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Alicandro G, La Vecchia C, Islam N, Pizzato M. A comprehensive analysis of all-cause and cause-specific excess deaths in 30 countries during 2020. Eur J Epidemiol 2023; 38:1153-1164. [PMID: 37684387 PMCID: PMC10663248 DOI: 10.1007/s10654-023-01044-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 08/12/2023] [Indexed: 09/10/2023]
Abstract
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.
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Affiliation(s)
- Gianfranco Alicandro
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
- Cystic Fibrosis Centre, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Nazrul Islam
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Margherita Pizzato
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
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Wu J, Wang Z, Xu H, Yang L, Liu J, Zheng Y, Kang C, Wang X, Shi J, Zhao N, Zhang XY. Thyroid dysfunction in young, first-episode and drug-naïve patients with major depressive disorder: prevalence and associated clinical factors. Front Psychiatry 2023; 14:1156481. [PMID: 37457778 PMCID: PMC10348838 DOI: 10.3389/fpsyt.2023.1156481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/15/2023] [Indexed: 07/18/2023] Open
Abstract
Objective The incidence of thyroid dysfunction (TD) and major depressive disorder (MDD) is increasing year by year in the general population. However, the prevalence and correlates of TD in first-episode drug-naive (FEDN) MDD patients have not been explored. This study sought to fill this gap and examine the association between TD and MDD. Methods We recruited 1,289 FEDN MDD patients aged 18 ~ 45 years. A total of 1,289 FEDN MDD outpatients were recruited. Demographical and suicide data were collected for each patient, and lipid profiles, thyroid function, and fasting blood glucose (FBG) levels were measured. The Hamilton Depression Scale 17 (HAMD-17) was assessed for depression. Results The prevalence of TD in young FEDN MDD patients was 64.86%. Compared with those without TD, patients with TD had longer duration of illness, greater HAMD score, higher BMI, TG, TC, and LDL-C levels, and higher suicide attempt rates, but lower HDL-C and FBG levels. Further logistic regression indicated that duration of illness, HAMD score, TC, HDL-C, BMI, and FBG levels were significantly associated with TD. Limitations No causal relationship can be drawn due to the cross-sectional design. Conclusion TD is common in young FEDN MDD patients. So clinicians should monitor thyroid function in patients with MDD.
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Affiliation(s)
- Jinbo Wu
- First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | | | - Hongjiao Xu
- Qingdao Mental Health Center, Qingdao, China
| | - Liying Yang
- Dalian No.7 People's Hospital, Dalian, Liaoning Province, China
| | - Jiacheng Liu
- First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Yue Zheng
- Peking University Sixth Hospital, Beijing, China
| | - Chuanyi Kang
- First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Xiaohong Wang
- First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Jingjing Shi
- First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Na Zhao
- First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Xiang Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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Colombo D, Del Nonno F, Marchioni L, Lalle E, Gallì P, Vaia F, Falasca L. Autopsies Revealed Pathological Features of COVID-19 in Unvaccinated vs. Vaccinated Patients. Biomedicines 2023; 11:biomedicines11020551. [PMID: 36831087 PMCID: PMC9953314 DOI: 10.3390/biomedicines11020551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 02/10/2023] [Accepted: 02/11/2023] [Indexed: 02/16/2023] Open
Abstract
Background: In Italy, by the end of 2021, a new pandemic wave led to increased hospitalizations and death, even in some vaccinated people. We aimed to investigate the death of COVID-19-vaccinated patients who acquired infection and developed severe disease, and to assess differences with fatal COVID-19 in unvaccinated subjects by studying the pathological events triggered by SARS-CoV-2. Methods: Detailed autoptic examination was performed on five fully vaccinated compared to five unvaccinated patients. Histopathological analysis focused on the lung and heart, the two major affected organs. Results: COVID-19 caused, or contributed to death, in all the unvaccinated cases. By contrast, in vaccinated group, pre-existing pathologies played a major role, and death was not COVID-19-related in four out of five patients. These patients did not show the histological features of SARS-CoV-2 lung damage. Diffuse inflammatory macrophages infiltration recently emerged as the main feature of COVID-19 cardiac injury. Interestingly, the most striking difference between the two groups was the absence of increased macrophage infiltration in the heart of vaccinated patients. Conclusions: Results of this study confirm the efficacy of anti-SARS-CoV-2 vaccination in protecting organs from injury and support the need to maintain an adequate immune response by booster dose administration.
