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Bloomberg L, Hong P, Hepburn C, Kaboff A, Fayad M, Varda B, Joyce C, Cotler S, Rubin J. Changes in provider responsibilities and associated outcomes for cirrhotic patients with telehealth: A single-center, retrospective study. J Telemed Telecare 2025:1357633X251323185. [PMID: 40080886 DOI: 10.1177/1357633x251323185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2025]
Abstract
BackgroundStudies show satisfaction with telemedicine, but there is limited data regarding changes in provider practices and clinical outcomes. We sought to evaluate the impact of telehealth on patient-provider communications between visits and clinical outcomes in patients with cirrhosis during the COVID-19 pandemic.MethodsSingle-center retrospective study of cirrhotic patients seen outpatient in 2019 and 2020 was conducted. Clinical characteristics, provider practices, and clinical outcomes were obtained. Provider practices included medication adjustments, labs ordered, and patient communication. Clinical outcomes included ED visits, hospitalizations, and mortality.ResultsTotally, 1395 patients were included with a mean age of 61, 51% female, and 73% Caucasian. The median baseline model for end-stage liver disease (MELD-Na) score was 10. During 2019 there were no telehealth visits. In 2020, 37% of clinic visits were telehealth and 64% of patients had at least one telehealth visit. The rate of medication changes significantly decreased in 2020. There was no significant difference in number of clinic visits, labs ordered, emergency department visits, hospitalizations, or intensive care unit (ICU) stays between 2019 and 2020. In 2020, the rate of telephone contacts and patient messages significantly increased. Compared to 2019, the odds of death were 2.6 times higher in 2020.ConclusionWhen a majority of cirrhotic patients had a telehealth visit, patients had similar rates of emergency department visits, hospitalizations, and ICU stays, but a higher rate of mortality compared to patients with in-person visits. Telehealth was associated with more patient contact between visits, increasing communication demands on providers.
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Affiliation(s)
- Lauren Bloomberg
- Department of Internal Medicine, Division of Gastroenterology, Loyola University Medical Center, Maywood, IL, USA
| | - Paul Hong
- Department of Internal Medicine, Division of Gastroenterology, Northshore University Health System, Evanston, IL, USA
| | - Corrin Hepburn
- Department of Internal Medicine, Loyola University Medical Center, Maywood, IL, USA
| | - Austin Kaboff
- Department of Internal Medicine, Loyola University Medical Center, Maywood, IL, USA
| | - Michael Fayad
- Department of Internal Medicine, Division of Gastroenterology, University of Illinois, Chicago, IL, USA
| | - Bianca Varda
- Department of Internal Medicine, Division of Gastroenterology, Rush University Medical Center, Chicago, IL, USA
| | - Cara Joyce
- Department of Biostatistics, Loyola University, Maywood, IL, USA
| | - Scott Cotler
- Department of Internal Medicine, Division of Hepatology, Loyola University Medical Center, Maywood, IL, USA
| | - Jonah Rubin
- Department of Internal Medicine, Division of Hepatology, Loyola University Medical Center, Maywood, IL, USA
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2
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Vashist K, Frediani JK, Weber MB, Ali MK, Narayan KMV, Patel SA. Changes in diabetes care and management practices during the COVID-19 pandemic. J Public Health (Oxf) 2025; 47:e20-e27. [PMID: 39521444 DOI: 10.1093/pubmed/fdae287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 09/17/2024] [Accepted: 10/26/2024] [Indexed: 11/16/2024] Open
Abstract
BACKGROUND We examined changes in diabetes care and management practices before and during the COVID-19 pandemic. METHODS Population-based data regarding four diabetes-related healthcare engagement and four self-management indicators were obtained from adults with diabetes surveyed in 19 US States and Washington DC through the Behavioral Risk Factor Surveillance System. Using logistic regression, we estimated changes in the prevalence of each indicator, overall and by sociodemographic subgroups in 2019 (before the pandemic) and 2021 (during the pandemic). RESULTS Between 2019 and 2021, the prevalence of biannual HbA1c tests reduced by 2.6 percentage points (pp; 95% confidence interval: -4.8, -0.4), from 75.4% to 73.1%, and prevalence of annual eye exams fell by 4.0 pp (-6.2, -2.8), from 72.2% to 68.7%. The composite indicator of engagement with healthcare for diabetes control fell by 3.5 pp (-5.9, -1.1), from 44.9% to 41.9%. Of self-management behaviors, avoidance of smoking increased by 2.0 pp (0.4, 3.6) from 84.7% to 87.1%. CONCLUSIONS The findings suggest a deterioration of the uptake of evidence-based, preventive health services requiring laboratory services and clinical examination for diabetes control during the pandemic. On the other hand, smoking rates decreased, suggesting potential positive impacts of the pandemic on health behaviors in people with diabetes.
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Affiliation(s)
- Kushagra Vashist
- Emory Global Diabetes Research Center of Woodruff Health Sciences Center and Emory University, Atlanta, GA 30322, USA
| | - Jennifer K Frediani
- Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, GA 30322, USA
| | - Mary Beth Weber
- Emory Global Diabetes Research Center of Woodruff Health Sciences Center and Emory University, Atlanta, GA 30322, USA
| | - Mohammed K Ali
- Emory Global Diabetes Research Center of Woodruff Health Sciences Center and Emory University, Atlanta, GA 30322, USA
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA 30322, USA
| | - K M Venkat Narayan
- Emory Global Diabetes Research Center of Woodruff Health Sciences Center and Emory University, Atlanta, GA 30322, USA
| | - Shivani A Patel
- Emory Global Diabetes Research Center of Woodruff Health Sciences Center and Emory University, Atlanta, GA 30322, USA
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Philis-Tsimikas A, San Diego ERN, Vincent L, Lohnes S, Singleton C. Are we Ready for Real-Time Continuous Glucose Monitoring in the Hospital Setting? Benefits, Challenges, and Practical Approaches for Implementation : Case Vignette: Remote Real-Time Continuous Glucose Monitoring for Hospitalized Care in Quincy Koala. Curr Diab Rep 2024; 24:217-226. [PMID: 39126617 DOI: 10.1007/s11892-024-01549-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/16/2024] [Indexed: 08/12/2024]
Abstract
PURPOSE OF REVIEW While preliminary evidence for use of real-time continuous glucose monitoring (rtCGM) in the hospital setting is encouraging, challenges with currently available devices and technology will need to be overcome as part of real-world integration. This paper reviews the current evidence and guidelines regarding use of rtCGM in the hospital and suggests a practical approach to implementation. RECENT FINDINGS There is now a considerable body of real-world evidence on the benefits of reducing dysglycemia in the hospital using both traditional point-of-care (POC) glucose testing and rtCGM. Benefits of rtCGM include decreased frequency of hypo- and hyperglycemia with reduced need of frequent POC checks and it is both feasible and well-accepted by nursing staff and providers. If expansion to additional sites is to be considered, practical solutions will need to be offered. Recommendations for an operational workflow and tools are described to guide implementation in the non-ICU setting. Further testing in randomized controlled trials and real-world dissemination and implementation designs is needed, together with industry and technology collaborations, to further streamline the integration into health systems.
