COST Action CA18218


COVID-19 has affected many countries in Europe in beyond. There is currently a growing interest to quantify the disease burden of COVID-19, in order to measure its population health impact and compare it to other diseases. On this page, we compile burden of disease resources specifically focused on COVID-19.

Burden of COVID-19 Task Force

The Burden of COVID-19 Task Force brings together members who are conducting or interested in launching national studies to estimate the burden of disease of COVID-19. The TF meets approximately every six weeks to discuss technical aspects of COVID-19 burden calculation.

More information about the Task Force is available here.

Burden of COVID-19 calculation protocol

The burden-eu Core Group has prepared a protocol to provide guidance for anyone planning to assess the burden of disease of COVID-19 at national level using DALYs. It focuses on the direct health impact of the disease, and describes the data requirements, the methods, and considerations for communicating results. It also aims to foster harmonization of methodologies for estimating the burden of disease of COVID-19 across countries.

You can download the protocol here.

Burden of COVID-19 webinars

On Friday 20 November 2020, our COST Action has organized a webinar on quantifying COVID-19 disease burden. You can replay the webinar and access the presentations here.

Burden of COVID-19 publications

DALY calculation methods for COVID-19

Wyper GM, Assunção RM, Colzani E, Grant I, Haagsma JA, Lagerweij G, Von der Lippe E, McDonald SA, Pires SM, Porst M, Speybroeck N, Devleesschauwer B. Burden of disease methods: a guide to calculate COVID-19 disability-adjusted life years. Int J Public Health. 2021;66:619011. doi: 10.3389/ijph.2021.619011

Devleesschauwer B, McDonald SA, Speybroeck N, Wyper GM. Valuing the years of life lost due to COVID-19: the differences and pitfalls. Int J Public Health. 2020;65:719–720. doi: 10.1007/s00038-020-01430-2

Wyper GM, Devleesschauwer B, Mathers CD, McDonald SA, Speybroeck N, Devleesschauwer B. Years of life lost methods must remain fully equitable and accountable. Eur J Epidemiol. 2022:37;215–216. doi: 10.1007/s10654-022-00846-9

DALY calculations for COVID-19  peer-reviewed

Haneef R, Fayad M, Fouillet A, Sommen C, Bonaldi C, Wyper GMA, Pires SM, Devleesschauwer B, Rachas A, Constantinou P, Levy-Bruhl D, Beltzer N, Gallay A. Direct impact of COVID-19 by estimating disability-adjusted life years at national level in France in 2020. PLOS ONE. 2023;18(1):e0280990. doi: 10.1371/journal.pone.0280990

McDonald SA, Lagerweij GR, de Boer P, de Melker HE, Pijnacker R, Gras LM, Kretzschmar ME, den Hartog G, van Gageldonk-Lafeber AB, RIVM COVID-19 surveillance and epidemiology team, van den Hof S, Wallinga J. The estimated disease burden of acute COVID-19 in the Netherlands in 2020, in disability-adjusted life-years. Eur J Epidemiol. 2022; in press. doi: 10.1007/s10654-022-00895-0

Pires SM, Redondo HG, Espenhain L, Jakobsen LS, Legarth R, Meaidi M, Koch A, Tribler S, Martin-Bertelsen T, Ethelberg S. Disability adjusted life years associated with COVID-19 in Denmark in the first year of the pandemic. BMC Public Health. 2022;22:1315. doi: 10.1186/s12889-022-13694-9

Moran D, Pires SM, Wyper GMA, Devleesschauwer B, Cuschieri S, Kabir Z. Estimating the direct Disability-Adjusted Life Years (DALYs) associated with SARS-CoV-2 (COVID-19) in the Republic of Ireland: The first full year. Int J Public Health. 2022;67:1604699. doi: 10.3389/ijph.2022.1604699

