RECENT research reveals that the COVID-19 pandemic caused a significant decline in life expectancy and years of life lost across 18 European countries from 2020–2022, with many years lost being disability-free.
Using multi-state Markov modelling, researchers analysed health transitions among individuals aged ≥35 years, incorporating data on cardiovascular disease, cognitive impairment, dementia, disability, and mortality. They quantified deaths directly attributed to COVID-19 and those from other causes, estimating the proportion of life expectancy lost due to the pandemic. Monte Carlo simulations with 500 iterations were used to generate 95% uncertainty intervals. Person-years of life lost (PYLL) were calculated per country, age group, and disability status to assess the pandemic’s broader impact.
Across the 18 countries studied, the total PYLL reached 16.8 million (95% UI: 12.0–21.8), with 4.7 million in 2020, 7.1 million in 2021, and 5.0 million in 2022. PYLL per capita ranged from 20–109 per 1,000 population. Over 60% of the total PYLL occurred in those aged >80 years, and 30% in individuals aged 65–80 years. Of the 16.8 million PYLL, 11.6–13.2 million were attributed to registered COVID-19 deaths, while 3.6–5.3 million were linked to non-COVID mortality.
Despite a decline in COVID-19-related PYLL after 2021, PYLL due to other causes continued to rise. Notably, over half of the total PYLL (9.8 million, 95% UI: 4.7–15.1) would have been lived without disability had the pandemic not occurred. Lower-income countries had higher PYLL per capita and a greater proportion of disability-free PYLL. By 2021, life expectancy at age 35 years had dropped by up to 2.8 years (95% UI: 2.3–3.3), with over two-thirds of the years lost being disability-free. By 2022, life expectancy had not returned to pre-pandemic levels in most countries, except Sweden.
The substantial loss of disability-free life years and the rise in non-COVID premature mortality reinforce the pandemic’s broader and lasting health effects, potentially linked to disruptions in healthcare services. These findings highlight the urgent need for improved pandemic preparedness as part of a comprehensive global public health strategy.
Reference
Ahmadi-Abhari S et al. Direct and indirect impacts of the COVID-19 pandemic on life expectancy and person-years of life lost with and without disability: a systematic analysis for 18 European countries, 2020-2022. PLoS Med. 2025;22(3):e1004541.
