Relate standardized age distribution of COVID-19 deaths in 22 countries in the Americas and Europe to different indicators of population characteristics and health systems.
Distributions of COVID-19 deaths by age group in 22 countries of the Americas and Europe were standardized based on the age pyramid of the world's population. Correlations were calculated between the standardized proportion of people aged <60 years among the deceased and each of six indicators.
Standardization based on the world age pyramid revealed considerable differences in age distribution among countries; the proportion of people aged <60 years was higher in Latin America and the United States than in Canada or Western Europe. The standardized proportion of people aged <60 years among persons who died of COVID-19 is strongly correlated to the existence of universal quality medical coverage (r=-0.92, p<0.01). This relationship remained significant after being adjusted for the other indicators.
We propose that weaknesses in medical coverage of the population may have created higher case-fatality in populations aged <60 years in Latin America and the United States.