No Excess Total Mortality in Italy in the First Semester of 2023 at All Ages and in the Working Age Population

Main Article Content

Gianfranco Alicandro
Alberto Gerli
Claudia Santucci
Stefano Centanni
Giuseppe Remuzzi
Carlo La Vecchia


COVID-19, SARS-CoV-2, pandemic, excess deaths, working age


Background: Italy experienced a sustained excess in total mortality between March 2020 and December 2022, resulting in approximately 226,000 excess deaths. This study extends the estimate of excess mortality in the country until June 2023, evaluating the persistence of excess mortality. Methods: We used mortality and population data from 2011 to 2019 to establish a baseline for expected deaths during the pandemic. Over-dispersed Poisson regression models were employed, stratified by sex, to predict expected deaths. These models included calendar year, age group, and a smoothed function for the day of the year as predictors. Excess mortality was then calculated for all ages and working ages (25-64 years). Results: From January to June 2023, we found a reduction in the number of deaths compared to the expected ones: 6,933 fewer deaths across all age groups and 1,768 fewer deaths in the working age category. This corresponds to a 2.1% and 5.2% decrease in mortality, respectively. Conclusions: The excess mortality observed in Italy from March to December 2022 was no longer observed in the first six months of 2023.

Abstract 180 | PDF Downloads 165


1. Edouard Mathieu, Hannah Ritchie, Lucas Rodés-Guirao, et al. (2020) - "Coronavirus Pandemic (COVID-19)". Published online at Retrieved from: '' [Online Resource] (Last Accessed October 9, 2023).
2. WHO. Statement on the fifteenth meeting of the IHR (2005) Emergency Committee on the COVID-19 pandemic. WHO Dir Gen Speeches 2023:1–6. [Online Resource] (accessed October 9, 2023).
3. Australian Bureau of Statistics. Measuring Australia’s excess mortality during the COVID-19 pandemic until the first quarter 2023 2023. (accessed October 9, 2023).
4. Adair T, Houle B, Canudas-Romo V. Effect of the COVID-19 pandemic on life expectancy in Australia, 2020-22. Int J Epidemiol. 2023.
5. Kung S, Hills T, Kearns N, Beasley R. New Zealand’s COVID-19 elimination strategy and mortality patterns. Lancet. 2023.
6. Islam N. “Excess Deaths” Is the Best Metric for Tracking the Pandemic. BMJ. 2022;376:o285. Doi:
7. Alicandro G, Gerli AG, Centanni S, Remuzzi G, Vecchia C La. Excess Total Mortality in Italy: An Update to February 2023 with Focus on Working Ages. Med Lav. 2023;114:e2023028. Doi:
8. Alicandro G, Gerli AG, Remuzzi G, Centanni S, La Vecchia CL. Updated estimates of excess total mortality in Italy during the circulation of the BA.2 and BA.4-5 Omicron variants: April-July 2022. Med Lav. 2022;113: e2022046. Doi:
9. Istituto Nazionale di Statistica. Decessi e cause di morte: cosa produce l’Istat 2021: from [Online Resource] [Last Accessed October 9, 2023].
10. Eurostat. 2023:1. [Last Accessed October 9, 2023).
11. Excess mortality in England and English regions - GOV.UK n.d. [Last Accessed October 9, 2023].
12. Alicandro G, La Vecchia C, Islam N, Pizzato M. A comprehensive analysis of all-cause and cause-specific excess deaths in 30 countries during 2020 [published online ahead of print, 2023 Sep 8]. Eur J Epidemiol. 2023;10/1007/s10654-023-01044-x. Doi: 10.1007/s10654-023-01044-x
13. Hartnett KP, Kite-Powell A, DeVies J, et al. Excess Deaths Associated with COVID-19. MMWR Morb Mortal Wkly Rep. 2020; https://ww:826–34. [Last Accessed October 9, 2023].
14. Levitt M, Zonta F, Ioannidis JPA. Excess death estimates from multiverse analysis in 2009-2021. Eur J Epidemiol. 2023:1-11. Doi: