Excess diabetes mellitus-related deaths during the COVID-19 pandemic in the United States.
Excess diabetes mellitus-related deaths during the COVID-19 pandemic in the United States.
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DOI：
10.1016/j.eclinm.2022.101671
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发表时间：
2022-12
影响因子：
15.1
通讯作者：
Ji, Fanpu
中科院分区：
文献类型：
--
作者：
Lv, Fan;Gao, Xu;Huang, Amy Huaishiuan;Zu, Jian;He, Xinyuan;Sun, Xiaodan;Liu, Jinli;Gao, Ning;Jiao, Yang;Keane, Margaret G.;Zhang, Lei;Yeo, Yee Hui;Wang, Youfa;Ji, Fanpu
糖尿病 (DM) 是严重 SARS-CoV-2 感染的关键危险因素，而 SARS-CoV-2 感染会导致血糖控制恶化。 COVID-19 大流行严重扰乱了糖尿病患者的护理服务。我们的目的是确定大流行期间与糖尿病相关的死亡趋势。在这项2006年1月1日至2021年12月31日期间基于人群的系列研究中，分析了国家人口动态统计系统数据集中年龄≥25岁死者的死亡率数据。死亡证明上以糖尿病为根本死因或促成死因的死者被定义为糖尿病相关死亡。通过将 2006-2019 年死亡率得出的观察到的年龄标准化死亡率与线性和多项式回归模型进行比较，估算超额死亡人数。通过连接点回归分析对死亡率趋势进行量化。按年龄、性别、种族/民族和州进行亚组分析。 2006年至2021年期间，有4·2500万例糖尿病相关死亡，其中大流行期间死亡率大幅飙升30％以上，从2019年的106·8（每10万人）增加到2020年的144·1和2021年的148·3。25-44岁的成年人死亡率上升最明显。种族/族裔差距扩大，西班牙裔的超额死亡率最高（67·5%；95% CI 60·9-74·7%），几乎是非西班牙裔白人的三倍（23·9%；95% CI 21·2-26·7%）。在大流行期间，美国与糖尿病相关的死亡率有所增加。年轻人的不成比例增长和种族/民族差距的扩大需要不同利益相关者采取紧急预防性干预措施。国家自然科学基金委。
Diabetes mellitus (DM) is a critical risk factor for severe SARS-CoV-2 infection, and SARS-CoV-2 infection contributes to worsening glycemic control. The COVID-19 pandemic profoundly disrupted the delivery of care for patients with diabetes. We aimed to determine the trend of DM-related deaths during the pandemic. In this serial population-based study between January 1, 2006 and December 31, 2021, mortality data of decedents aged ≥25 years from the National Vital Statistics System dataset was analyzed. Decedents with DM as the underlying or contributing cause of death on the death certificate were defined as DM-related deaths. Excess deaths were estimated by comparing observed versus expected age-standardized mortality rates derived from mortality during 2006-2019 with linear and polynomial regression models. The trends of mortality were quantified with joinpoint regression analysis. Subgroup analyses were performed by age, sex, race/ethnicity, and state. Among 4·25 million DM-related deaths during 2006-2021, there was a significant surge of more than 30% in mortality during the pandemic, from 106·8 (per 100,000 persons) in 2019 to 144·1 in 2020 and 148·3 in 2021. Adults aged 25-44 years had the most pronounced rise in mortality. Widened racial/ethnic disparity was observed, with Hispanics demonstrating the highest excess deaths (67·5%; 95% CI 60·9-74·7%), almost three times that of non-Hispanic whites (23·9%; 95% CI 21·2-26·7%). The United States saw an increase in DM-related mortality during the pandemic. The disproportionate rise in young adults and the widened racial/ethnic disparity warrant urgent preventative interventions from diverse stakeholders. National Natural Science Foundation of China.
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