• Peter Strang, Per Fürst, and Torbjörn Schultz.
• Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
• Ups. J. Med. Sci. 2020 Nov 1; 125 (4): 297-304.

BackgroundThe COVID-19 pandemic has affected the entire health care system, internationally as well as in Sweden. We aimed to study excess deaths (all death causes, but also COVID-19-related deaths) during the COVID-19 pandemic regarding age, socio-economic status, the situation in nursing homes, and place of death for nursing home residents.DesignWe performed a descriptive regional registry data study using VAL, the Stockholm Regional Council's central data warehouse, which covers almost all health care use in the county of Stockholm. T tests and chi-square tests were used for comparisons.ResultsCompared with 2016-2019, there were excess deaths in March-May 2020 (p < 0.0001), mainly explained by COVID-19, but in April there were also unexplained excess deaths. Individuals dying from COVID-19 were older than patients dying from other causes (p < 0.0001). There were more patient deaths among people residing in less advantaged socio-economic areas (p < 0.0001). Nursing home residents dying from COVID-19 were more often admitted to acute hospitals than residents dying from other causes (p < 0.0001). Also, the proportion of admissions of nursing home residents dying from other causes increased from April to May 2020 (p < 0.0001).ConclusionsDying from COVID-19 mainly affects the elderly, nursing home residents, and persons from less advantaged socio-economic groups. The pandemic has resulted in an increase in acute admissions of dying nursing home residents to acute hospitals.

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