A previous analysis carried out in Northeastern Italy reported a 14% increase in the number of COPD-related deaths in 2020 compared to the 2018-2019 average.

The study aimed to assess the impact of all pandemic waves on COPD-related mortality by means of time series analyses of causes of death data

The yearly and monthly number of deaths and age-standardized mortality rates of residents aged ?40 ys with any mention of COPD were extracted from Venetian region registry, from January 1, 2008, to March 31, 2022.  Using monthly age standardized COPD-related mortality rates, generalized estimating equation (GEE) models were fitted to estimate expected mortality during the pandemic. Rates were modelled assuming a Gamma distribution with a log-link function.

COPD was mentioned in 3,478 death certificates in 2020 (14% increase with respect to the 2018-2019 average), decreasing to 3,133 in 2021 (3% increase with respect to the 2018-2019 average). A large excess COPD-related mortality rates was observed during the first epidemic wave (11 observed vs 9 [IC 95% 6-8.5] GEE models std rate per 100.00) and the second wave (14 observed vs 8 [IC 95% 6.9-9.5] GEE std rate per 100.00), while only limited increases in mortality were detected in the subsequent period. This trend was more evident in older COPDs aged > 80 years.

Patients with COPD experienced significant excess mortality during the first year of the pandemic, which was limited during the second year due to subsequent positive impact of COVID-19 vaccination.