. Age, gender, and month-wise mortality data of these villages (for the years 2015-2023) were extracted from the records. Two models, historical five-year average and negative binomial regression, were used to estimate all-cause excess mortality for the COVID-19 period (January 2020-May 2023) compared with pre-pandemic years (2015-2019). Excess mortality was estimated as the difference between the number of all-cause deaths and baseline expected deaths for each model. Percentage excess mortality (ratio of excess deaths to expected deaths) was calculated. Results Monthly all-cause excess mortality was observed to be higher (exceeding 95% CI upper bounds) during the months of April, May, and August 2021 than expected mortality. May 2021 had the highest excess mortality, consisting of 47 and 43 deaths (223.8%, 167.4%) using historical average and negative binomial regression analysis, respectively. However, it was lower than expected in 2020, 2022, and 2023. Males and adults aged 40-59 years had higher excess mortality. Overall excess mortality was 19 (1.8%), with the year 2021 reporting high excess mortality of 72 (24%). Conclusions Findings indicate significant excess all-cause mortality during the COVID-19 pandemic. The study witnessed high excess mortality across age groups, particularly among 40- to 59-year-old adults and males.
SN - 2168-8184
ER -