Excess deaths in people with cardiovascular diseases during the COVID-19 pandemic.
Excess deaths in people with cardiovascular diseases during the COVID-19 pandemic.
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DOI：
10.1093/eurjpc/zwaa155
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发表时间：
2021-12-20
影响因子：
8.3
通讯作者：
Hemingway H
中科院分区：
文献类型：
--
作者：
Banerjee A;Chen S;Pasea L;Lai AG;Katsoulis M;Denaxas S;Nafilyan V;Williams B;Wong WK;Bakhai A;Khunti K;Pillay D;Noursadeghi M;Wu H;Pareek N;Bromage D;McDonagh TA;Byrne J;Teo JTH;Shah AM;Humberstone B;Tang LV;Shah ASV;Rubboli A;Guo Y;Hu Y;Sudlow CLM;Lip GYH;Hemingway H
心血管疾病 (CVD) 会增加冠状病毒感染 (COVID-19) 的死亡风险。人们还担心大流行影响了急性心血管护理的供需。我们估计了特定心血管疾病的超额死亡率，包括通过感染“直接”和通过医疗保健变化“间接”。我们使用 (i) 英格兰和威尔士的全国死亡率数据来调查非 COVID-19 和 CVD 超额死亡的趋势； (ii) 来自英国 (n = 2)、意大利 (n = 1) 和中国 (n = 5) 医院的常规数据，用于评估大流行病对 CVD 转诊、诊断和治疗服务的间接影响； (iii) 来自英格兰 3 862 012 人的基于人群的电子健康记录，用于调查发生和流行 CVD 患者在 COVID-19 之前和之后的死亡率。我们纳入了 COVID-19 之前的风险（按年龄、性别和合并症）、估计的人群 COVID-19 患病率以及 CVD 和 COVID-19 患者与 CVD 和非感染者相比的估计死亡相对风险 (RR)（RR：1.2、1.5、2.0 和 3.0）。死亡率数据表明对 CVD 的间接影响将是延迟的，而不是同时发生的（峰值 RR 1.14）。中国、意大利和英国的八家医院的 CVD 服务活动与大流行前水平相比下降了 60-100%。在中国，即使在放松封锁之后，经济活动在 2-3 个月内仍低于 COVID-19 之前的水平，而意大利和英国的经济活动仍然减少。对于总 CVD（发病率和流行率），在 COVID-19 患病率为 10% 的情况下，我们估计英格兰有 31 205 例和 62 410 例超额死亡（RR 分别为 1.5 和 2.0）的直接影响，以及 49 932 到 99 865 例死亡的间接影响。各国对心血管疾病服务的供应和需求都急剧减少，在大流行期间和之后可能会出现大量但可以避免的死亡率过高。
Cardiovascular diseases (CVDs) increase mortality risk from coronavirus infection (COVID-19). There are also concerns that the pandemic has affected supply and demand of acute cardiovascular care. We estimated excess mortality in specific CVDs, both ‘direct’, through infection, and ‘indirect’, through changes in healthcare. We used (i) national mortality data for England and Wales to investigate trends in non-COVID-19 and CVD excess deaths; (ii) routine data from hospitals in England (n = 2), Italy (n = 1), and China (n = 5) to assess indirect pandemic effects on referral, diagnosis, and treatment services for CVD; and (iii) population-based electronic health records from 3 862 012 individuals in England to investigate pre- and post-COVID-19 mortality for people with incident and prevalent CVD. We incorporated pre-COVID-19 risk (by age, sex, and comorbidities), estimated population COVID-19 prevalence, and estimated relative risk (RR) of mortality in those with CVD and COVID-19 compared with CVD and non-infected (RR: 1.2, 1.5, 2.0, and 3.0). Mortality data suggest indirect effects on CVD will be delayed rather than contemporaneous (peak RR 1.14). CVD service activity decreased by 60–100% compared with pre-pandemic levels in eight hospitals across China, Italy, and England. In China, activity remained below pre-COVID-19 levels for 2–3 months even after easing lockdown and is still reduced in Italy and England. For total CVD (incident and prevalent), at 10% COVID-19 prevalence, we estimated direct impact of 31 205 and 62 410 excess deaths in England (RR 1.5 and 2.0, respectively), and indirect effect of 49 932 to 99 865 deaths. Supply and demand for CVD services have dramatically reduced across countries with potential for substantial, but avoidable, excess mortality during and after the pandemic.
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DOI：
10.15585/mmwr.mm6915e3
发表时间：
2020-04-17
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Garg S;Kim L;Whitaker M;O'Halloran A;Cummings C;Holstein R;Prill M;Chai SJ;Kirley PD;Alden NB;Kawasaki B;Yousey-Hindes K;Niccolai L;Anderson EJ;Openo KP;Weigel A;Monroe ML;Ryan P;Henderson J;Kim S;Como-Sabetti K;Lynfield R;Sosin D;Torres S;Muse A;Bennett NM;Billing L;Sutton M;West N;Schaffner W;Talbot HK;Aquino C;George A;Budd A;Brammer L;Langley G;Hall AJ;Fry A
通讯作者：
Fry A
影响因子：
39.3
作者：
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通讯作者：
Indolfi, Ciro
DOI：
10.1001/jama.2020.6775
发表时间：
2020-01-01
期刊：
JAMA, Journal of the American Medical Association
影响因子：
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作者：
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通讯作者：
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DOI：
10.1016/s0140-6736(18)32335-3
发表时间：
2018-11-10
期刊：
Lancet (London, England)
影响因子：
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作者：
GBD 2017 DALYs and HALE Collaborators
通讯作者：
GBD 2017 DALYs and HALE Collaborators
DOI：
10.1093/jamia/ocz105
发表时间：
2019-12-01
影响因子：
6.4
作者：
Denaxas, Spiros;Gonzalez-Izquierdo, Arturo;Hemingway, Harry
通讯作者：
Hemingway, Harry