Background: COVID-19 introduced an unprecedented public health catastrophe in India with a high population density and a diverse demographic profile, along with heightened vulnerability to disease burden of the health care system. Although early evaluations concentrated on single-year estimates, scant information is available about how direct health loss changed over time at the national level, and numerical estimates for different pandemic waves are available only on the basis of standard and burden-of-disease metrics.
Objective: To estimate the year-wise and total direct health burden of COVID-19 in India for 2020-August 2025 based on disability adjusted life years (DALYs).
Methods: We performed a retrospective, population-based burden of disease study in the framework of the Global Burden of Disease. National data on COVID-19 morbidity and mortality were sourced from official Indian government and standardized with GBD life tables and disability weights. DALYs were based on the sum of YLLs from premature death and YLDs resulting from symptomatic infections. The estimates were calculated per year and then synthesized over the study period.
Results: The disease caused an estimated 18.1 million DALYs between 2020 to August 2025 in India. The burden was overwhelmingly constituted by premature mortality, with YLLs accounting for approximately 94% of total DALYs. The peak burden was in 2021, associated with the delta wave, and then there was a sharp decrease in the subsequent years, fitting with improved vaccination coverage and clinical management.
Conclusions: COVID-19 resulted in a substantial direct loss of population health in India, dominated by premature mortality and concentrated within a single epidemic year. Year-wise DALY estimation is essential for understanding pandemic dynamics and emphasizes the importance of standardized burden estimates to inform public health preparedness, healthcare planning, and future pandemic responses.
Keywords: COVID-19, Disability Adjusted Life Years (DALYs), Years of Life Lost (YLLs), Years lived with Disability (YLDs), Global Burden of Disease (GBD), Year-wise Burden, Epidemiological Trends.
How to cite this article: Anand G, Maity P, Das S, Upadhyay S, Kumari P, Singh R, Goyal S. Pandemic wave-driven dynamics of disability-adjusted life years attributable to coronavirus in India. Int J Drug Deliv Technol. 2026;16(7s): 247-255; DOI: 10.25258/ijddt.16.7s.28
Source of support: Nil.
Conflict of interest: None