Trends in the dynamics of morbidity and mortality from COVID-19 in Russia (2020-2025)

Relevance. The study COVID-19 is due to its continued circulation in SARS-CoV-2 in the world and the beginning of an increase cases in Russia this season. 
Aims. To compare the trends of the COVID-19 epidemic process in terms of morbidity and mortality in epidemic and inter-epidemic periods among the Russian population. 
Materials and methods. The analysis of the incidence and mortality of COVID-19 in Russia, megacities and 54 cities was carried out according to the стопкоронавирус. рф and the computer database of the Influenza Research Institute. 
Results. In Russia, 9 epidemics of COVID-19 and 4 inter-epidemic periods have been egistered in 5 years, the first in the summer of 2022, then in 2023, 2024 and in 2025 (from January to May). There are similar trends in reducing morbidity and mortality in epidemics and inter–epidemic periods: at the same time, the dynamics of epidemics shows an increase in morbidity in the first 5 waves, and from the sixth – a decrease, and an increase in mortality with a peak in the fourth wave, and in the fifth – a decrease in mortality to a minimum in the ninth wave. In the dynamics of epidemics in St. Petersburg, 54 cities and the Russian Federation as a whole, the coefficients of the trend of increasing morbidity were lower (k=215, k=119.3, k=87.3) than the decrease in morbidity (k = -250, k = -134.8, k = -108.5). The coefficients of the trend lines of increased mortality from COVID-19 were greater (from k = 20 to k = 162) than the decrease (from k = -15.3 to k = -29), and in interepidemic periods, morbidity (from k=-5 to k=-10.5) and mortality (from k = -1.6 to k = -19.8). The first interepidemic period was shorter and higher in morbidity and mortality than the subsequent ones. The incidence rates, as well as the coefficients of the trend lines of increased incidence, were higher in the North-Western, Far Eastern, Siberian and Ural Federal Districts than in Central, Volga, Southern, and North Caucasian. During periods of epidemics, there was a tendency for the proportion of children to increase among those who became ill, especially 7–14 years old (k = 1), and among those who died – people over 65 years old (k = 1.6), and in inter-epidemic periods, the proportion of people aged 15 –64 years (k = 2) and children 0 –2 years (k = 1.5), and among the deceased – the proportion of people aged 15–64 years (k = 2.5). 
Conclusions. The predominant development of the COVID-19 epidemics in the autumn-winter seasons (6 versus 3), the high intensity of the epidemics of the autumn-winter season in terms of duration and incidence over the entire period and at its peak, and the presence of 4 inter-epidemic periods (3 of them in summer) indicate the seasonal nature of the COVID-19. 

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