Life expectancy in India was 25.4 in the year 1800, and over the course of the next 220 years, it has increased to almost 70. Between 1800 and 1920, life expectancy in India remained in the mid to low twenties, with the largest declines coming in the 1870s and 1910s; this was because of the Great Famine of 1876-1878, and the Spanish Flu Pandemic of 1918-1919, both of which were responsible for the deaths of up to six and seventeen million Indians respectively; as well as the presence of other endemic diseases in the region, such as smallpox. From 1920 onwards, India's life expectancy has consistently increased, but it is still below the global average.

The Indian state with the highest projected life expectancy at birth from 2031 to 2036 was Kerala with **** years. Kerala also reflected the overall highest projected life expectancy from 2009 to 2036. By contrast, the state with the lowest projected life expectancy at birth from 2031 to 2036 was Uttar Pradesh with **** years. The state with the overall lowest projected projected life expectancy from 2009 to 2036 were the North Eastern states excluding Assam.

Objectives: From the beginning of the COVID-19 pandemic, clinical practice and research, globally, have centered on the prevention of transmission and treatment of the disease. The pandemic has had a huge impact on the economy and stressed the healthcare systems worldwide. The present study estimates Disability-Adjusted Life Years (DALYs), Years of Potential Productive Life Lost (YPPLL), and Cost of Productivity Lost (CPL) due to premature mortality and absenteeism, secondary to COVID-19 in Kerala state, India.

Setting: Details on sociodemography, incidence, death, quarantine, recovery time, etc were derived from public sources and CODD-K for Kerala. The working proportion for 5-year age-gender cohorts and corresponding life expectancy were obtained from the Census of India 2011.

Primary and secondary outcome measures: The impact of disease was computed through model based analysis on various age-gender cohorts. Sensitivity Analysis has been conducted by adjusting six variables across 21 scenarios. We present two estimates, one till November 15, 2020, and later updated till June 10, 2021.

Results: Severity of infection and mortality were higher among the older cohorts, with males being more susceptible than females in most sub-groups. The DALYs for males and females were 15954.5 and 8638.4 till November 15, 2020, and 83853.0 and 56628.3 till June 10, 2021. The corresponding YPPLL were 1323.57 and 612.31 till November 15, 2020, and 6993.04 and 3811.57 till June 10, 2021 and CPL (premature mortality) were 263780579.94 and 41836001.82 till November 15, 2020, and 1419557903.76 and 278275495.29 till June 10, 2021.

Conclusions: Most of the COVID-19 disease burden was contributed by YLL. Losses due to YPPLL were reduced as the impact of COVID-19 infection was lesser among productive cohorts. CPL values for 40-49 year-olds were the highest. These estimates provide the data necessary for policymakers to work on, to reduce the economic burden of COVID-19 in Kerala.