Temporal variation of excess deaths from diabetes during the COVID-19 pandemic in the United States

The impact of the COVID-19 pandemic and associated disruptions in health-care provision on clinical outcomes in people with diabetes: a systematic review

The COVID-19 pandemic triggered disruptions to health care and lifestyles that could conceivably impact diabetes management. We set out to identify the impact of disruptions caused by COVID-19 on clinical outcomes in people with diabetes. We performed a systematic review of the available literature in the MEDLINE and OVID databases from Jan 1, 2020, to June 7, 2023, and included 138 studies (n>1 000 000 people). All but five studies were judged to be at some risk of bias. All studies compared prepandemic with pandemic periods. All-cause mortality (six studies) and diabetes-related mortality (13 studies) showed consistent increases, and most studies indicated increases in sight loss (six studies). In adult and mixed samples, data generally suggested no difference in diabetic ketoacidosis frequency or severity, whereas in children and adolescents most studies showed increases with some due to new-onset diabetes (69 studies). Data suggested decreases in hospital admissions in adults but increases in diabetes-related admissions to paediatric intensive care units (35 studies). Data were equivocal on diabetic foot ulcer presentations (nine studies), emergency department admissions (nine studies), and overall amputation rates (20 studies). No studies investigated renal failure. Where reported, the impact was most pronounced for females, younger people, and racial and ethnic minority groups. Further studies are needed to investigate the longer-term impact of the pandemic and the on potential differential impacts, which risk further exacerbating existing inequalities within people with diabetes.

A comprehensive analysis of all-cause and cause-specific excess deaths in 30 countries during 2020

The impact of COVID-19 on mortality from specific causes of death remains poorly understood. This study analysed cause-of-death data provided by the World Health Organization from 2011 to 2019 to estimate excess deaths in 2020 in 30 countries. Over-dispersed Poisson regression models were used to estimate the number of deaths that would have been expected if the pandemic had not occurred, separately for men and women. The models included year and age categories to account for temporal trends and changes in size and age structure of the populations. Excess deaths were calculated by subtracting observed deaths from expected ones. Our analysis revealed significant excess deaths from ischemic heart diseases (IHD) (in 10 countries), cerebrovascular diseases (CVD) (in 10 countries), and diabetes (in 19 countries). The majority of countries experienced excess mortality greater than 10%, including Mexico (+ 38·8% for IHD, + 34·9% for diabetes), Guatemala (+ 30·0% for IHD, + 10·2% for CVD, + 39·7% for diabetes), Cuba (+ 18·8% for diabetes), Brazil (+ 12·9% for diabetes), the USA (+ 15·1% for diabetes), Slovenia (+ 33·8% for diabetes), Poland (+ 30·2% for IHD, + 19·5% for CVD, + 26 1% for diabetes), Estonia (+ 26·9% for CVD, + 34·7% for diabetes), Bulgaria (+ 22·8% for IHD, + 11·4% for diabetes), Spain (+ 19·7% for diabetes), Italy (+ 18·0% for diabetes), Lithuania (+ 17·6% for diabetes), Finland (+ 13·2% for diabetes) and Georgia (+ 10·7% for IHD, + 19·0% for diabetes). In 2020, 22 out of 30 countries had a significant increase in total mortality. Some of this excess was attributed to COVID-19, but a substantial increase was also observed in deaths attributed to cardiovascular diseases and diabetes.

Unique SARS-CoV-2 Variants, Tourism Metrics, and B.1.2 Emergence in Early COVID-19 Pandemic: A Correlation Analysis in South Dakota

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus, which is the source of the coronavirus disease 2019 (COVID-19), was declared a pandemic in the March of 2020. Travel and tourism were severely impacted as restrictions were imposed to help slow the disease spread, but some states took alternative approaches to travel restrictions. This study investigated the spread of COVID-19 in South Dakota during the early pandemic period to better understand how tourism affected the movement of the virus within the region. Sequences from the fall of 2020 were retrieved from public sources. CDC and other sources were used to determine infections, deaths, and tourism metrics during this time. The data were analyzed using correlation and logistic regression. This study found that the number of unique variants per month was positively correlated with hotel occupancy, but not with the number of cases or deaths. Interestingly, the emergence of the B.1.2 variant in South Dakota was positively correlated with increased case numbers and deaths. Data show that states with a shelter-in-place order were associated with a slower emergence of the B.1.2 variant compared to states without such an order, including South Dakota. Findings suggest complex relationships between tourism, SARS-CoV-2 infections, and mitigation strategies. The unique approach that South Dakota adopted provided insights into the spread of the disease in areas without state-wide restrictions. Our results suggest both positive and negative aspects of this approach. Finally, our data highlight the need for future surveillance efforts, including efforts focused on identifying variants with known increased transmission potential to produce effective population health management.