Trends in mortality in Spain, with a special focus on respiratory-related conditions in the midst of the COVID-19 pandemic.

Background and objective: The COVID-19 pandemic significantly increased the global burden of respiratory morbidity and mortality. In Spain, 2020 saw a 68.5% surge in deaths from respiratory diseases compared to 2019, largely due to COVID-19. This study aims to describe respiratory disease mortality in Spain from 2019 to 2022, focusing on the intersection of COVID-19, pre-existing respiratory conditions, and specific health determinants.

Materials and methods: We analyzed mortality data from the Spanish National Institute of Statistics (INE), covering 102 causes of death, including tuberculosis, COVID-19, and lung cancer as respiratory-related conditions. The analysis considered absolute death counts and proportions by sex, age, and region, along with percentage changes in proportional mortality. Logistic regression models were used to identify factors potentially associated with COVID-19 and respiratory-specific mortality.

Results: In 2022, Spain reported 98,128 deaths from respiratory diseases, accounting for 21.1% of all deaths and ranking as the second leading cause of death after cardiovascular diseases. Although deaths due to COVID-19 decreased in 2021 and 2022, there was a notable rise in other respiratory causes, indicating a lasting post-pandemic impact. Factors linked to higher mortality included male gender, older age, being divorced, and residing in urban areas, with significant regional variability.

Conclusions: Despite overall mortality returning to pre-pandemic levels, this study highlights a significant increase in respiratory disease deaths in Spain in 2022 compared to 2019.