The nation recorded excess deaths of about 4,000 due to Covid-19 in 2021. The death toll in 2021 increased by 3.8 percent on-year. The death toll from Covid-19 was the highest, and deaths from symptoms or syndromes not classified otherwise also rose by 29.3 percent compared to the previous year.

The Health Insurance Review and Assessment Service (HIRA) has released a study result grasping excess death in 2021 when Covid-19 spread in earnest and making an in-depth analysis of major causes of death. Lee Pung-hun, an associate researcher, led the study.

Excess death refers to deaths that occur over a certain period above the normal level due to specific diseases, such as influenza, MERS, Covid-19, and crises.

The research team compared predicted and real values by detailed cases based on the death data of the previous 11 years and 2021. It used Statistics Korea’s registered population, death statistics at Micro Data Integrated Service (MDIS), and climate statistical analysis data at the Korea Meteorological Administration.

The death total in 2021 totaled 317,680, 4,168 over the predicted death toll, surpassing the 95 percent confidence range (290,587-313,512).

Researchers said the result of analyzing Covid-19’s influence showed that the 2021 death toll increased by 3.8 percent on-year in a statistically significant analysis.

To analyze it by exact causes, the researchers referred to the major classification system according to the Korean Standard Classification of Diseases (KCD). Notably, it analyzed 12 causes of death, including damage, other specific results by addiction and other people (S00-T98), special purpose code (U00-U99), factors affecting health status and contact with health services (Z00-Z99), and pregnancy, childbirth, and the postpartum period (O00-O99)

As a result, among the 12 causes, excess deaths occurred in five detailed causes -- specific infectious diseases and parasitic diseases, endocrine, nutrition and metabolic diseases, digestive system disease, musculoskeletal system and connective tissue disease, and symptoms and syndromes not classified otherwise.

On the other hand, three causes of death- psychiatric behavior disorder, neurological disease, and respiratory disease – decreased the death toll compared to pre-Covid-19 years.

By cause, excess death from specific infectious diseases and parasitic diseases increased by 39.4 percent on-year. The most significantly increased group of excess deaths for these reasons were men (46.8 percent), 20-34-year-olds (48.5 percent), and Seoul (88.0 percent)

Excess deaths from endocrine, nutrition, and metabolic diseases increased by 5.67 percent, particularly so among men (9.1 percent), 35-49-year-olds (21.6 percent), and Seoul (35.0 percent). Deaths from digestive diseases rose by 5.2 percent, especially among men (7.3 percent), 35-49-year-olds (10.5 percent), and Seoul (35.0 percent).

The number of deaths from musculoskeletal and connective tissue diseases increased by 8.9 percent compared to the average year, notably so among men (14.3 percent), over 80 (15.5 percent), and North Gyeongsang Province (64 percent).

Deaths from other unclassified symptoms and syndromes increased by 29.3 percent, especially so in men (33.2 percent), 20-34-year-olds (35.3 percent), and Daegu (53.9 percent).

The research team said this study only confirmed excess deaths by causes and analyzed death causes by sex, age, and region using statistical data of death causes, adding that additional analysis is needed by connecting the underlying conditions of the dead to information that can affect death, such as previous treatment records.

“If we analyze these data by connecting information on confirmed Covid-19 cases at KDCA, death cause information at Statistics Korea, and insurance claims data at HIRA, we can grasp direct and indirect influence on death,” the research team said. “We also can use it as base data to work out countermeasures if a similar infectious disease breaks out in the future.”