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Considering weighted multiple causes of death from death certificates (underlying and others) may help compare post- versus pre-pandemic mortality patterns, while potentially reducing the impact of cause misattribution. Estimates of post-pandemic impact are critical also for proper continuing public health policies (e.g. vaccinations).\u00a0We retrospectively analyse national all-cause mortality rate ratios between 2024 and pre-pandemic years (2017\u20132019) for sex-stratified 10-year age groups in Austria. In weighted analyses, the underlying death cause was weighted 50% and other causes shared the remaining 50%. Sensitivity analyses explored different weightings. Cause-specific weightings were also compared between 2024 and 2019.\u00a0Despite 1212 reported COVID-19 deaths in 2024, all-cause mortality rates were equal or lower in 2024 compared to 2019 in all strata at risk from COVID-19 (i.e., aged 60 years and over). All-cause mortality rates in 2024 were higher than in 2019 in adolescent and young adult strata. The ratio of weighted over unweighted COVID-19 death rates was 0.51\u20130.58 for age strata 60 years and older and even lower in sensitivity analyses, indicating that COVID-19 deaths were possibly overestimated.\u00a0Post-pandemic COVID-19 deaths had no visible impact on mortality patterns in Austria and were possibly overcounted. Increased post-pandemic mortality patterns in the young are particularly worrisome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10654-026-01462-7","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T10:25:33Z","timestamp":1790159133000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Post-pandemic mortality patterns and COVID-19 burden considering multiple death causes"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2541-9604","authenticated-orcid":false,"given":"Uwe","family":"Riedmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8414-7397","authenticated-orcid":false,"given":"Michael","family":"Levitt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7959-1311","authenticated-orcid":false,"given":"Stefan","family":"Pilz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3118-6859","authenticated-orcid":false,"given":"John PA","family":"Ioannidis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"issue":"10334","key":"1462_CR1","doi-asserted-by":"publisher","first-page":"1513","DOI":"10.1016\/S0140-6736(21)02796-3","volume":"399","author":"H Wang","year":"2022","unstructured":"Wang H, Paulson KR, Pease SA, Watson S, Comfort H, Zheng P, et al. 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