COMPARATIVE ASSESSMENT OF THE LEVEL OF CAUSES OF MORTALITY OF THE POPULATION IN AZERBAIJAN BEFORE, DURING AND AFTER THE COVID - 19 PANDEMIC

Research Objective: To comparatively assess the levels and causes of population mortality in Azerbaijan before, during, and after the COVID-19 pandemic. Materials and Methods: The study used official state statistics from 2018 to 2023 (two years before, two years during, and two years after the pandemic). The average annual number of deaths was calculated for the periods 2018–2019, 2020–2021, and 2022–2023, along with the average annual mortality rate per 1,000 population. To neutralize the effect of age as a factor, standardized mortality rates were calculated using the direct standardization method. Results: During the two years prior to the pandemic and the second year after it, mortality from infectious and parasitic diseases (including viral infections) did not differ significantly (0,077; 0,067; and 0,077‰ respectively). In the first and second years of the pandemic, mortality rates increased by 7.6, 8.6, and 2.4 times respectively compared to 2018 (0,587; 0,665; and 0,288‰). The average annual excess mortality during and after the pandemic was 0,554‰ and 0,0605‰, respectively. Before the pandemic, mortality from circulatory system diseases (3,453 and 3,270‰) showed a decreasing trend. During the pandemic, this rate significantly increased (4,123 and 4,152‰), and after the pandemic, it dropped back to pre-pandemic levels (0,269 and 0,224‰). The average annual excess mortality from circulatory system diseases during the pandemic was 0,776‰, which exceeded the excess mortality from infectious diseases (0,554‰). Conclusion: In Azerbaijan, the pre-pandemic annual mortality rate was 5,7‰ (standardized rate: 8,5‰), with leading causes being circulatory system diseases (3,361‰), neoplasms (0,888‰), external influences (0,281‰) and digestive system diseases (0.268‰). During the pandemic, mortality increased from 5,7‰ to 7,65‰ (excess mortality of 1,95‰), primarily due to excess deaths from infectious diseases (COVID-19) (0,554‰), circulatory system diseases (0,776‰), respiratory diseases (0,176‰), external causes (0,17‰), neoplasms (0,095‰), nervous system diseases (0,077‰), and symptoms, syndromes, and ill-defined conditions (0,12‰). After the pandemic, the average annual mortality rate remained high at 5,95‰ compared to the pre-pandemic period, with an excess mortality of 0,25‰ (0,221‰ from symptoms, syndromes, and ill-defined conditions; 0,0605‰ from infectious diseases; 0,0195‰ from external causes; 0,01‰ from neoplasms).