新冠疫情与非传染性疾病负担：一项基于185个国家数据的生态学研究
COVID-19 Pandemic and Burden of Non-Communicable Diseases: An Ecological Study on Data of 185 Countries.
作者信息
Azarpazhooh M Reza, Morovatdar Negar, Avan Abolfazl, Phan Thanh G, Divani Afshin A, Yassi Nawaf, Stranges Saverio, Silver Brian, Biller José, Tokazebani Belasi Masoud, Kazemi Neya Sepideh, Khorram Bita, Frydman Asher, Nilanont Yongchai, Onorati Elisa, Di Napoli Mario
机构信息
Stroke Prevention and Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Ontario, Canada; Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
Clinical Research Development Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
出版信息
J Stroke Cerebrovasc Dis. 2020 Sep;29(9):105089. doi: 10.1016/j.jstrokecerebrovasdis.2020.105089. Epub 2020 Jun 25.
BACKGROUND
The interaction between coronavirus disease 2019 (COVID-19) and non-communicable diseases may increase the global burden of disease. We assessed the association of COVID-19 with ageing and non-communicable diseases.
METHODS
We extracted data regarding non-communicable disease, particularly cardiovascular disease, deaths, disability-adjusted life years (DALYs), and healthy life expectancy (HALE) from the Global Burden of Disease Study (GBD) 2017. We obtained data of confirmed COVID-19 cases, deaths, and tests from the Our World in Data database as of May 28, 2020. Potential confounders of pandemic outcomes analyzed include institutional lockdown delay, hemispheric geographical location, and number of tourists. We compared all countries according to GBD classification and World Bank income level. We assessed the correlation between independent variables associated with COVID-19 caseload and mortality using Spearman's rank correlation and adjusted mixed model analysis.
FINDINGS
High-income had the highest, and the Southeast Asia, East Asia, and Oceania region had the least cases per million population (3050.60 vs. 63.86). Sub-saharan region has reported the lowest number of COVID-19 mortality (1.9). Median delay to lockdown initiation varied from one day following the first case in Latin America and Caribbean region, to 34 days in Southeast Asia, East Asia, and Oceania. Globally, non-communicable disease DALYs were correlated with COVID-19 cases (r = 0.32, p<0.001) and deaths (r = 0.37, p<0.001). HALE correlated with COVID-19 cases (r = 0.63, p<0.001) and deaths (r = 0.61, p<0.001). HALE was independently associated with COVID-19 case rate and the number of tourists was associated with COVID-19 mortality in the adjusted model.
INTERPRETATION
Preventive measures against COVID-19 should protect the public from the dual burden of communicable and non-communicable diseases, particularly in the elderly. In addition to active COVID-19 surveillance, policymakers should utilize this evidence as a guide for prevention and coordination of health services. This model is timely, as many countries have begun to reduce social isolation.
背景
2019冠状病毒病（COVID-19）与非传染性疾病之间的相互作用可能会增加全球疾病负担。我们评估了COVID-19与老龄化及非传染性疾病之间的关联。
方法
我们从《2017年全球疾病负担研究》（GBD）中提取了有关非传染性疾病的数据，特别是心血管疾病、死亡人数、伤残调整生命年（DALYs）和健康预期寿命（HALE）。我们从“Our World in Data”数据库中获取了截至2020年5月28日的COVID-19确诊病例、死亡人数和检测数据。分析的大流行结果的潜在混杂因素包括机构封锁延迟、半球地理位置和游客数量。我们根据GBD分类和世界银行收入水平对所有国家进行了比较。我们使用Spearman等级相关性和调整后的混合模型分析评估了与COVID-19病例数和死亡率相关的自变量之间的相关性。
研究结果
高收入国家每百万人口中的病例数最高，而东南亚、东亚和大洋洲地区每百万人口中的病例数最少（3050.60对63.86）。撒哈拉以南地区报告的COVID-19死亡人数最少（1.9）。封锁开始的中位延迟时间从拉丁美洲和加勒比地区首例病例后的一天到东南亚、东亚和大洋洲的34天不等。在全球范围内，非传染性疾病伤残调整生命年与COVID-19病例（r = 0.32，p<0.001）和死亡（r = 0.37，p<0.001）相关。健康预期寿命与COVID-19病例（r = 0.63，p<0.001）和死亡（r = 0.61，p<0.001）相关。在调整后的模型中，健康预期寿命与COVID-19病例率独立相关，游客数量与COVID-19死亡率相关。
解读
针对COVID-19的预防措施应保护公众免受传染病和非传染性疾病的双重负担，特别是在老年人中。除了积极监测COVID-19外，政策制定者应利用这一证据作为预防和协调卫生服务的指导。鉴于许多国家已开始减少社会隔离，该模型具有及时性。
Zotero 插件