Excess mortality in Europe estimated by EuroMOMO during the COVID-19 pandemic and previous influenza seasons

Sarah K. Nørgaard; Jens Nielsen; Christel B. Schjørring; Albert S. Kalnæs; Lukas Richter; Alena Chalupka; Toon Braeye; Serge Nganda Mekogo; Maria Athanasiadou; Theodore Lytras; Gleb Denissov; Oskari Luomala; Isabelle Pontais; Benedikt Zacher; Matthias an der Heiden; Kassiani Mellou; Ioannis Panagoulias; Anna Paldy; Tibor Malnasi; Eva Kelly; Naama Rotem; Francesca K. de’Donato; Chiara Di Blasi; Joël Mossong; Anne Vergison; Kathleen England; Neville Calleja; Liselotte van Asten; Jan van de Kassteele; Christian Madsen; Susana Silva; Ana Paula Rodrigues; Natalija Kranjec; Inmaculada León-Gómez; Diana Gomez-Barroso; Ilias Galanis; Ahmed Farah; Rolf Weitkunat; Nick Andrews; Tom Clare; Magda Bucholc; Declan T. Bradley; Naoma William; Mark Hamilton; Pernille Jorgensen; Richard G. Pebody; Nick Bundle; Bolette Søborg; Tyra G. Krause; Kåre Mølbak; Lasse S. Vestergaard

doi:10.1038/s41467-025-67981-1

Excess mortality in Europe estimated by EuroMOMO during the COVID-19 pandemic and previous influenza seasons

Sarah K. Nørgaard
, Jens Nielsen
, Christel B. Schjørring
, Albert S. Kalnæs
, Lukas Richter
, Alena Chalupka
, Toon Braeye
, Serge Nganda Mekogo
, Maria Athanasiadou
, Theodore Lytras
, Gleb Denissov
, Oskari Luomala
, Isabelle Pontais
, Benedikt Zacher
, Matthias an der Heiden
, Kassiani Mellou
, Ioannis Panagoulias
, Anna Paldy
, Tibor Malnasi
, Eva Kelly

Naama Rotem, Francesca K. de’Donato, Chiara Di Blasi, Joël Mossong, Anne Vergison, Kathleen England, Neville Calleja, Liselotte van Asten, Jan van de Kassteele, Christian Madsen, Susana Silva, Ana Paula Rodrigues, Natalija Kranjec, Inmaculada León-Gómez, Diana Gomez-Barroso, Ilias Galanis, Ahmed Farah, Rolf Weitkunat, Nick Andrews, Tom Clare, Magda Bucholc, Declan T. Bradley, Naoma William, Mark Hamilton, Pernille Jorgensen, Richard G. Pebody, Nick Bundle, Bolette Søborg, Tyra G. Krause, Kåre Mølbak, Lasse S. Vestergaard

Research output: Contribution to journal › Article › peer-review

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Abstract

Important questions remain regarding differences in geographical and age-specific mortality patterns as the COVID-19 pandemic evolved in consecutive waves, and how COVID-19 mortality compares to seasonal influenza. In a pandemic situation, excess all-cause mortality provides a more complete and robust measure than cause-specific mortality. Data submitted by 26 countries participating in the European Mortality Monitoring (EuroMOMO) network between 2020 and 2023 was analysed to quantify excess all-cause mortality during the COVID-19 pandemic. Excess mortality from this period was compared to previous influenza seasons from 2014 to 2019. Pooled estimates of excess mortality showed four main waves during the COVID-19 pandemic period, most markedly in people aged 65 years and above, with timing and magnitude that varied between countries. Here we show that prior to implementation of control measures and COVID-19 vaccination, excess mortality greatly exceeded typical seasonal influenza mortality, but later during the pandemic was at levels comparable to influenza.

Original language	English
Article number	1356
Pages (from-to)	1-11
Number of pages	11
Journal	Nature Communications
Volume	17
Issue number	1
Early online date	15 Jan 2026
DOIs	https://doi.org/10.1038/s41467-025-67981-1
Publication status	Published (in print/issue) - 5 Feb 2026

Bibliographical note

Publisher Copyright:
© The Author(s) 2026.

