Excess Deaths of Gastrointestinal, Liver, and Pancreatic Diseases During the COVID-19 Pandemic in the United States

Han, Lefei; Shi, Haoting; Li, Yongxuan; Qi, Hongchao; Wang, Yuhua; Gu, Jin; Wu, Jiayin; Zhao, Shi; Cao, Peihua; Xu, Lan; Deng, Xiaobei; Yao, Xiaoxin I; Ran, Jinjun

doi:10.3389/ijph.2023.1606305

Cited by 4 publications

(3 citation statements)

References 36 publications

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“…Subsequently, other studies comparing cardiovascular mortality rates before and after the pandemic found significant increase in mortality and excess deaths despite 2 years since the onset of the pandemic ( 6 ). A recent study demonstrated elevated cardiovascular deaths persisted until early 2022 by characterizing trends in excess CVD deaths ( 15 ). Our study expands from prior work by analyzing recent provisional data from the online database covering a longer time span, describing trends in mortality, comparing observed to predicted mortality rates, assessing the excess deaths and further stratifying by age, sex and race/ethnicity.…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on cardiovascular mortality and contrast analysis within subgroups

Song,

Guo,

et al. 2024

Front. Cardiovasc. Med.

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BackgroundAn increase in deaths has been perceived during the pandemic, which cannot be explained only by COVID-19. The actual number of deaths far exceeds the recorded data on deaths directly related to SARS-CoV-2 infection. Data from early and short-lived pandemic studies show a dramatic shift in cardiovascular mortality. Grounded in the post-pandemic era, macroscopic big data on cardiovascular mortality during the pandemic need to be further reviewed and studied, which is crucial for cardiovascular disease prevention and control.MethodsWe retrieved and collected data associated with cardiovascular disease mortality from the National Vital Statistic System from the Center for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) platform based on the ICD-10 codes. We applied regression analysis to characterize overall cardiovascular disease mortality trends from 2010 to 2023 and built a time series model to predict mortality for 2020–2023 based on mortality data from 2010 to 2019 in order to affirm the existence of the excess deaths by evaluating observed vs. predicted mortality. We also conducted subgroup analyses by sex, age and race/ethnicity for the purpose of obtaining more specific sociodemographic information.ResultsAll-cause age-standardised mortality rates (ASMRs) for CVD dramatically increased between 2019 and 2021[annual percentage change (APC) 11.27%, p < 0.01], and then decreased in the following 2021–2023(APC: −7.0%, p < 0.01). Subgroup analyses found that the ASMR change was most pronounced in Alaska Indians/Native American people (APC: 16.5% in 2019–2021, −12.5% in 2021–2023, both p < 0.01), Hispanics (APC: 12.1% in 2019–2021, −12.2% in 2021–2023, both p < 0.05) and non-Hispanic Black people (APC:11.8% in 2019–2021, −10.3% in 2021–2023, both p < 0.01)whether during the increasing or declining phase. Similarly, the ASMR change was particularly dramatic for the 25–44 age group (APC:19.8% in 2019–2021, −15.4% in 2021–2023, both p < 0.01) and males (APC: 11.5% in 2019–2021, −7.6% in 2021–2023, both p < 0.01). By the end of 2023, the proportion of COVID-related excess death remained high among the elderly (22.4%), males (42.8%) and Alaska Indians/Native American people(39.7%). In addition, we did not find the presence of excess deaths in the young (25–44) and middle-aged cohort (45–64) in 2023, while excess deaths remained persistent in the elderly.ConclusionsAll-cause ASMRs for CVD increased notably during the initial two years of the COVID-19 pandemic and then witnessed a decline in 2021–2023. The cohorts (the young, males and minorities) with the steepest rise in mortality decreased at the fastest rate instead. Previous initiatives to promote cardiovascular health were effective, but further research on cardiovascular healthcare for the elderly and racial disparities should be attached to priority considering the presence of sociodemographic differences in CVD death.

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Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on cardiovascular mortality and contrast analysis within subgroups

Song,

Guo,

et al. 2024

Front. Cardiovasc. Med.