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Affiliation(s)
- Athena Philis-Tsimikas
- Scripps Whittier Diabetes Institute, 9834 Genesee Ave, Suite 300, La Jolla, CA, 92037, USA.
| | - Emily Rose N San Diego
- Scripps Whittier Diabetes Institute, 9834 Genesee Ave, Suite 300, La Jolla, CA, 92037, USA
- Scripps Research Translational Institute, La Jolla, CA, USA
| | - Lauren Vincent
- Scripps Whittier Diabetes Institute, 9834 Genesee Ave, Suite 300, La Jolla, CA, 92037, USA
- Scripps Health Inpatient Providers Medical Group, San Diego, CA, USA
| | - Suzanne Lohnes
- Scripps Whittier Diabetes Institute, 9834 Genesee Ave, Suite 300, La Jolla, CA, 92037, USA
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Nilsson A, Emilsson L, Kepp KP, Knudsen AKS, Forthun I, Madsen C, Björk J, Lallukka T. Cause-specific excess mortality in Denmark, Finland, Norway, and Sweden during the COVID-19 pandemic 2020-2022: a study using nationwide population data. Eur J Epidemiol 2024; 39:1037-1050. [PMID: 39285102 PMCID: PMC11470911 DOI: 10.1007/s10654-024-01154-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 08/16/2024] [Indexed: 10/13/2024]
Abstract
While there is substantial evidence on excess mortality in the first two years of the COVID-19 pandemic, no study has conducted a cause-specific analysis of excess mortality for the whole period 2020-2022 across multiple countries. We examined cause-specific excess mortality during 2020-2022 in Denmark, Finland, Norway, and Sweden-four countries with similar demographics and welfare provisions, which implemented different pandemic response policies. To this end, we utilized nationwide register-based information on annual cause-specific deaths stratified by age and sex, and applied linear regression models to predict mortality in 2020-2022 based on the reference period 2010-2019. Excess deaths were obtained by contrasting actual and expected deaths. Additional analyses employed standardization to a common population, as well as population adjustments to account for previous deaths. Our results showed that, besides deaths due to COVID-19 (a total of 32,491 during 2020-2022), all countries experienced excess deaths due to cardiovascular diseases (in total 11,610 excess deaths), and under-mortality due to respiratory diseases other than COVID-19 (in total 9878) and dementia (in total 8721). The excess mortality due to cardiovascular diseases was particularly pronounced in Finland and Norway in 2022, and the under-mortality due to dementia was particularly pronounced in Sweden in 2021-2022. In conclusion, while COVID-19 deaths emerge as the most apparent consequence of the pandemic, our findings suggest that mortality has also been influenced by substitutions between different causes of death and over time, as well as indirect consequences of COVID-19 infection and pandemic responses-albeit to different extents in the different countries.
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Affiliation(s)
- Anton Nilsson
- Epidemiology, Population Studies and Infrastructures (EPI@LUND), Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.
| | - Louise Emilsson
- General Practice Research Unit (AFE) and Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
- Vårdcentralen Värmlands Nysäter and Centre for Clinical Research, County Council of Värmland, Värmland, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Solna, Sweden
| | - Kasper P Kepp
- Section of Biophysical and Biomedicinal Chemistry, Technical University of Denmark, Copenhagen, Denmark
- Epistudia, Bern, Switzerland
| | | | - Ingeborg Forthun
- Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | - Christian Madsen
- Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | - Jonas Björk
- Epidemiology, Population Studies and Infrastructures (EPI@LUND), Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
- Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
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Slusser W, Schmidt L, Imbery C, Watson T, Moin T, Chobdee J, Alas S, Ezenwugo S, Sheean-Remotto G. Anchor universities as leaders in the well-being movement: lessons learned from the University of California Healthy Campus Network & pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-5. [PMID: 38848274 DOI: 10.1080/07448481.2024.2351407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 03/15/2024] [Accepted: 04/19/2024] [Indexed: 06/09/2024]
Abstract
The University of California (UC) Healthy Campus Network (HCN) is a robust network of diverse coalitions across 10 UC campuses, 5 UC teaching hospitals, and UC Agriculture & Natural Resources working to promote individual campus and systemwide changes toward a culture of health and equity. The success of this work has been evident in the HCN's ability to quickly pivot to meet emergent needs during the COVID-19 pandemic, including social support through the UC Diabetes Prevention Program, tap water access for essential workers through the UC Healthy Beverage Initiative, and food security efforts through the UC Global Food Initiative. Building a culture of health and equity across a large public university system generated valuable lessons learned which enhanced the UC's preparedness and resilience in the face of the pandemic, and other institutions may benefit from these best practices to respond effectively to emergencies and thrive in states of relative normalcy.
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Affiliation(s)
- Wendelin Slusser
- Chancellor's Office, University of California at Los Angeles, Los Angeles, California, USA
- David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA
- Jonathan and Karin Fielding School of Public Health, University of California at Los Angeles, Los Angeles, California, USA
| | - L Schmidt
- Philip R Lee Institute for Health Policy Studies and Department of Humanities and Social Sciences, University of California at San Francisco, San Francisco, California, USA
| | - C Imbery
- Chancellor's Office, University of California at Los Angeles, Los Angeles, California, USA
| | - T Watson
- Jonathan and Karin Fielding School of Public Health, University of California at Los Angeles, Los Angeles, California, USA
| | - T Moin
- David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA
- HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - J Chobdee
- Workplace Health & Wellness/Human Resources, University of California at Riverside, Riverside, California, USA
| | - S Alas
- Chancellor's Office, University of California at Los Angeles, Los Angeles, California, USA
| | - S Ezenwugo
- Chancellor's Office, University of California at Los Angeles, Los Angeles, California, USA
| | - G Sheean-Remotto
- Strategy and Program Management, University of California Office of the President, Oakland, California, USA
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Sagheb S, Gholamrezanezhad A, Pavlovic E, Karami M, Fakhrzadegan M. Country-based modelling of COVID-19 case fatality rate: A multiple regression analysis. World J Virol 2024; 13:87881. [PMID: 38616858 PMCID: PMC11008404 DOI: 10.5501/wjv.v13.i1.87881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/07/2023] [Accepted: 12/25/2023] [Indexed: 03/11/2024] Open
Abstract
BACKGROUND The spread of the severe acute respiratory syndrome coronavirus 2 outbreak worldwide has caused concern regarding the mortality rate caused by the infection. The determinants of mortality on a global scale cannot be fully understood due to lack of information. AIM To identify key factors that may explain the variability in case lethality across countries. METHODS We identified 21 Potential risk factors for coronavirus disease 2019 (COVID-19) case fatality rate for all the countries with available data. We examined univariate relationships of each variable with case fatality rate (CFR), and all independent variables to identify candidate variables for our final multiple model. Multiple regression analysis technique was used to assess the strength of relationship. RESULTS The mean of COVID-19 mortality was 1.52 ± 1.72%. There was a statistically significant inverse correlation between health expenditure, and number of computed tomography scanners per 1 million with CFR, and significant direct correlation was found between literacy, and air pollution with CFR. This final model can predict approximately 97% of the changes in CFR. CONCLUSION The current study recommends some new predictors explaining affect mortality rate. Thus, it could help decision-makers develop health policies to fight COVID-19.
