# Age at death during the Covid-19 lockdown in French metropolitan regions: a non parametric quantile regression approach

## TL;DR

This study examines how the age at death changed during the COVID-19 lockdown in three French regions, finding that younger people, especially males, were less likely to die during this period.

## Contribution

The paper introduces a non-parametric quantile regression approach to analyze age at death during lockdowns, revealing sex-specific and regional differences.

## Key findings

- Lockdowns led to an increase in the first quantiles of age at death, with fewer young males dying during the period.
- Excess mortality varied regionally, with the highest increase observed in Ile-de-France.
- Females showed less significant shifts in younger age quantiles and greater regional heterogeneity.

## Abstract

Lockdowns have been implemented to limit the number of hospitalisations and deaths during the first wave of 2019 coronavirus disease. These measures may have affected differently death characteristics, such age and sex. France was one of the hardest hit countries in Europe with a decreasing east–west gradient in excess mortality. This study aimed at describing the evolution of age at death quantiles during the lockdown in spring 2020 (17 March—11 May 2020) in the French metropolitan regions focusing on 3 representatives of the epidemic variations in the country: Bretagne, Ile-de-France (IDF) and Bourgogne-Franche-Comté (BFC).

Data were extracted from the French public mortality database from 1 January 2011 to 31 August 2020. The age distribution of mortality observed during the lockdown period (based on each decile, plus quantiles 1, 5, 95 and 99) was compared with the expected one using Bayesian non-parametric quantile regression.

During the lockdown, 5457, 5917 and 22 346 deaths were reported in Bretagne, BFC and IDF, respectively. An excess mortality from + 3% in Bretagne to + 102% in IDF was observed during lockdown compared to the 3 previous years. Lockdown led to an important increase in the first quantiles of age at death, irrespective of the region, while the increase was more gradual for older age groups. It corresponded to fewer young people, mainly males, dying during the lockdown, with an increase in the age at death in the first quantile of about 7 years across regions. In females, a less significant shift in the first quantiles and a greater heterogeneity between regions were shown. A greater shift was observed in eastern region and IDF, which may also represent excess mortality among the elderly.

This study focused on the innovative outcome of the age distribution at death. It shows the first quantiles of age at death increased differentially according to sex during the lockdown period, overall shift seems to depend on prior epidemic intensity before lockdown and complements studies on excess mortality during lockdowns.

The online version contains supplementary material available at 10.1186/s12889-024-18699-0.