Across regions: Are most COVID-19 deaths above or below life expectancy?

Life expectancy varies across geographical and political landscapes for a multitude of reasons. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for the 2020 coronavirus disease (COVID-19) and pandemic, is present in 215 countries, and is described as a pathogen that is most deadly to individuals 65 years and older. However, it is unclear if the majority of COVID-19-related deaths are targeting individuals above or below life expectancy.

Through seven months of the 2020 COVID-19 pandemic, an association between life expectancy and COVID-19 related deaths was assessed. The reported age of those suffering from COVID-19-related deaths was evaluated across eight countries (United States, Germany, Italy, Hungary, Poland, South Africa, Sweden, and Switzerland), and placed into binary categories depending on whether or not the death occurred above or below the country's life expectancy.

Given this dataset, it was observed that there was a greater proportion of COVID related deaths above life expectancy (M=64.58%, SD=6.46) as opposed to below life expectancy (M=35.41%, SD=6.46), as these differences were significant (95%CI [18.518, 42.881], p<0.001). In contrast, an insignificant trend was observed when examining the relationship between deaths above life expectancy and Gini index (Pearson correlation coefficient r= -0.62, n=8, p=0.09). The disparity, or percent difference in death occurring above versus below life expectancy was greatest in the countries with life expectancies of 80+ (Sweden, Switzerland, Germany).

Considering life expectancy may be an appropriate approach for reporting COVID-19-related deaths, as well as planning responses to localized COVID-19 outbreaks, prioritizing drug treatment, and assessing ICU capacity.