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Publications

Journal Article Epublish

PubMed: 40336577 DOI: 10.1016/j.lanwpc.2025.101554

Post-pandemic excess mortality of COVID-19 in Hong Kong: a retrospective study.

Lancet Reg Health West Pac 58:101554

Authors: Kehang Li, Yuchen Wei, Chi Tim Hung, Carlos King Ho Wong, Xi Xiong, Paul Kay Sheung Chan, Shi Zhao, Zihao Guo, Guozhang Lin, Qiaoge Chi, Carrie Ho Kwan Yam, Tsz Yu Chow, Conglu Li, Xiaoting Jiang, Shuk Yu Leung, Ka Li Kwok, Eng Kiong Yeoh, Ka Chun Chong

Affiliations

  • School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China.
  • Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region of China. Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China. Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region of China. Research Department of Practice and Policy, School of Pharmacy, University College London, London, United Kingdom.
  • Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China.
  • School of Public Health, Tianjin Medical University, China.
  • Department of Statistics, University of Pittsburgh, Pittsburgh, USA.
  • Department of Paediatrics, Kwong Wah Hospital, Hong Kong Special Administrative Region of China.
  • School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China. Clinical Trials and Biostatistics Laboratory, Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China.

Abstract

Background

As the COVID-19 pandemic shifted into the post-pandemic period in early 2023, following the COVID-19 normalization with relaxation of stringent control measures and high vaccination coverage in Hong Kong, its long-term impact on mortality remains challenging with necessary needs of data-driven insights. This study examined the pattern of post-pandemic excess mortality in Hong Kong.

Methods

We analyzed weekly inpatient death data from public hospitals from January 1, 2013, to June 1, 2024, using a mixed model with over-dispersed Poisson regression. Expected mortality was estimated as the difference between observed mortality and baseline derived from pre-pandemic data. Age-stratified analyses of overall and cause-specific mortality were conducted across the pre-Omicron pandemic, Omicron, and post-pandemic periods.

Findings

In the post-pandemic period, the excess mortality declined but remained six-fold higher (37.66 [95% CI: 32.72-42.60] per 100,000) than pre-Omicron level, maintaining significance after adjusting for age (32.79 [95% CI: 28.13-37.46] per 100,000). The older population experienced sustained excess mortality, with crude estimates of 100.51 and 586.74 per 100,000 among those aged 65-79 years and ≥80 years, respectively, primarily due to respiratory diseases. Younger population showed near-zero overall excess mortality, whereas increased excess mortality among them occurred in heart disease, cerebrovascular disease, and injuries.

Interpretation

Our findings highlight the lasting mortality impact of pandemic among vulnerable populations, specifically the older population, possibly due to the post-COVID conditions and circulating COVID-19, suggesting the need for targeted interventions for this group.

Funding

Health and Medical Research Fund.

MeSH

Mortality, Retrospective Studies, Covid-19, Cerebrovascular Disorders, Pandemics