Angeles MR, Wanni Arachchige Dona S, Nguyen H, Khanh-Dao Le L, Hensher M. Modelling the potential acute and post-acute burden of COVID-19 under the Australian border re-opening plan. BMC Public Health. 2022;22:757. doi: 10.1186/s12889-022-13169-x

Asdaq SMB, Rabbani SI, Alshammari MK, Alshammari RS, Kamal M, Imran M, AlShammari NA, Al Twallah MF, Alshahrani AH. Burden of COVID-19: a preliminary analysis in the population of Saudi Arabia. PeerJ. 2022;10:e13219. doi: 10.7717/peerj.13219

Wyper GMA, Fletcher E, Grant I, McCartney G, Fischbacher C, Harding O, Jones H, de Haro Moro MT, Speybroeck N, Devleesschauwer B, Stockton DL. Measuring disability-adjusted life years (DALYs) due to COVID-19 in Scotland, 2020. Arch Public Health. 2022;80:105. doi: 10.1186/s13690-022-00862-x

Singh BB, Devleesschauwer B, Khatkar MS, Lowerison M, Singh B, Dhand NK, Barkema HW. Disability-adjusted life years (DALYs) due to the direct health impact of COVID-19 in India. Sci Rep. 2022;12:2454. doi: 10.1038/s41598-022-06505-z

Soodejani MT, Gheshlaghi LA, Bahrevar V, Hosseini S, Lotfi MH. Burden of severe COVID-19 in center of Iran: results of disability-adjusted life years (DALYs). Int J Mol Epidemiol Genet. 2022;12(6):120-125.

Smith MP. Estimating total morbidity burden of COVID-19: relative importance of death and disability. J Clin Epidemiol. 2021; in press. doi: 10.1016/j.jclinepi.2021.10.018

Cuschieri S, Calleja N, Devleesschauwer B, Wyper GMA. Estimating the direct Covid-19 disability-adjusted life years impact on the Malta population for the first full year. BMC Public Health. 2021;21:1827. doi: 10.1186/s12889-021-11893-4

Rugani B, Conticini E, Frediani B, Caro D. Decrease in life expectancy due to COVID-19 disease not offset by reduced environmental impacts associated with lockdowns in Italy. Environ Pollut. 2021; in press. doi: 10.1016/j.envpol.2021.118224

Bell D, Hansen KS. Relative Burdens of the COVID-19, Malaria, Tuberculosis, and HIV/AIDS Epidemics in Sub-Saharan Africa. Am J Trop Med Hyg. 2021;105(6):1510–1515. doi: 10.4269/ajtmh.21-0899

Wyper GMA, Fletcher E, Grant I, Harding O, de Haro Moro MT, Stockton DL, McCartney G. Inequalities in population health loss by multiple deprivation: COVID-19 and pre-pandemic all-cause disability-adjusted life years (DALYs) in Scotland. Int J Equity Health. 2021;20:214. doi: 10.1186/s12939-021-01547-7

John D, Narassima MS, Menon J, Jammy GR, Banerjee A. Estimation of economic burden of COVID-19 using disability-adjusted life years (DALYs) and Productivity Losses in Kerala, India: a model-based analysis. BMJ Open. 2021;11:e049619. doi: 10.1136/bmjopen-2021-049619

Salinas-Escudero G, Toledano-Toledano F, García-Peña C, Parra-Rodríguez L, Granados-García V, Carrillo-Vega MF. Disability-adjusted life years for the COVID-19 pandemic in the Mexican population. Front Public Health. 2021:9;686700. doi: 10.3389/fpubh.2021.686700

Fan CY, Fann JC, Yang MC, Lin TY, Chen HH, Liu JT, Yang KC. Estimating global burden of COVID-19 with disability-adjusted life years and value of statistical life metrics. J Formos Med Assoc. 2021:S0929-6646(21)00234-5. doi: 10.1016/j.jfma.2021.05.019