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Affiliation(s)
- Soodeh Sagheb
- Department of Radiology, Seattle Children's Hospital, University of Washington, Seattle, WA 98145, United States
| | - Ali Gholamrezanezhad
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States
| | - Elizabeth Pavlovic
- Department of Nursing, University of New Brunswick, New Brunswick E3B 5A3, Canada
| | - Mohsen Karami
- Department of Orthopedics, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran 1516745811, Iran
| | - Mina Fakhrzadegan
- Department of Orthopedics, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran 1516745811, Iran
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Vashist K, Frediani JK, Weber MB, Ali MK, Narayan KMV, Patel SA. Changes in Diabetes Care and Management Practices during the COVID-19 Pandemic. RESEARCH SQUARE 2024:rs.3.rs-3849240. [PMID: 38313263 PMCID: PMC10836114 DOI: 10.21203/rs.3.rs-3849240/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
Background Evidence suggests diabetes management was negatively impacted early in the pandemic. However, the impact of the pandemic on key healthcare services for diabetes control and diabetes self-management practices is less known. We examined changes in diabetes care and management practices before and during the COVID-19 pandemic. Methods Population-based data regarding 4 diabetes-related healthcare engagement and 4 self-management indicators were obtained from adults with diabetes surveyed in 19 US States and Washington DC through the Behavioral Risk Factor Surveillance System. Using logistic regression, we estimated changes in the prevalence of each indicator, overall and by sociodemographic subgroups, before (2019; n = 15,307) and during (2021; n = 13,994) the COVID-19 pandemic. Results Between 2019 and 2021, the prevalence of biannual HbA1c tests reduced by 2.6 percentage points (pp, 95% CI :-4.8, -0.4), from 75.4-73.1%, and prevalence of annual eye exams fell by 4.0 pp (-6.2, -2.8), from 72.2-68.7%. The composite indicator of engagement with healthcare for diabetes control fell by 3.5 pp (-5.9, -1.1), from 44.9-41.9%. Reductions in engagement with healthcare were largely seen across sex, age, education, employment status, marital status, insurance status, and urbanicity; and were more pronounced among those aged 18-34 and the uninsured. Reductions in engagement with healthcare were seen in several states, with Delaware and Washington DC reporting the largest decrease. Of self-management behaviors, we only observed change in avoidance of smoking, an increase of 2.0 pp (0.4, 3.6) from 84.7-87.1%. Conclusions The pandemic had mixed impacts on diabetes care and self-management. The findings suggest a deterioration of the uptake of evidence-based, preventive health services requiring laboratory services and clinical examination for diabetes control during the pandemic. On the other hand, smoking rates decreased, suggesting potential positive impacts of the pandemic on health behaviors in people with diabetes.
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Seghieri G. Postrecovery COVID-19 and interlinking diabetes and cardiovascular events. MANAGEMENT, BODY SYSTEMS, AND CASE STUDIES IN COVID-19 2024:377-382. [DOI: 10.1016/b978-0-443-18703-2.00056-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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Resende BDS, Dias RM, Ferrari G, Rezende LFM. Excess mortality in adults from Sao Paulo during the COVID-19 pandemic in 2020: analyses of all-cause and noncommunicable diseases mortality. Sci Rep 2023; 13:23006. [PMID: 38155297 PMCID: PMC10754941 DOI: 10.1038/s41598-023-50388-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/19/2023] [Indexed: 12/30/2023] Open
Abstract
In this study, we estimated the excess mortality from all-causes of death and noncommunicable diseases (NCDs) in adults living in the state of São Paulo during the COVID-19 pandemic in 2020. Number of deaths were retrieved from the Mortality Information System before (2017-2019) and during (2020) the COVID-19 pandemic, considering the following underlying causes of death: Neoplasms; Diabetes Mellitus; Circulatory System Diseases, and Respiratory System Diseases. Standardized Mortality Ratio (SMR) were calculated by dividing the mortality rates in 2020 by average mortality rates in 2017-2019, according to sex, age group, geographic location (state, capital, and Regional Health Departments). In 2020, occurred 341,704 deaths in the state of São Paulo vs 290,679 deaths in 2017-2019, representing an 18% increase in all-cause mortality (SMR 1.18) or 51,025 excess deaths during the first year of COVID-19 pandemic. The excess mortality was higher in men (186,741 deaths in 2020 vs 156,371 deaths in 2017-2019; SMR 1.18; 30,370 excess deaths) compared to women (154,963 deaths in 2020 vs 134,308 deaths in 2017-2019; SMR 1.15; 20,655 excess deaths). Regarding NCDs mortality, we observed a reduction in cancer mortality (SMR 0.98; -1,354 deaths), diseases of the circulatory system (SMR 0.95; -4,277 deaths), and respiratory system (SMR 0.88; -1,945). We found a 26% increase in Diabetes Mellitus mortality (SMR 1.26; 2885 deaths) during the pandemic year. Our findings corroborate the need to create and strengthen policies aimed at the prevention and control of NCDs, in order to mitigate the impact of future infectious disease pandemics.
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Affiliation(s)
- Bruna de Souza Resende
- Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Rayara Mozer Dias
- Department of Epidemiology, Instituto de Medicina Social Hesio Cordeiro, Universidade Do Estado Do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gerson Ferrari
- Universidad de Santiago de Chile (USACH), Escuela de Ciencias de La Actividad Física, El Deporte y La Salud, Santiago, Chile
| | - Leandro F M Rezende
- Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, Sao Paulo, Brazil.
- Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia, Chile.
