Introduction and objective: The COVID-19 pandemic had a significant disease burden on the healthcare system worldwide. There is limited reliable national data on COVID-19 associated morbidity, mortality, and healthcare costs in Latin America. This study explored the COVID-19 disease and economic burden in Argentina, Brazil, Chile, Colombia, Mexico, and Peru in the pre-vaccination period.  Methods: We analyzed national databases and conducted a systematic review of the published literature on COVID-19 in adults aged 18 years and above. We reported cases, death rates, years of life lost, and excess mortality associated with COVID-19 in pre-vaccination period. In addition, we used a cost of illness analysis to estimate the direct medical costs associated with COVID-19. All costs are reported in US dollars as of 2023.  Results: Before the national COVID vaccination program rollout, the average incidence rate of COVID-19 in adults aged 18 and above was 6,741 per 100,000 persons. Approximately 91% of the cases were mild, 7% were moderate/severe, and 2% were critical. Among 2,201,816 hospitalized cases, 27.8% were in intensive care, and 17.5% required mechanical ventilation. The country-specific data varied greatly across Latin American countries, with hospitalization admission: 469-18,096 per 100,000, excess mortality: 76-557 per 100,000, and years of life lost: 241,089-3,312,346. Direct medical costs ranged from US$258 million to US$10,437 million, representing approximately 2%-5% of national health expenditure. Conclusion. COVID-19 imposed a substantial public health and economic burden on Latin American countries during the pre-vaccination period. The findings should help policymakers to make informed decisions and allocate resources effectively to improve national strategies around surveillance, preventive and treatment strategies to control the spread of COVID-19 disease in the future

I have read the journal's policy and Julia Spinardi Moe H. Kyaw Carlos Fernando Mendoza Carolina M. Carballo, and Celina G. Vega have the following competing interests: they are employees of Pfizer. The rest of the authors have declared that no competing interests exist.

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