He M, Li X, Tan Q, Chen Y, Kong Y, You J, Lin X, Lin Y, Zheng Q. Disease burden from COVID-19 symptoms among inpatients at the temporary military hospitals in Wuhan: a retrospective multicentre cross–sectional study. BMJ Open. 2021;11(5):e048822. doi: 10.1136/bmjopen-2021-048822

Quast T, Andel R, Gregory S, Storch EA. Years of life lost associated with COVID-19 deaths in the USA during the first year of the pandemic. J Public Health. 2021; in press. doi: 10.1093/pubmed/fdab123

Vasishtha G, Mohanty SK, Mishra US, Dubey M, Sahoo U. Impact of COVID-19 infection on life expectancy, premature mortality, and DALY in Maharashtra, India. BMC Infect Dis. 2021;21:343. doi: 10.1186/s12879-021-06026-6

Rommel A, von der Lippe E, Plass D, Ziese T, Diercke M, An der Heiden M, Haller S, Wengler A. The COVID-19 disease burden in Germany in 2020—years of life lost to death and disease over the course of the pandemic. Dtsch Arztebl Int. 2021;118:arztebl.m2021.0147. doi: 10.3238/arztebl.m2021.0147

Zhao J, Jin H, Li X, Jia J, Zhang C, Zhao H, Ma W, Wang Z, He Y, Lee J, Zhang D, Yin B, Zheng W, Wang H, Pennington M. Disease burden attributable to the first wave of COVID-19 in China and the effect of timing on the cost-effectiveness of movement restriction policies. Value Health. 2021; in press. doi: 10.1016/j.jval.2020.12.009

Pifarré i Arolas H, Acosta E, López-Casasnovas G, Lo A, Nicodemo C, Riffe T, Myrskylä M. Years of life lost to COVID-19 in 81 countries. Sci Rep. 2021;11:3504. doi: 10.1038/s41598-021-83040-3

Ortiz-Prado E, Simbaña-Rivera K, Barreno LG, Diaz AM, Barreto A, Moyano C, Arcos V, Vásconez-González E, Paz C, Simbaña-Guaycha F, Molestina-Luzuriaga M, Fernández-Naranjo R, Feijoo J, Henriquez AR, Adana L, Cortés AL, Fletcher I, Lowe R. Epidemiological, socio-demographic and clinical features of the early phase of the COVID-19 epidemic in Ecuador. PLOS Negl Trop Dis. 2020;15(1):e0008958. doi: 10.1371/journal.pntd.0008958

Mitra AK, Payton M, Kabir N, Whitehead A, Ragland KN, Brown A. Potential Years of Life Lost due to COVID-19 in the United States, Italy, and Germany: an old formula with newer ideas. Int J Environ Res Public Health. 2020;17(12):4392. doi: 10.3390/ijerph17124392

Oh IH, Ock M, Jang SY, Go DS, Kim YE, Jung YS, Kim KB, Park H, Jo MW, Yoon SJ. Years of Life Lost attributable to COVID-19 in high-incidence countries. J Korean Med Sci. 2020;35(32):e300. doi: 10.3346/jkms.2020.35.e300

Bell D, Schultz Hansen K, Kiragga AN, Kambugu A, Kissa J, Mbonye AK. Predicting the impact of COVID-19 and the potential impact of the public health response on disease burden in Uganda. Am J Trop Med Hyg. 2020; in press. doi: 10.4269/ajtmh.20-0546

Tchole AIM, Li ZW, Wei JT, Ye RZ, Wang WJ, Du WY, Wang HT, Yin CN, Ji XK, Xue FZ, Bachir AM, Zhao L, Cao WC, Cheeloo EcoHealth Consortium (CLEC). Epidemic and control of COVID-19 in Niger: quantitative analyses in a least developed country. J Glob Health. 2020;10(2):020513. doi: 10.7189/jogh.10.020513