Data Availability Statement

The national datasets underlying the findings of this study are not publicly available due to country-specific data protection regulations. The data are stored in controlled-access repositories at national institutes and may be obtained upon direct request to the respective national authorities (see https://euromomo.eu/about-us/partners for detailed contact information). However, updated national z-scores and aggregated data from the weekly EuroMOMO mortality monitoring are publicly available at from the EuroMOMO website: https://euromomo.eu/graphs-and-maps. Specific data inquiries may also be directed to the EuroMOMO hub at [email protected]. Source data are provided with this paper.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Humans
COVID-19/mortality
Europe/epidemiology
Influenza, Human/mortality
Seasons
Aged
SARS-CoV-2
Pandemics
Female
Male
Middle Aged
Adult
Aged, 80 and over
Child
Adolescent
Young Adult
Child, Preschool
Infant
Mortality/trends

Access to Document

10.1038/s41467-025-67981-1Licence: CC BY-NC-ND

s41467-025-67981-1Final published version, 2.12 MBLicence: CC BY-NC-ND

Cite this

Nørgaard, S. K., Nielsen, J., Schjørring, C. B., Kalnæs, A. S., Richter, L., Chalupka, A., Braeye, T., Mekogo, S. N., Athanasiadou, M., Lytras, T., Denissov, G., Luomala, O., Pontais, I., Zacher, B., an der Heiden, M., Mellou, K., Panagoulias, I., Paldy, A., Malnasi, T., ... Vestergaard, L. S. (2026). Excess mortality in Europe estimated by EuroMOMO during the COVID-19 pandemic and previous influenza seasons. Nature Communications, 17(1), 1-11. Article 1356. https://doi.org/10.1038/s41467-025-67981-1

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abstract = "Important questions remain regarding differences in geographical and age-specific mortality patterns as the COVID-19 pandemic evolved in consecutive waves, and how COVID-19 mortality compares to seasonal influenza. In a pandemic situation, excess all-cause mortality provides a more complete and robust measure than cause-specific mortality. Data submitted by 26 countries participating in the European Mortality Monitoring (EuroMOMO) network between 2020 and 2023 was analysed to quantify excess all-cause mortality during the COVID-19 pandemic. Excess mortality from this period was compared to previous influenza seasons from 2014 to 2019. Pooled estimates of excess mortality showed four main waves during the COVID-19 pandemic period, most markedly in people aged 65 years and above, with timing and magnitude that varied between countries. Here we show that prior to implementation of control measures and COVID-19 vaccination, excess mortality greatly exceeded typical seasonal influenza mortality, but later during the pandemic was at levels comparable to influenza.",

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note = "Publisher Copyright: {\textcopyright} The Author(s) 2026.",

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doi = "10.1038/s41467-025-67981-1",

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Nørgaard, SK, Nielsen, J, Schjørring, CB, Kalnæs, AS, Richter, L, Chalupka, A, Braeye, T, Mekogo, SN, Athanasiadou, M, Lytras, T, Denissov, G, Luomala, O, Pontais, I, Zacher, B, an der Heiden, M, Mellou, K, Panagoulias, I, Paldy, A, Malnasi, T, Kelly, E, Rotem, N, de’Donato, FK, Di Blasi, C, Mossong, J, Vergison, A, England, K, Calleja, N, van Asten, L, van de Kassteele, J, Madsen, C, Silva, S, Rodrigues, AP, Kranjec, N, León-Gómez, I, Gomez-Barroso, D, Galanis, I, Farah, A, Weitkunat, R, Andrews, N, Clare, T, Bucholc, M, Bradley, DT, William, N, Hamilton, M, Jorgensen, P, Pebody, RG, Bundle, N, Søborg, B, Krause, TG, Mølbak, K & Vestergaard, LS 2026, 'Excess mortality in Europe estimated by EuroMOMO during the COVID-19 pandemic and previous influenza seasons', Nature Communications, vol. 17, no. 1, 1356, pp. 1-11. https://doi.org/10.1038/s41467-025-67981-1

TY - JOUR

T1 - Excess mortality in Europe estimated by EuroMOMO during the COVID-19 pandemic and previous influenza seasons

AU - Nørgaard, Sarah K.

AU - Nielsen, Jens

AU - Schjørring, Christel B.

AU - Kalnæs, Albert S.