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Affiliation(s)
- Daniele Colombo
- Pathology Unit, National Institute for Infectious Diseases “Lazzaro Spallanzani”-IRCCS, 00149 Rome, Italy
| | - Franca Del Nonno
- Pathology Unit, National Institute for Infectious Diseases “Lazzaro Spallanzani”-IRCCS, 00149 Rome, Italy
| | - Luisa Marchioni
- Clinical Department, National Institute for Infectious Diseases “Lazzaro Spallanzani”-IRCCS, 00149 Rome, Italy
| | - Eleonora Lalle
- Laboratory of Virology, National Institute for Infectious Diseases “Lazzaro Spallanzani”-IRCCS, 00149 Rome, Italy
| | - Paola Gallì
- Health Direction, National Institute for Infectious Diseases “Lazzaro Spallanzani”-IRCCS, 00149 Rome, Italy
| | - Francesco Vaia
- Health Direction, National Institute for Infectious Diseases “Lazzaro Spallanzani”-IRCCS, 00149 Rome, Italy
| | - Laura Falasca
- Laboratory of Electron Microscopy, National Institute for Infectious Diseases “Lazzaro Spallanzani”-IRCCS, 00149 Rome, Italy
- Correspondence:
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Fauvel C, Trimaille A, Weizman O, Pezel T, Mika D, Waldmann V, Cohen A, Bonnet G. Cardiovascular manifestations secondary to COVID-19: A narrative review. Respir Med Res 2022; 81:100904. [PMID: 35525097 PMCID: PMC9065692 DOI: 10.1016/j.resmer.2022.100904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/01/2022] [Accepted: 03/08/2022] [Indexed: 02/07/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has spread rapidly, becoming a major threat to global health. In addition to having required the adaptation of healthcare workers for almost 2 years, it has been much talked about, both in the media and among the scientific community. Beyond lung damage and respiratory symptoms, the involvement of the cardiovascular system largely explains COVID-19 morbimortality. In this review, we emphasize that cardiovascular involvement is common and is associated with a worse prognosis, and that earlier detection by physicians should lead to better management. First, direct cardiac involvement will be discussed, in the form of COVID-19 myocarditis, then secondary cardiac involvement, such as myocardial injury, myocardial infarction and arrhythmias, will be considered. Finally, worsening of previous cardiovascular disease as a result of COVID-19 will be examined, as well as long-term COVID-19 effects and cardiovascular complications of COVID-19 vaccines.
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Affiliation(s)
- C. Fauvel
- Cardiology Department, Rouen University Hospital, Rouen 76000, France,Division of Cardiovascular Medicine, Wexner Medical Center, The Ohio State University, 410 West 10th Avenue, Columbus, OH 43210, USA,Corresponding author at: Division of Cardiovascular Medicine, Wexner Medical Center, The Ohio State University, 410 West 10th Avenue, Columbus, OH 43210, USA
| | - A. Trimaille
- Department of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg 67000, France
| | - O. Weizman
- Cardiology Department, Institut Lorrain du Cœur et des Vaisseaux, CHU de Nancy, 54500, France
| | - T. Pezel
- Cardiology Department, Lariboisière Hospital, AP-HP, Université de Paris, Paris 75010, France
| | - D. Mika
- Paris-Saclay University, Inserm, UMR-S 1180, Châtenay-Malabry 92296, France
| | - V. Waldmann
- Cardiology Department, Hôpital Européen Georges Pompidou, Université de Paris, Paris 75015, France
| | - A. Cohen
- Department of Cardiology, Saint Antoine and Tenon Hospital, AP-HP, INSERM UMRS-ICAN 1166 and Sorbonne University, Paris, France
| | - G. Bonnet
- Université de Bordeaux, 33000, France,Service Médico-Chirurgicale de Valvulopathies et Cardiomyopathies, Hôpital Cardiologique Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac 33600, France
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Ling RR, Ramanathan K, Tan FL, Tai BC, Somani J, Fisher D, MacLaren G. Myopericarditis following COVID-19 vaccination and non-COVID-19 vaccination: a systematic review and meta-analysis. The Lancet Respiratory Medicine 2022; 10:679-688. [PMID: 35421376 PMCID: PMC9000914 DOI: 10.1016/s2213-2600(22)00059-5] [Citation(s) in RCA: 90] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/09/2022] [Accepted: 02/09/2022] [Indexed: 12/17/2022]
