Impact of COVID-19 infection on life expectancy, premature mortality, and DALY in Maharashtra, India.

Background: The COVID-19 infections and deaths have largely been uneven within and between countries. With 17% of the world's population, India has so far had 13% of global COVID-19 infections and 8.5% of deaths. Maharashtra accounting for 9% of India's population, is the worst affected state, with 19% of infections and 33% of total deaths in the country until 23rd December 2020. Though a number of studies have examined the vulnerability to and spread of COVID-19 and its effect on mortality, no attempt has been made to understand its impact on mortality in the states of India.

Method: Using data from multiple sources and under the assumption that COVID-19 deaths are additional deaths in the population, this paper examined the impact of the disease on premature mortality, loss of life expectancy, years of potential life lost (YPLL), and disability-adjusted life years (DALY) in Maharashtra. Descriptive statistics, a set of abridged life tables, YPLL, and DALY were used in the analysis. Estimates of mortality indices were compared pre- and during COVID-19.

Result: COVID-19 attributable deaths account for 5.3% of total deaths in the state and have reduced the life expectancy at birth by 0.8 years, from 73.2 years in the pre-COVID-19 period to 72.4 years by the end of 2020. If COVID-19 attributable deaths increase to 10% of total deaths, life expectancy at birth will likely reduce by 1.4 years. The probability of death in 20-64 years of age (the prime working-age group) has increased from 0.15 to 0.16 due to COVID-19. There has been 1.06 million additional loss of years (YPLL) in the state, and DALY due to COVID-19 has been estimated to be 6 per thousand.

Conclusion: COVID-19 has increased premature mortality, YPLL, and DALY and has reduced life expectancy at every age in Maharashtra.