AU - Richter, Lukas

AU - Chalupka, Alena

AU - Braeye, Toon

AU - Mekogo, Serge Nganda

AU - Athanasiadou, Maria

AU - Lytras, Theodore

AU - Denissov, Gleb

AU - Luomala, Oskari

AU - Pontais, Isabelle

AU - Zacher, Benedikt

AU - an der Heiden, Matthias

AU - Mellou, Kassiani

AU - Panagoulias, Ioannis

AU - Paldy, Anna

AU - Malnasi, Tibor

AU - Kelly, Eva

AU - Rotem, Naama

AU - de’Donato, Francesca K.

AU - Di Blasi, Chiara

AU - Mossong, Joël

AU - Vergison, Anne

AU - England, Kathleen

AU - Calleja, Neville

AU - van Asten, Liselotte

AU - van de Kassteele, Jan

AU - Madsen, Christian

AU - Silva, Susana

AU - Rodrigues, Ana Paula

AU - Kranjec, Natalija

AU - León-Gómez, Inmaculada

AU - Gomez-Barroso, Diana

AU - Galanis, Ilias

AU - Farah, Ahmed

AU - Weitkunat, Rolf

AU - Andrews, Nick

AU - Clare, Tom

AU - Bucholc, Magda

AU - Bradley, Declan T.

AU - William, Naoma

AU - Hamilton, Mark

AU - Jorgensen, Pernille

AU - Pebody, Richard G.

AU - Bundle, Nick

AU - Søborg, Bolette

AU - Krause, Tyra G.

AU - Mølbak, Kåre

AU - Vestergaard, Lasse S.

PY - 2026/2/5

Y1 - 2026/2/5

N2 - Important questions remain regarding differences in geographical and age-specific mortality patterns as the COVID-19 pandemic evolved in consecutive waves, and how COVID-19 mortality compares to seasonal influenza. In a pandemic situation, excess all-cause mortality provides a more complete and robust measure than cause-specific mortality. Data submitted by 26 countries participating in the European Mortality Monitoring (EuroMOMO) network between 2020 and 2023 was analysed to quantify excess all-cause mortality during the COVID-19 pandemic. Excess mortality from this period was compared to previous influenza seasons from 2014 to 2019. Pooled estimates of excess mortality showed four main waves during the COVID-19 pandemic period, most markedly in people aged 65 years and above, with timing and magnitude that varied between countries. Here we show that prior to implementation of control measures and COVID-19 vaccination, excess mortality greatly exceeded typical seasonal influenza mortality, but later during the pandemic was at levels comparable to influenza.

AB - Important questions remain regarding differences in geographical and age-specific mortality patterns as the COVID-19 pandemic evolved in consecutive waves, and how COVID-19 mortality compares to seasonal influenza. In a pandemic situation, excess all-cause mortality provides a more complete and robust measure than cause-specific mortality. Data submitted by 26 countries participating in the European Mortality Monitoring (EuroMOMO) network between 2020 and 2023 was analysed to quantify excess all-cause mortality during the COVID-19 pandemic. Excess mortality from this period was compared to previous influenza seasons from 2014 to 2019. Pooled estimates of excess mortality showed four main waves during the COVID-19 pandemic period, most markedly in people aged 65 years and above, with timing and magnitude that varied between countries. Here we show that prior to implementation of control measures and COVID-19 vaccination, excess mortality greatly exceeded typical seasonal influenza mortality, but later during the pandemic was at levels comparable to influenza.

KW - Humans

KW - COVID-19/mortality

KW - Europe/epidemiology

KW - Influenza, Human/mortality

KW - Seasons

KW - Aged

KW - SARS-CoV-2

KW - Pandemics

KW - Female

KW - Male

KW - Middle Aged

KW - Adult

KW - Aged, 80 and over

KW - Child

KW - Adolescent

KW - Young Adult

KW - Child, Preschool

KW - Infant

KW - Mortality/trends

UR - https://www.scopus.com/pages/publications/105029493661

U2 - 10.1038/s41467-025-67981-1

DO - 10.1038/s41467-025-67981-1

M3 - Article

C2 - 41540002

AN - SCOPUS:105029493661

SN - 2041-1723

VL - 17

SP - 1

EP - 11

JO - Nature Communications

JF - Nature Communications

IS - 1

M1 - 1356

ER -

Excess mortality in Europe estimated by EuroMOMO during the COVID-19 pandemic and previous influenza seasons

Abstract

Bibliographical note

Data Availability Statement

UN SDGs

Keywords

Access to Document

Other files and links

Cite this