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“…In a study based on weekly death counts from the National Vital Statistics System of the USA [36], Han et al observed increased mortality for AP (measured by excess risk) of 20.6% higher than expected during the March 2020-September 2022 period, with demographic disparities and varied temporal and spatial patterns during the pandemic. In their study, they also confirmed increased mortality due to gastrointestinal hemorrhage and ulcers of 24.8% and 15.1%, respectively, and due to alcoholic liver disease of 19.9%.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 and Acute Pancreatitis: Not Increased Risk but Reduced Care

Cevolani,

Ferronato,

Lizzio

et al. 2023

Gastroenterology Insights

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Background and aim: Over the last few years, SARS-CoV-2 has been reported as a possible cause of acute pancreatitis (AP), but whether it is a relevant clinical–epidemiological entity is still a matter of debate. We aim to evaluate the epidemiological characteristics of AP during the first year of the COVID pandemic (2020) and compare them with the pre-COVID period (2008–2019) to identify any differences and clarify a potential causative role of SARS-CoV-2. Methods: We used a monocentric retrospective study of 132 AP patients during 2020 and 1987 AP patients during 2008–2019. Diagnosis and severity were classified according to the revised Atlanta criteria. Propensity score matching was performed according to clinical–epidemiological features, and outcome analysis was performed on two subgroups of 109 patients. Results: The total number of AP cases in 2020 is one of the lowest in the last 13 years (132 cases, median 161, IQR 146-183). No major epidemiological differences were noted. During 2020, we observed a significant modification of the distribution of etiologies (p < 0.001), mainly based on a decrease in biliary forms (59.6% vs. 43.2%) and an increase in alcoholic forms (6.9% vs. 12.9%). Idiopathic forms remain unchanged (20.5% vs. 21.9%). The proportion of AP of idiopathic etiology and SARS-CoV-2 infection was 0.008%. There were no differences in terms of severity distribution (p = 0.127), length of stay (p = 0.916), need for ICU (p = 0.139), or mortality (p = 0.462). Even among statistically matched groups, there were no differences between the length of stay (9 vs. 10 days, p = 0.890), need for ICU admission (1.8% vs. 3.7%, p = 0.683), or in-hospital mortality (0 vs. 1.8%, p = 0.342). Conclusions: The lower AP diagnoses indicate delayed and likely missed diagnoses, probably because of both hesitancy and organizational problems during the pandemic. The unchanged proportion of idiopathic forms supports the hypothesis that SARS-CoV-2 is not an AP trigger.

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“…Another source of data revealed that in 2020 ALD constituted 40.1% of all LT listings and this result was greater than cases related to hepatitis C virus (HCV) and NASH taken together. Another retrospective study performed in the United States between March 2020 and September 2022 showed a more pronounced mortality due to ALD, cirrhosis and hepatic failure in all; the excess risks were 1.4-2.8 times higher [182,203]. One could ask: why?…”

Section: Ethanol Liver and Covid-19-a Global Perspectivementioning

confidence: 99%

COVID-19, Possible Hepatic Pathways and Alcohol Abuse—What Do We Know up to 2023?

Michalak,

Lach,

Szczygieł

et al. 2024

IJMS

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The pandemic period due to coronavirus disease 2019 (COVID-19) revolutionized all possible areas of global health. Significant consequences were also related to diverse extrapulmonary manifestations of this pathology. The liver was found to be a relatively common organ, beyond the respiratory tract, affected by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Multiple studies revealed the essential role of chronic liver disease (CLD) in the general outcome of coronavirus infection. Present concerns in this field are related to the direct hepatic consequences caused by COVID-19 and pre-existing liver disorders as risk factors for the severe course of the infection. Which mechanism has a key role in this phenomenon—previously existing hepatic disorder or acute liver failure due to SARS-CoV-2—is still not fully clarified. Alcoholic liver disease (ALD) constitutes another not fully elucidated context of coronavirus infection. Should the toxic effects of ethanol or already developed liver cirrhosis and its consequences be perceived as a causative or triggering factor of hepatic impairment in COVID-19 patients? In the face of these discrepancies, we decided to summarize the role of the liver in the whole picture of coronavirus infection, paying special attention to ALD and focusing on the pathological pathways related to COVID-19, ethanol toxicity and liver cirrhosis.

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Excess Deaths of Gastrointestinal, Liver, and Pancreatic Diseases During the COVID-19 Pandemic in the United States

Cited by 4 publications

References 36 publications

Impact of the COVID-19 pandemic on cardiovascular mortality and contrast analysis within subgroups

Impact of the COVID-19 pandemic on cardiovascular mortality and contrast analysis within subgroups

COVID-19 and Acute Pancreatitis: Not Increased Risk but Reduced Care

COVID-19, Possible Hepatic Pathways and Alcohol Abuse—What Do We Know up to 2023?

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