{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T06:50:03Z","timestamp":1781765403024,"version":"3.54.5"},"reference-count":45,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Understanding the impact of the SARS-CoV-2 pandemic on mortality requires more than aggregate statistics. While whole-population indicators have informed policy, they risk concealing subgroup-specific patterns. We analysed all-cause mortality in Germany from 2000 to 2024 using a weekly, cohort-resolved framework across 15 age groups to detect excess and under-mortality before, during, and after the pandemic.<\/jats:p>\n                  <jats:p>Expected mortality was modelled using exponential trends from two decades of pre-pandemic data. Deviations from expectation were quantified as normalised excess all-cause mortality rates (NEAMR), enabling the identification of significant, age-specific anomalies.<\/jats:p>\n                  <jats:p>We found sustained NEAMR in adults aged 75-79 and 35-49 from late 2021 through 2024\u2014patterns absent in whole-population trends. Conversely, cohorts aged 30-34 and 55-59 showed persistent under-mortality. Earlier excess peaks in older cohorts (e.g., 85-89 in 2003, 95+ in 2013) suggest generational vulnerabilities potentially linked to early-life adversity. Cross-correlation analyses indicate that associations between NEAMR and SARS-CoV-2 mRNA injection rates diverge from expected protective patterns in most age cohorts, especially during the 2021 \u2018alpha-to-delta\u2019 transition. These findings highlight the need for further hypothesis-driven investigations as well as a high-resolution mortality surveillance. Cohort-resolved analysis reveals NEAMR signals that aggregate data obscure, offering a more accurate assessment of public health outcomes across demographic groups.<\/jats:p>","DOI":"10.1371\/journal.pone.0334884","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T17:56:58Z","timestamp":1761587818000},"page":"e0334884","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cohort-resolved excess mortality in Germany (2000-2024): Patterns and implications for the SARS-CoV-2 era"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2856-5025","authenticated-orcid":true,"given":"Robert","family":"Rockenfeller","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"G\u00fcnther","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,10,27]]},"reference":[{"key":"pone.0334884.ref001","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.b3471","article-title":"Calibrated response to emerging infections","volume":"339","author":"P Doshi","year":"2009","journal-title":"BMJ."},{"issue":"7","key":"pone.0334884.ref002","doi-asserted-by":"crossref","first-page":"532","DOI":"10.2471\/BLT.11.086173","article-title":"The elusive definition of pandemic influenza","volume":"89","author":"P Doshi","year":"2011","journal-title":"Bull World Health Organ."},{"issue":"1","key":"pone.0334884.ref003","first-page":"157","article-title":"WHO declares COVID-19 a pandemic","volume":"91","author":"D Cucinotta","year":"2020","journal-title":"Acta Biomed."},{"issue":"8","key":"pone.0334884.ref004","doi-asserted-by":"crossref","first-page":"221551","DOI":"10.1098\/rsos.221551","article-title":"Reports of deaths are an exaggeration: all-cause and NAA-test-conditional mortality in Germany during the SARS-CoV-2 era","volume":"10","author":"R Rockenfeller","year":"2023","journal-title":"R Soc Open Sci."},{"issue":"5","key":"pone.0334884.ref005","article-title":"Estimation of excess mortality in Germany during 2020 -2022","volume":"15","author":"C Kuhbandner","year":"2023","journal-title":"Cureus."},{"key":"pone.0334884.ref006","unstructured":"Anonymous. 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