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Fedeli U, Amidei CB, Casotto V, Schievano E, Zoppini G. Excess diabetes-related deaths: The role of comorbidities through different phases of the COVID-19 pandemic. Nutr Metab Cardiovasc Dis 2023; 33:1709-1715. [PMID: 37407311 PMCID: PMC10228157 DOI: 10.1016/j.numecd.2023.05.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/28/2023] [Accepted: 05/26/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND AND AIMS Diabetes confers an excess risk of death to COVID-19 patients. Causes of death are now available for different phases of the pandemic, encompassing different viral variants and COVID-19 vaccination. The aims of the present study were to update multiple causes of death data on diabetes-related mortality during the pandemic and to estimate the impact of common diabetic comorbidities on excess mortality. METHODS AND RESULTS Diabetes-related deaths in 2020-2021 were compared with the 2018-2019 average; furthermore, age-standardized rates observed during the pandemic were compared with expected figures obtained from the 2008-2019 time series through generalized estimating equation models. Changes in diabetes mortality associated with specific comorbidities were also computed. Excess diabetes-related mortality was +26% in 2020 and +18% in 2021, after the initiation of the vaccination campaign. The presence of diabetes and hypertensive diseases was associated with the highest mortality increase, especially in subjects aged 40-79 years, +41% in 2020 and +30% in 2021. CONCLUSION The increase in diabetes-related deaths exceeded that observed for all-cause mortality, and the risk was higher when diabetes was associated with hypertensive diseases. Notably, the excess mortality decreased in 2021, after the implementation of vaccination against COVID-19.
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Affiliation(s)
- Ugo Fedeli
- Department of Epidemiology, Azienda Zero, Veneto Region, Padua, Italy
| | | | - Veronica Casotto
- Department of Epidemiology, Azienda Zero, Veneto Region, Padua, Italy
| | - Elena Schievano
- Department of Epidemiology, Azienda Zero, Veneto Region, Padua, Italy
| | - Giacomo Zoppini
- Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, University and Hospital Trust of Verona, Verona, Italy.
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Temporal variation of excess deaths from diabetes during the COVID-19 pandemic in the United States. J Infect Public Health 2023; 16:483-489. [PMID: 36801628 PMCID: PMC9873362 DOI: 10.1016/j.jiph.2023.01.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 01/06/2023] [Accepted: 01/23/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Although the COVID-19 pandemic has persisted for more than two years with the evident excess mortality from diabetes, few studies have investigated its temporal patterns. This study aims to estimate the excess deaths from diabetes in the United States (US) during the COVID-19 pandemic and evaluate the excess deaths by spatiotemporal pattern, age groups, sex, and race/ethnicity. METHODS Diabetes as one of multiple causes of death or an underlying cause of death were both considered into analyses. The Poisson log-linear regression model was used to estimate weekly expected counts of deaths during the pandemic with adjustments for long-term trend and seasonality. Excess deaths were measured by the difference between observed and expected death counts, including weekly average excess deaths, excess death rate, and excess risk. We calculated the excess estimates by pandemic wave, US state, and demographic characteristic. RESULTS From March 2020 to March 2022, deaths that diabetes as one of multiple causes of death and an underlying cause of death were about 47.6 % and 18.4 % higher than the expected. The excess deaths of diabetes had evident temporal patterns with two large percentage increases observed during March 2020, to June 2020, and June 2021 to November 2021. The regional heterogeneity and underlying age and racial/ethnic disparities of the excess deaths were also clearly observed. CONCLUSIONS This study highlighted the increased risks of diabetes mortality, heterogeneous spatiotemporal patterns, and associated demographic disparities during the pandemic. Practical actions are warranted to monitor disease progression, and lessen health disparities in patients with diabetes during the COVID-19 pandemic.
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Han L, Zhao S, Li S, Gu S, Deng X, Yang L, Ran J. Excess cardiovascular mortality across multiple COVID-19 waves in the United States from March 2020 to March 2022. NATURE CARDIOVASCULAR RESEARCH 2023; 2:322-333. [PMID: 39195997 DOI: 10.1038/s44161-023-00220-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 01/24/2023] [Indexed: 08/29/2024]
Abstract
The COVID-19 pandemic has limited the access of patients with cardiovascular diseases to healthcare services, causing excess deaths. However, a detailed analysis of temporal variations of excess cardiovascular mortality during the COVID-19 pandemic has been lacking. Here we estimate time-varied excess cardiovascular deaths (observed deaths versus expected deaths predicted by the negative binomial log-linear regression model) in the United States. From March 2020 to March 2022 there were 90,160 excess cardiovascular deaths, or 4.9% more cardiovascular deaths than expected. Two large peaks of national excess cardiovascular mortality were observed during the periods of March-June 2020 and June-November 2021, coinciding with two peaks of COVID-19 deaths, but the temporal patterns varied by state, age, sex and race and ethnicity. The excess cardiovascular death percentages were 5.7% and 4.0% in men and women, respectively, and 3.6%, 8.8%, 7.5% and 7.7% in non-Hispanic White, Black, Asian and Hispanic people, respectively. Our data highlight an urgent need for healthcare services optimization for patients with cardiovascular diseases in the COVID-19 era.
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Affiliation(s)
- Lefei Han
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- One Health Center, Shanghai Jiao Tong University-The University of Edinburgh, Shanghai, China
| | - Shi Zhao
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Siyuan Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Siyu Gu
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- One Health Center, Shanghai Jiao Tong University-The University of Edinburgh, Shanghai, China
| | - Xiaobei Deng
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lin Yang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China.
| | - Jinjun Ran
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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McCoy RG, Campbell RL, Mullan AF, Bucks CM, Clements CM, Reichard RR, Jeffery MM. Changes in all-cause and cause-specific mortality during the first year of the COVID-19 pandemic in Minnesota: population-based study. BMC Public Health 2022; 22:2291. [PMID: 36474190 PMCID: PMC9727873 DOI: 10.1186/s12889-022-14743-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 11/27/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic resulted in unprecedented increases in mortality in the U.S. and worldwide. To better understand the impact of the COVID-19 pandemic on mortality in the state of Minnesota, U.S.A., we characterize the changes in the causes of death during 2020 (COVID-19 period), compared to 2018-2019 (baseline period), assessing for differences across ages, races, ethnicities, sexes, and geographic characteristics. METHODS Longitudinal population-based study using Minnesota death certificate data, 2018-2020. Using Poisson regression models adjusted for age and sex, we calculated all-cause and cause-specific (by underlying causes of death) mortality rates per 100,000 Minnesotans, the demographics of the deceased, and years of life lost (YLL) using the Chiang's life table method in 2020 relative to 2018-2019. RESULTS We identified 89,910 deaths in 2018-2019 and 52,030 deaths in 2020. The mean daily mortality rate increased from 123.1 (SD 11.7) in 2018-2019 to 144.2 (SD 22.1) in 2020. COVID-19 comprised 9.9% of deaths in 2020. Other categories of causes of death with significant increases in 2020 compared to 2018-2019 included assault by firearms (RR 1.68, 95% CI 1.34-2.11), accidental poisonings (RR 1.49, 95% CI 1.37-1.61), malnutrition (RR 1.48, 95% CI 1.17-1.87), alcoholic liver disease (RR, 95% CI 1.14-1.40), and cirrhosis and other chronic liver diseases (RR 1.28, 95% CI 1.09-1.50). Mortality rates due to COVID-19 and non-COVID-19 causes were higher among racial and ethnic minority groups, older adults, and non-rural residents. CONCLUSIONS The COVID-19 pandemic was associated with a 17% increase in the death rate in Minnesota relative to 2018-2019, driven by both COVID-19 and non-COVID-19 causes. As the COVID-19 pandemic enters its third year, it is imperative to examine and address the factors contributing to excess mortality in the short-term and monitor for additional morbidity and mortality in the years to come.
