key: cord-0852388-vck42pe3 authors: Gutiérrez Cortes, William Arbey; Perdomo Morales, Paula Alejandra title: COVID‐19 mortality in older people in Colombia date: 2021-03-31 journal: J Am Geriatr Soc DOI: 10.1111/jgs.17134 sha: ad1dc45bc6895abeab76448f9aecc3a1c47c3e24 doc_id: 852388 cord_uid: vck42pe3 nan By 2020, people aged 60 and older corresponded to 13% (6, 548 .415/50,372.424) of the Colombian population. The group of people aged 60 or over increased on an average annual rate of 3.3%, in contrast to the youngest population, which increased by 1.7%. 1 However, the country is not prepared to respond to the health needs that the growing older population requires. This issue has been reflected now when facing the COVID-19 pandemic. 2 As we approach 1 year since the first COVID-19 case in Colombia in March 2020, the numbers are still overwhelming. By January 21, 2021, 1,972,345 cases have been confirmed and 50,187 deaths have been reported, which represents a fatality rate of 3.1 and 805 deaths per million inhabitants. Now, since the beginning of the pandemic, there has been a constant increase on the mortality rate of older people, especially in those with multimorbidity and 80 years or more. 3 Determining mortality rates in times of pandemic represents a challenge due to the constant variability, and the difficulty to determine those who have died directly for COVID-19, for a concomitant infection, or for a different cause. Therefore, strategies such as monitoring of excess mortality (the difference between observed and expected deaths, based on mortality rates from previous years) 4 and the active search for registered cases with a confirmed and presumptive diagnosis of COVID-19 infection have become important tools. These have been adopted and implemented in the follow-up of the COVID-19 pandemic by the Colombian Ministry of Health and Social Protection. 5 We aim to describe the excess mortality of 2020 in the country and its relationship with the peak of the COVID-19 pandemic. On January 2021, we carried out a cross-sectional study based on data, on all-cause mortality in people aged 60 and older, analyzing information from the last 5 years provided by the National Administrative Department of Statistics (DANE). In the same way, we describe the expected percentage increase in mortality, and finally, a comparison was made between the third trimester of 2019 and the third trimester of 2020 to calculate the excess deaths to describe the impact on mortality generated by the COVID-19 infection. We found a percentage growth of 15% in the mortality rate in patients aged 60 and older between 2015 and 2020. For the year 2015, the mortality rate from all causes in older people was 68% (150.126/219.472), reaching 72% (172.110/238.209) in 2020 (Table 1) . Also, when we performed the analysis of mortality rates in all age groups by comparing the third trimester of 2019 with 58,436 deaths registered (31,868 male/26,541 female) and compared with the 88,854 deaths registered on the third trimester of increase as the main cause also COVID-19 with 11,044 deaths and 5,321 due to ischemic heart disease. 6 Another result we found is that the population aged 80 and older is the most affected group in terms of absolute mortality; therefore, the importance of the measures that were taken during 2020 for their protection and isolation contributed to the reduction of the rate of infection (Rt) and the impact on mortality. 7 Our work showed that the older population in Colombia was the most seriously affected by COVID-19 in terms of mortality. 8 In addition, this age group has the higher burden of comorbidities 9 where an average of three comorbidities was reported, which could explain the increased number of deaths per million inhabitants. Besides, social inequality is highly prevalent in this population; according to the SABE study, 68% (16.111/23.694) belong to the lowest socioeconomic strata. The previous situation is aggravated by the fact that there is no differential care for the older population. Thus, specific public health strategies seeking to reduce the burden of disease are needed. 10 We declare no competing interests. William Gutiérrez conducted a bibliographic search, designed the tables described, performed the data collection and its respective analysis, and also contributed to the writing of the article. Paula Perdomo conducted a bibliographic search, collaborated with the writing of the text, made a style correction, and collaborated with the translation of the article. The authors did not have funding for the article. El proceso de envejecimiento de la población en Colombia: 1985-2050. En: Fedesarrollo y Fundación Saldarriaga Concha. Misión Colombia Envejece: cifras, retos y recomendaciones. Editorial Fundación Saldarriaga Concha Papel del geriatra colombiano ante la pandemia por COVID 19 1 Mortality in older people in Colombia in the last 5 years Age group/year Boletín COVID-19 en Colombia Tracking covid-19 excess deaths across countries Mejoramiento de la vigilancia de mortalidad por COVID-19 en América Latina y el Caribe mediante la vigilancia de mortalidad por todas las causas. Documento de orientación Defunciones no fetales cifras definitivas Recomendaciones de flexibilización del aislamiento obligatorio en personas mayores Human talent in geriatrics in Colombia and its relevance for the management of COVID-19 Estudio nacional de salud, bienestar y envejecimiento Ageing in a post COVID world. The Lancet Healthy Longevity Perdomo Morales PA. COVID-19 mortality in older people in Colombia