The direct disease burden of COVID-19 in Belgium in 2020 and 2021.

Publication date: Sep 04, 2023

Burden of disease estimates have become important population health metrics over the past decade to measure losses in health. In Belgium, the disease burden caused by COVID-19 has not yet been estimated, although COVID-19 has emerged as one of the most important diseases. Therefore, the current study aims to estimate the direct COVID-19 burden in Belgium, observed despite policy interventions, during 2020 and 2021, and compare it to the burden from other causes. Disability-adjusted life years (DALYs) are the sum of Years Lived with Disability (YLDs) and Years of Life Lost (YLLs) due to disease. DALYs allow comparing the burden of disease between countries, diseases, and over time. We used the European Burden of Disease Network consensus disease model for COVID-19 to estimate DALYs related to COVID-19. Estimates of person-years for (a) acute non-fatal disease states were calculated from a compartmental model, using Belgian seroprevalence, social contact, hospital, and intensive care admission data, (b) deaths were sourced from the national COVID-19 mortality surveillance, and (c) chronic post-acute disease states were derived from a Belgian cohort study. In 2020, the total number of COVID-19 related DALYs was estimated at 253,577 [252,541 - 254,739], which is higher than in 2021, when it was 139,281 [136,704 - 142,306]. The observed COVID-19 burden was largely borne by the elderly, and over 90% of the burden was attributable to premature mortality (i. e., YLLs). In younger people, morbidity (i. e., YLD) contributed relatively more to the DALYs, especially in 2021, when vaccination was rolled out. Morbidity was mainly attributable to long-lasting post-acute symptoms. COVID-19 had a substantial impact on population health in Belgium, especially in 2020, when COVID-19 would have been the main cause of disease burden if all other causes had maintained their 2019 level.

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Concepts Keywords
Belgium Burden of disease
Fatal COVID-19
Vaccination Disability-adjusted life years


Type Source Name
disease MESH COVID-19
disease VO population
disease MESH causes
disease VO time
disease MESH acute disease
disease MESH premature mortality
disease MESH morbidity
disease VO vaccination
disease MESH Long Covid
pathway REACTOME Reproduction
disease MESH infections
disease IDO country
disease IDO intervention
disease MESH death
disease IDO infection
disease MESH complications
disease MESH hemorrhagic stroke
disease MESH movement disorders
disease MESH mental disorders
disease MESH sensory disorders
disease MESH syndrome
disease MESH encephalitis
disease MESH encephalopathy
disease VO vaccine
disease IDO process
disease MESH uncertainty
disease MESH asymptomatic infections
drug DRUGBANK Aspartame
drug DRUGBANK Coenzyme M
drug DRUGBANK Methionine
disease MESH rhinitis
disease MESH sore throat
disease MESH anorexia
drug DRUGBANK Pentaerythritol tetranitrate
drug DRUGBANK Ademetionine
disease MESH ischemic heart disease
disease MESH respiratory infections
disease MESH stroke
disease MESH vaccine preventable diseases
disease MESH gout
disease MESH urticaria
disease MESH viral skin diseases
drug DRUGBANK Spinosad
disease IDO acute infection
disease IDO symptom
disease MESH non communicable diseases
disease VO protocol
drug DRUGBANK Trestolone
disease MESH Infectious Diseases
disease VO organization
disease MESH emergencies
drug DRUGBANK (S)-Des-Me-Ampa
disease VO effectiveness
drug DRUGBANK Gold

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