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Affiliation(s)
- Rozalina G. McCoy
- grid.66875.3a0000 0004 0459 167XDivision of Community Internal Medicine, Geriatrics, and Palliative Care. Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 USA ,grid.66875.3a0000 0004 0459 167XMayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN 55905 USA ,Mayo Clinic Ambulance, Rochester, MN 55905 USA ,grid.66875.3a0000 0004 0459 167XDivision of Health Care Delivery Research, Mayo Clinic, Rochester, MN 55905 USA
| | - Ronna L. Campbell
- grid.66875.3a0000 0004 0459 167XDepartment of Emergency Medicine, Mayo Clinic, Rochester, MN 55905 USA
| | - Aidan F. Mullan
- grid.66875.3a0000 0004 0459 167XDepartment of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905 USA
| | - Colin M. Bucks
- grid.66875.3a0000 0004 0459 167XDepartment of Emergency Medicine, Mayo Clinic, Rochester, MN 55905 USA
| | - Casey M. Clements
- grid.66875.3a0000 0004 0459 167XDepartment of Emergency Medicine, Mayo Clinic, Rochester, MN 55905 USA
| | - R. Ross Reichard
- grid.66875.3a0000 0004 0459 167XDepartment of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905 USA
| | - Molly M. Jeffery
- grid.66875.3a0000 0004 0459 167XDivision of Health Care Delivery Research, Mayo Clinic, Rochester, MN 55905 USA ,grid.66875.3a0000 0004 0459 167XDepartment of Emergency Medicine, Mayo Clinic, Rochester, MN 55905 USA
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14
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Li S, Han L, Shi H, Chong MKC, Zhao S, Ran J. Excess deaths from Alzheimer's disease and Parkinson's disease during the COVID-19 pandemic in the USA. Age Ageing 2022; 51:6936401. [PMID: 36571781 DOI: 10.1093/ageing/afac277] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND COVID-19 pandemic has indirect impacts on patients with chronic medical conditions, which may increase mortality risks for various non-COVID-19 causes. This study updates excess death statistics for Alzheimer's disease (AD) and Parkinson's disease (PD) up to 2022 and evaluates their demographic and spatial disparities in the USA. METHODS This is an ecological time-series analysis of AD and PD mortality in the USA from January 2018 to March 2022. Poisson log-linear regressions were utilised to fit the weekly death data. Excess deaths were calculated with the difference between the observed and expected deaths under a counterfactual scenario of pandemic absence. RESULTS From March 2020 to March 2022, we observed 41,115 and 10,328 excess deaths for AD and PD, respectively. The largest percentage increases in excess AD and PD deaths were found in the initial pandemic wave. For people aged ≥85 years, excess mortalities of AD and PD (per million persons) were 3946.0 (95% confidence interval [CI]: 2954.3, 4892.3) and 624.3 (95% CI: 369.4, 862.5), which were about 23 and 9 times higher than those aged 55-84 years, respectively. Females had a three-time higher excess mortality of AD than males (182.6 vs. 67.7 per million persons). The non-Hispanic Black people experienced larger increases in AD or PD deaths (excess percentage: 31.8% for AD and 34.6% for PD) than the non-Hispanic White population (17.1% for AD and 14.7% for PD). CONCLUSION Under the continuing threats of COVID-19, efforts should be made to optimise health care capacity for patients with AD and PD.
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Affiliation(s)
- Siyuan Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Lefei Han
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Haoting Shi
- School of Clinical Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Marc K C Chong
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Shi Zhao
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jinjun Ran
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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15
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Lv F, Gao X, Huang AH, Zu J, He X, Sun X, Liu J, Gao N, Jiao Y, Keane MG, Zhang L, Yeo YH, Wang Y, Ji F. Excess diabetes mellitus-related deaths during the COVID-19 pandemic in the United States. EClinicalMedicine 2022; 54:101671. [PMID: 36168320 PMCID: PMC9500386 DOI: 10.1016/j.eclinm.2022.101671] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND 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. METHODS 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. FINDINGS 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%). INTERPRETATION 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. FUNDING National Natural Science Foundation of China.
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Affiliation(s)
- Fan Lv
- School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, Shaanxi, Peoples Republic of China
| | - Xu Gao
- Division of Gastroenterology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, Peoples Republic of China
- Department of Infectious Diseases, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, Peoples Republic of China
| | - Amy Huaishiuan Huang
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Jian Zu
- School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, Shaanxi, Peoples Republic of China
| | - Xinyuan He
- Department of Infectious Diseases, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, Peoples Republic of China
| | - Xiaodan Sun
- School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, Shaanxi, Peoples Republic of China
| | - Jinli Liu
- China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, Shaanxi, Peoples Republic of China
| | - Ning Gao
- Department of Infectious Diseases, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, Peoples Republic of China
| | - Yang Jiao
- Department of Endocrinology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, Peoples Republic of China
| | - Margaret G. Keane
- Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Lei Zhang
- China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, Shaanxi, Peoples Republic of China
- Artificial Intelligence and Modelling in Epidemiology Program, Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
- Central Clinical School, Faculty of Medicine, Monash University, Melbourne, Australia
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, Peoples Republic of China
| | - Yee Hui Yeo
- Division of General Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Youfa Wang
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, Peoples Republic of China
| | - Fanpu Ji
- Department of Infectious Diseases, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, Peoples Republic of China
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, Peoples Republic of China
- National & Local Joint Engineering Research Center of Biodiagnosis and Biotherapy, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, Peoples Republic of China
- Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education of China, Xi'an, Shaanxi, Peoples Republic of China
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16
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Ahmadi Gohari M, Chegeni M, Haghdoost AA, Mirzaee F, White L, Kostoulas P, Mirzazadeh A, Karamouzian M, Jahani Y, Sharifi H. Excess deaths during the COVID-19 pandemic in Iran. Infect Dis (Lond) 2022; 54:909-917. [PMID: 36121798 DOI: 10.1080/23744235.2022.2122554] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The actual number of deaths during the COVID-19 pandemic is expected to be higher than the reported deaths. We aimed to estimate the number of deaths in Iran during the COVID-19 pandemic from December 22, 2019 to March 20, 2022. METHODS We compared the number of age- and sex-specific deaths reported by Iran's Bureau of Vital Statistics with the predicted deaths estimated using an improved Lee-Carter model. We estimated the number of all-cause excess deaths in three scenarios, including the baseline scenario (without any undercounting of deaths) and 4% and 8% undercounting of all-cause deaths. RESULTS We estimated 282,378 (95% confidence intervals [CI]: 225,439; 341,951) excess deaths in the baseline model. This number was 303,148 (95% CI: 246,417; 357,823) and 308,486 (95% CI: 250,607; 364,417) in the 4% and 8% scenarios, respectively. During the same period, Iran reported 139,610 deaths as being directly related to COVID-19. The ratio of reported COVID-19 deaths to total excess deaths ranged from 45.2% to 49.4% in the various scenarios. Most excess deaths occurred in the baseline scenario in males (157,552 [95% CI: 125,142; 191,265]) and those aged ≥75 years (102,369 [95% CI: 93,894; 111,188]). CONCLUSIONS The reported number of COVID-19 deaths was less than half of Iran's estimated number of excess deaths. The results of this study will be helpful for health policymakers' planning, and call for strengthening the timeliness and accuracy of Iran's death registration systems, planning for more accurate monitoring of epidemics, and planning to provide support services for survivors' families.
