Mortality by cause of death in Brazil: effects of the COVID-19 pandemic and contribution to changes in life expectancy at birth

We investigate the consequences of the COVID-19 pandemic on other underlying causes of death in Brazil in 2020 and 2021. We estimate monthly age-standardized mortality rates for 2010-2021 and decompose those time series into three additive components: trend, seasonality, and remainder. Given the long-term trend and historical seasonal fluctuations, we assume that any impact from the pandemic will be left on the remainder. We also decompose the contributions of COVID-19 deaths (direct effect) and those from other causes (indirect effects) to the annual change in life expectancy at birth (𝑒 0 ) from 2017 to 2021. Broadly, the remainder mirrors the trajectory of pandemic waves. The impact of the COVID-19 pandemic on other causes of death was not limited to increases but also decreases. The direct effects of the pandemic reduced 𝑒 0 by 1.89 years between 2019 and 2020 and 1.77 between 2020 and 2021. Indirect effects increased 𝑒 0 by 0.44 between 2019 and 2020 and had virtually no impact on 𝑒 0 between 2020 and 2021. Whether trajectories in mortality rates and annual gains in 𝑒 0 will quickly return to pre-pandemic levels depends on governmental actions to mitigate the consequences of the COVID-19 pandemic.