Nurchis MC, Pascucci D, Sapienza M, Villani L, D’Ambrosio F, Castrini F, Specchia ML, Laurenti P, Damiani G. Impact of the burden of COVID-19 in Italy: Results of Disability-Adjusted Life Years (DALYs) and productivity loss. Int J Environ Res Public Health. 2020;17:4233. doi: 10.3390/ijerph17124233

Jo MW, Go DS, Kim R, Lee SW, Ock M, Kim YE, Oh IH, Yoon SJ, Park H. The burden of disease due to COVID-19 in Korea using Disability-Adjusted Life Years. J Korean Med Sci. 2020;35(21):e199. doi: 10.3346/jkms.2020.35.e199

DALY calculations for COVID-19 grey literature and institutional reports

Australian Institute of Health and Welfare (AIHW). The first year of COVID-19 in Australia: direct and indirect health effects. Cat. no. PHE 287. Canberra: AIHW. URL:

Lagerweij G, Schimmer B, Mooij S, Raven S, Schoffelen A, de Gier B, Hahné D. State of Infectious Diseases in the Netherlands, 2019. RIVM-Rapport 2020-0048. doi: 10.21945/rivm-2020-0048

DALY calculations for COVID-19 non peer-reviewed

Mirzaee N, Barouni M, Goudarzi R, Jahani Y, Haghdoost AA, Gohari MA, Nakhaeizadeh M, McFarland W, Sharifi H. Prediction the burden of COVID-19 in Iran: Application of disability-adjusted life years (DALYs). Research Square. September 21, 2020. doi: 10.21203/

Mohanty SK, Dubey M, Mishra US, Sahoo U. Impact of COVID-19 attributable deaths on longevity, premature mortality and DALY: Estimates of USA, Italy, Sweden and Germany. medRxiv. July 07, 2020. doi: 10.1101/2020.07.06.20147009

Mohanty SK, Sahoo U, Mishra US, Dubey M. Age pattern of premature mortality under varying scenarios of COVID-19 infection in India. medRxiv. June 12, 2020. doi: 10.1101/2020.06.11.20128587

Khan S. Can we estimate the Disability Adjusted Life-Years (DALYs) for COVID-19 yet?

COVID-19 and burden of disease context

Pires SM, Wyper GMA, Wengler A, Peñalvo JL, Haneef R, Moran D, Cuschieri S, Redondo HG, De Pauw R, McDonald SA, Moon L, Shedrawy J, Pallari E, Charalampous P, Devleesschauwer B, von Der Lippe E. Burden of disease of COVID-19: strengthening the collaboration for national studies. Front Public Health. 2022;10:907012. doi: 10.3389/fpubh.2022.907012

Else H. The pandemic’s true health cost: how much of our lives has COVID stolen?. Nature. 2022;605:411-413. doi: 10.1038/d41586-022-01341-7

Noy I, Doan N, Ferrarini B, Park D. Measuring the economic risk of COVID‐19. Global Policy. 2020;11(4):413-23. doi: 10.1111/1758-5899.12851

Azarpazhooh MR, Morovatdar N, Avan A, Phan TG, Divani AA, Yassi N, Stranges S, Silver B, Biller J, Tokazebani Belasi M, Kazemi Neya S, Khorram B, Frydman A, Nilanont Y, Onorati E, Di Napoli M. COVID-19 pandemic and burden of non-communicable diseases: an ecological study on data of 185 countries. J Stroke Cerebrovasc Dis. 2020;29(9):105089. doi: 10.1016/j.jstrokecerebrovasdis.2020.105089

Wyper GM, Assunção RM, Cuschieri S, Devleeschauwer B, Fletcher E, Haagsma JA, Hilderink H, Idavain J, Lesnik T, Von der Lippe E, Majdan M, Santric-Milicevic M, Pallari E, Peñalvo JL, Pires SM, Plass D, Santos JV, Stockton DL, Thomsen ST, Grant I. Population vulnerability to COVID-19 in Europe: a burden of disease analysis. Arch Public Health. 2020;78:47. doi: 10.1186/s13690-020-00433-y

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