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Affiliation(s)
- Milad Ahmadi Gohari
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Chegeni
- Molecular and Medicine Research Center, Khomein University of Medical Sciences, Khomein, Iran
| | - Ali Akbar Haghdoost
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Firoozeh Mirzaee
- Department of Midwifery, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Lisa White
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Ali Mirzazadeh
- Department of Epidemiology and Biostatistics, Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, USA.,HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Karamouzian
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA.,HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Yunes Jahani
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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17
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McCoy RG, Mullan AF, Jeffery MM, Bucks CM, Clements CM, Campbell RL. Excess All-Cause and Cause-Specific Mortality Among People with Diabetes During the COVID-19 Pandemic in Minnesota: Population-Based Study. J Gen Intern Med 2022; 37:3228-3231. [PMID: 35768679 PMCID: PMC9244002 DOI: 10.1007/s11606-022-07709-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/16/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Rozalina G McCoy
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, USA. .,Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA. .,Mayo Clinic Ambulance, Rochester, MN, USA. .,Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA.
| | - Aidan F Mullan
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Molly M Jeffery
- Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA.,Department of Emergency Medicine, Mayo Clinic, Rochester, MN, USA
| | - Colin M Bucks
- Department of Emergency Medicine, Mayo Clinic, Rochester, MN, USA
| | - Casey M Clements
- Department of Emergency Medicine, Mayo Clinic, Rochester, MN, USA
| | - Ronna L Campbell
- Department of Emergency Medicine, Mayo Clinic, Rochester, MN, USA
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18
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Excess mortality associated with the COVID-19 pandemic in Latvia: a population-level analysis of all-cause and noncommunicable disease deaths in 2020. BMC Public Health 2022; 22:1109. [PMID: 35659648 PMCID: PMC9163859 DOI: 10.1186/s12889-022-13491-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 05/19/2022] [Indexed: 02/08/2023] Open
Abstract
Background Age-standardised noncommunicable disease (NCD) mortality and the proportion of the elderly population in Latvia are high, while public health and health care systems are underresourced. The emerging COVID-19 pandemic raised concerns about its detrimental impact on all-cause and noncommunicable disease mortality in Latvia. We estimated the timing and number of excess all-cause and cause-specific deaths in 2020 in Latvia due to COVID-19 and selected noncommunicable diseases. Methods A time series analysis of all-cause and cause-specific weekly mortality from COVID-19, circulatory diseases, malignant neoplasms, diabetes mellitus, and chronic lower respiratory diseases from the National Causes of Death Database from 2015 to 2020 was used by applying generalised additive modelling (GAM) and joinpoint regression analysis. Results Between weeks 14 and 52 (from 1 April to 29 December) of 2020, a total of 3111 excess deaths (95% PI 1339 – 4832) were estimated in Latvia, resulting in 163.77 excess deaths per 100 000. Since September 30, with the outbreak of the second COVID-19 wave, 55% of all excess deaths have occurred. Altogether, COVID-19-related deaths accounted for only 28% of the estimated all-cause excess deaths. A significant increase in excess mortality was estimated for circulatory diseases (68.91 excess deaths per 100 000). Ischemic heart disease and cerebrovascular disease were listed as the underlying cause in almost 60% of COVID-19-contributing deaths. Conclusions All-cause mortality and mortality from circulatory diseases significantly increased in Latvia during the first pandemic year. All-cause excess mortality substantially exceeded reported COVID-19-related deaths, implying COVID-19-related mortality during was significantly underestimated. Increasing mortality from circulatory diseases suggests a negative cumulative effect of COVID-19 exposure and reduced access to healthcare services for NCD patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13491-4.
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19
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Kim D, Alshuwaykh O, Sandhu KK, Dennis BB, Cholankeril G, Ahmed A. Trends in All-Cause and Cause-Specific Mortality Among Individuals With Diabetes Before and During the COVID-19 Pandemic in the U.S. Diabetes Care 2022; 45:e107-e109. [PMID: 35446372 DOI: 10.2337/dc22-0348] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 03/25/2022] [Indexed: 02/03/2023]
Affiliation(s)
- Donghee Kim
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA
| | - Omar Alshuwaykh
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA
| | - Keeryth K Sandhu
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA
| | - Brittany B Dennis
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - George Cholankeril
- Liver Center, Division of Abdominal Transplantation, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX
- Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Aijaz Ahmed
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA
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20
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Profili F, Seghieri G, Francesconi P. Effect of diabetes on short-term mortality and incidence of first hospitalizations for cardiovascular events after recovery from SARS-CoV-2 infection. Diabetes Res Clin Pract 2022; 187:109872. [PMID: 35429573 PMCID: PMC9006403 DOI: 10.1016/j.diabres.2022.109872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/06/2022] [Accepted: 04/10/2022] [Indexed: 11/16/2022]
Abstract
AIM To evaluate the impact of diabetes and COVID-19 on all-cause-mortality and first hospitalizations for cardiovascular events (CVE): myocardial infarction or stroke, within six months after being tested positive and having recovered from SARS-CoV-2 infection. METHODS Resident population in Tuscany, Italy of age 45-94 yr without prior hospitalization for CVE, tested positive for SARS-CoV-2 by March 1st, 2020 and afterwards recovering from COVID-19 was compared with age, gender and diabetes matched controls without infection, for incidence rate ratio (IRR) of all-cause-deaths or first CVE at six months follow up. RESULTS 46,152 subjects of whom 4,597 with diabetes, tested positive and recovered from SARS-CoV-2 were compared with 1:1 age, gender and diabetes matched controls without infection. COVID-19 was associated with higher all-cause-mortality: IRR:1.92(95 %CI:1.63-2.25) while diabetes with increased risk of first CVE hospitalizations: IRR:2.24(2.18-4.25). Co-presence of COVID-19 and diabetes didn't add any additional excess risk. Being women and statins' use significantly reduced death risk. CONCLUSIONS After recovery from COVID-19, independently of diabetes, all-cause-mortality risk at six months was twofold increased, while risk of first CVE hospitalization remained unmodified. Diabetes, independently of prior COVID-19, resulted in higher six-months risk of first CVE not of death. Female gender and statins' use reduced both excess risks.