Abstract
Background Myopericarditis is a rare complication of vaccination. However, there have been increasing reports of myopericarditis following COVID-19 vaccination, especially among adolescents and young adults. We aimed to characterise the incidence of myopericarditis following COVID-19 vaccination, and compare this with non-COVID-19 vaccination. Methods We did a systematic review and meta-analysis, searching four international databases from Jan 1, 1947, to Dec 31, 2021, for studies in English reporting on the incidence of myopericarditis following vaccination (the primary outcome). We included studies reporting on people in the general population who had myopericarditis in temporal relation to receiving vaccines, and excluded studies on a specific subpopulation of patients, non-human studies, and studies in which the number of doses was not reported. Random-effects meta-analyses (DerSimonian and Laird) were conducted, and the intra-study risk of bias (Joanna Briggs Institute checklist) and certainty of evidence (Grading of Recommendations, Assessment, Development and Evaluations approach) were assessed. We analysed the difference in incidence of myopericarditis among subpopulations, stratifying by the type of vaccine (COVID-19 vs non-COVID-19) and age group (adult vs paediatric). Among COVID-19 vaccinations, we examined the effect of the type of vaccine (mRNA or non-mRNA), sex, age, and dose on the incidence of myopericarditis. This study was registered with PROSPERO (CRD42021275477). Findings The overall incidence of myopericarditis from 22 studies (405 272 721 vaccine doses) was 33·3 cases (95% CI 15·3–72·6) per million vaccine doses, and did not differ significantly between people who received COVID-19 vaccines (18·2 [10·9–30·3], 11 studies [395 361 933 doses], high certainty) and those who received non-COVID-19 vaccines (56·0 [10·7–293·7], 11 studies [9 910 788 doses], moderate certainty, p=0·20). Compared with COVID-19 vaccination, the incidence of myopericarditis was significantly higher following smallpox vaccinations (132·1 [81·3–214·6], p<0·0001) but was not significantly different after influenza vaccinations (1·3 [0·0–884·1], p=0·43) or in studies reporting on various other non-smallpox vaccinations (57·0 [1·1–3036·6], p=0·58). Among people who received COVID-19 vaccines, the incidence of myopericarditis was significantly higher in males (vs females), in people younger than 30 years (vs 30 years or older), after receiving an mRNA vaccine (vs non-mRNA vaccine), and after a second dose of vaccine (vs a first or third dose). Interpretation The overall risk of myopericarditis after receiving a COVID-19 vaccine is low. However, younger males have an increased incidence of myopericarditis, particularly after receiving mRNA vaccines. Nevertheless, the risks of such rare adverse events should be balanced against the risks of COVID-19 infection (including myopericarditis). Funding None.
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Affiliation(s)
- Ryan Ruiyang Ling
- Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
| | - Kollengode Ramanathan
- Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore; Cardiothoracic Intensive Care Unit, National University Heart Centre, National University Hospital, Singapore.
| | - Felicia Liying Tan
- Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
| | - Bee Choo Tai
- Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore
| | - Jyoti Somani
- Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore; Division of Infectious Diseases, Department of Medicine, National University Hospital, Singapore
| | - Dale Fisher
- Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore; Division of Infectious Diseases, Department of Medicine, National University Hospital, Singapore
| | - Graeme MacLaren
- Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore; Cardiothoracic Intensive Care Unit, National University Heart Centre, National University Hospital, Singapore
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