Original research
Life-years lost by COVID-19 patients in public hospitals of Marseille (APHM-South-Eastern France): a limited death toll: a retrospective analysis
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  • Published on:
    In regard to Arlotto et al.
    • Nicolas Bertrand, Oncologist Univ. Lille, CHU Lille, ULR 2694 METRICS, F-59000 Lille, France
    • Other Contributors:
      • Anthony Turpin, Oncologist
      • Michael Rochoy, General Practitionner

    In BMJ Open, Arlotto and colleagues reported the results of a retrospective single center study in Marseille, about the life-years lost by COVID-19 patients during the first pandemic wave from 1 March 2020 to 15 June 2020 (1). The authors concluded that a mortality due to COVID-19 lead to a limited number of years of life lost (YLL) due to both old age and preexisting comorbidities in the most vulnerable patients. As written in the conclusion, theses results should be interpreted “with caution”.
    Crucially, we report several methodological bias:
    -the Charlson Comorbidity Index (CCI) is used to assess what would have been the probability of death within 1 year of these patients in the absence of COVID-19. The 1-year mortality rates used are from the original study based on an inception cohort study of 604 patients admitted to the medical service at New York Hospital during 1 month in 1984. The comorbidity index was then tested for its ability to predict risk of death from comorbid disease in a cohort of 685 patients who were treated for primary breast cancer at Yale New Haven Hospital between 1962 and 1969 (2).

    -Several studies have shown that the weighting of comorbidities is no longer appropriate. Moreover, medical progress since 1984 has not been taken into account at all, as the authors point out in the discussion (3).
    A recent and exhaustive study has been conducted based on 6,602,641 subjects hospitalized in 2010, from medical, surgical, or o...

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    Conflict of Interest:
    None declared.