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21
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Miller L, Berber E, Sumbria D, Rouse BT. Controlling the Burden of COVID-19 by Manipulating Host Metabolism. Viral Immunol 2022; 35:24-32. [PMID: 34905407 PMCID: PMC8863913 DOI: 10.1089/vim.2021.0150] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic caused by the coronavirus-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to cause global health problems, but its impact would be minimized if the many effective vaccines that have been developed were available and in widespread use by all societies. This ideal situation is not occurring so other means of controlling COVID-19 are needed. In this short review, we make the case that manipulating host metabolic pathways could be a therapeutic approach worth exploring. The rationale for such an approach comes from the fact that viruses cause metabolic changes in cells they infect, effective host defense mechanisms against viruses requires the activity of one or more metabolic pathways, and that hosts with metabolic defects such as diabetes are more susceptible to severe consequences after COVID-19. We describe the types of approaches that could be used to redirect various aspects of host metabolism and the success that some of these maneuvers have had at controlling other virus infections. Manipulating metabolic activities to control the outcome of COVID-19 has to date received minimal attention. Manipulating host metabolism will never replace vaccines to control COVID-19 but could be used as an adjunct therapy to the extent of ongoing infection.
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Affiliation(s)
- Logan Miller
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee, USA
| | - Engin Berber
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee, USA
| | - Deepak Sumbria
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee, USA
| | - Barry T. Rouse
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee, USA
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22
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Aziz F, Aberer F, Bräuer A, Ciardi C, Clodi M, Fasching P, Karolyi M, Kautzky-Willer A, Klammer C, Malle O, Pawelka E, Pieber T, Peric S, Ress C, Schranz M, Sourij C, Stechemesser L, Stingl H, Stöcher H, Stulnig T, Tripolt N, Wagner M, Wolf P, Zitterl A, Reisinger AC, Siller-Matula J, Hummer M, Moser O, von-Lewinski D, Eller P, Kaser S, Sourij H. COVID-19 In-Hospital Mortality in People with Diabetes Is Driven by Comorbidities and Age-Propensity Score-Matched Analysis of Austrian National Public Health Institute Data. Viruses 2021; 13:v13122401. [PMID: 34960670 PMCID: PMC8705658 DOI: 10.3390/v13122401] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/22/2021] [Accepted: 11/27/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND It is a matter of debate whether diabetes alone or its associated comorbidities are responsible for severe COVID-19 outcomes. This study assessed the impact of diabetes on intensive care unit (ICU) admission and in-hospital mortality in hospitalized COVID-19 patients. METHODS A retrospective analysis was performed on a countrywide cohort of 40,632 COVID-19 patients hospitalized between March 2020 and March 2021. Data were provided by the Austrian data platform. The association of diabetes with outcomes was assessed using unmatched and propensity-score matched (PSM) logistic regression. RESULTS 12.2% of patients had diabetes, 14.5% were admitted to the ICU, and 16.2% died in the hospital. Unmatched logistic regression analysis showed a significant association of diabetes (odds ratio [OR]: 1.24, 95% confidence interval [CI]: 1.15-1.34, p < 0.001) with in-hospital mortality, whereas PSM analysis showed no significant association of diabetes with in-hospital mortality (OR: 1.08, 95%CI: 0.97-1.19, p = 0.146). Diabetes was associated with higher odds of ICU admissions in both unmatched (OR: 1.36, 95%CI: 1.25-1.47, p < 0.001) and PSM analysis (OR: 1.15, 95%CI: 1.04-1.28, p = 0.009). CONCLUSIONS People with diabetes were more likely to be admitted to ICU compared to those without diabetes. However, advanced age and comorbidities rather than diabetes itself were associated with increased in-hospital mortality in COVID-19 patients.
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Affiliation(s)
- Faisal Aziz
- Interdisciplinary Metabolic Medicine Trials Unit, Department of Endocrinology and Diabetology, Medical University of Graz, 8036 Graz, Austria; (F.A.); (F.A.); (O.M.); (H.S.); (N.T.)
| | - Felix Aberer
- Interdisciplinary Metabolic Medicine Trials Unit, Department of Endocrinology and Diabetology, Medical University of Graz, 8036 Graz, Austria; (F.A.); (F.A.); (O.M.); (H.S.); (N.T.)
| | - Alexander Bräuer
- Medical Division of Endocrinology, Rheumatology and Acute Geriatrics, Hospital Ottakring, 1160 Vienna, Austria; (A.B.); (P.F.)
| | - Christian Ciardi
- Clinical Division for Internal Medicine, Endocrinology, Diabetology and Metabolic Diseases, St. Vinzenz Hospital Zams, 6511 Zams, Austria;
| | - Martin Clodi
- Clinical Division for Internal Medicine, Konvent Hospital Barmherzige Brüder Linz, 4020 Linz, Austria; (M.C.); (C.K.)
| | - Peter Fasching
- Medical Division of Endocrinology, Rheumatology and Acute Geriatrics, Hospital Ottakring, 1160 Vienna, Austria; (A.B.); (P.F.)
| | - Mario Karolyi
- 4th Medical Division with Infectiology, SMZ Süd—KFJ-Hospital Vienna, 1100 Vienna, Austria; (M.K.); (E.P.)
| | - Alexandra Kautzky-Willer
- Division for Endocrinology and Metabolism, Medical University of Vienna, AKH, 1090 Vienna, Austria; (A.K.-W.); (P.W.)
| | - Carmen Klammer
- Clinical Division for Internal Medicine, Konvent Hospital Barmherzige Brüder Linz, 4020 Linz, Austria; (M.C.); (C.K.)
| | - Oliver Malle
- Interdisciplinary Metabolic Medicine Trials Unit, Department of Endocrinology and Diabetology, Medical University of Graz, 8036 Graz, Austria; (F.A.); (F.A.); (O.M.); (H.S.); (N.T.)
| | - Erich Pawelka
- 4th Medical Division with Infectiology, SMZ Süd—KFJ-Hospital Vienna, 1100 Vienna, Austria; (M.K.); (E.P.)
| | - Thomas Pieber
- Division of Endocrinology and Diabetology, Medical University of Graz, 8036 Graz, Austria;
| | - Slobodan Peric
- Department of Medicine III and Karl Landsteiner, Institute for Metabolic Diseases and Nephrology, Clinic Hietzing, Vienna Health Care Group, 1130 Vienna, Austria; (S.P.); (T.S.); (A.Z.)
| | - Claudia Ress
- Department for Internal Medicine I, Medical University of Innsbruck, 6020 Innsbruck, Austria;
| | - Michael Schranz
- Department for Inner Medicine, Paracelsus-Private Medical University, 5020 Salzburg, Austria; (M.S.); (L.S.)
| | - Caren Sourij
- Division of Cardiology, Medical University of Graz, 8036 Graz, Austria; (C.S.); (D.v.-L.)
| | - Lars Stechemesser
- Department for Inner Medicine, Paracelsus-Private Medical University, 5020 Salzburg, Austria; (M.S.); (L.S.)
| | - Harald Stingl
- Clinical Division for Internal Medicine, Hospital Melk, 3390 Melk, Austria; (H.S.); (M.W.)
| | - Hannah Stöcher
- Interdisciplinary Metabolic Medicine Trials Unit, Department of Endocrinology and Diabetology, Medical University of Graz, 8036 Graz, Austria; (F.A.); (F.A.); (O.M.); (H.S.); (N.T.)
| | - Thomas Stulnig
- Department of Medicine III and Karl Landsteiner, Institute for Metabolic Diseases and Nephrology, Clinic Hietzing, Vienna Health Care Group, 1130 Vienna, Austria; (S.P.); (T.S.); (A.Z.)
| | - Norbert Tripolt
- Interdisciplinary Metabolic Medicine Trials Unit, Department of Endocrinology and Diabetology, Medical University of Graz, 8036 Graz, Austria; (F.A.); (F.A.); (O.M.); (H.S.); (N.T.)
| | - Michael Wagner
- Clinical Division for Internal Medicine, Hospital Melk, 3390 Melk, Austria; (H.S.); (M.W.)
| | - Peter Wolf
- Division for Endocrinology and Metabolism, Medical University of Vienna, AKH, 1090 Vienna, Austria; (A.K.-W.); (P.W.)
| | - Andreas Zitterl
- Department of Medicine III and Karl Landsteiner, Institute for Metabolic Diseases and Nephrology, Clinic Hietzing, Vienna Health Care Group, 1130 Vienna, Austria; (S.P.); (T.S.); (A.Z.)
| | - Alexander Christian Reisinger
- Intensive Care Unit, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria; (A.C.R.); (P.E.)
| | | | - Michael Hummer
- Austrian National Public Health Institute, 1010 Vienna, Austria;
| | - Othmar Moser
- Department of Exercise Physiology & Metabolism, Institute of Sports Science, University of Bayreuth, 95445 Bayreuth, Germany;
| | - Dirk von-Lewinski
- Division of Cardiology, Medical University of Graz, 8036 Graz, Austria; (C.S.); (D.v.-L.)
| | - Philipp Eller
- Intensive Care Unit, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria; (A.C.R.); (P.E.)
| | - Susanne Kaser
- Department for Internal Medicine I, Medical University of Innsbruck, 6020 Innsbruck, Austria;
- Correspondence: (S.K.); (H.S.); Tel.: +43-512-504-81407 (S.K.); +43-316-385-81310 (H.S.)
| | - Harald Sourij
- Interdisciplinary Metabolic Medicine Trials Unit, Department of Endocrinology and Diabetology, Medical University of Graz, 8036 Graz, Austria; (F.A.); (F.A.); (O.M.); (H.S.); (N.T.)
- Correspondence: (S.K.); (H.S.); Tel.: +43-512-504-81407 (S.K.); +43-316-385-81310 (H.S.)
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Preventing the Next Pandemic: The Case for Investing in Circulatory Health - A Global Coalition for Circulatory Health Position Paper. Glob Heart 2021; 16:66. [PMID: 34692391 PMCID: PMC8516006 DOI: 10.5334/gh.1077] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 12/23/2022] Open
Abstract
The Coronavirus Disease 2019 (COVID-19) has had a continuous and robust impact on world health. The resulting COVID-19 pandemic has had a devastating physical, mental and fiscal impact on the millions of people living with noncommunicable diseases (NCDs). In addition to older age, people living with CVD, stroke, obesity, diabetes, kidney disease, and hypertension are at a particularly greater risk for severe forms of COVID-19 and its consequences. Meta-analysis indicates that hypertension, diabetes, chronic kidney disease, and thrombotic complications have been observed as both the most prevalent and most dangerous co-morbidities in COVID-19 patients. And despite the nearly incalculable physical, mental, emotional, and economic toll of this pandemic, forthcoming public health figures continue to place cardiovascular disease as the number one cause of death across the globe in the year 2020. The world simply cannot wait for the next pandemic to invest in NCDs. Social determinants of health cannot be addressed only through the healthcare system, but a more holistic multisectoral approach with at its basis the Sustainable Development Goals (SDGs) is needed to truly address social and economic inequalities and build more resilient systems. Yet there is reason for hope: the 2019 UN Political Declaration on UHC provides a strong framework for building more resilient health systems, with explicit calls for investment in NCDs and references to fiscal policies that put such investment firmly within reach. By further cementing the importance of addressing circulatory health in a future Framework Convention on Emergency Preparedness, WHO Member States can take concrete steps towards a pandemic-free future. As the chief representatives of the global circulatory health community and patients, the Global Coalition for Circulatory Health calls for increased support for the healthcare workforce, global vaccine equity, embracing new models of care and digital health solutions, as well as fiscal policies on unhealthy commodities to support these investments.
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24
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Han L, Zhao S, Cao W, Javanbakht M, Ran J, Sun S. Changes in renal failure mortality during the COVID-19 pandemic in the United States. J Nephrol 2021; 34:2167-2170. [PMID: 34417995 PMCID: PMC8379559 DOI: 10.1007/s40620-021-01145-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 08/12/2021] [Indexed: 11/05/2022]
Affiliation(s)
- Lefei Han
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shi Zhao
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China.,CUHK Shenzhen Research Institute, Shenzhen, China
| | - Wangnan Cao
- Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, RI, USA.,Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Mohammad Javanbakht
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Jinjun Ran
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA.
| | - Shenzhi Sun
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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