Jindal Har Ashish, Sahoo Soumya Swaroop, Jamir Limalemla, Kedar Ashwini, Sharma Sugandhi, Bhatt Bhumika
Senior Consulatant, Ministry of Health and Family Welfare, New Delhi, India.
Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, India.
J Educ Health Promot. 2021 Oct 29;10:377. doi: 10.4103/jehp.jehp_142_21. eCollection 2021.
Global burden of disease (GBD) provides the estimates of mortality and morbidity, while case fatality rate (CFR) helps in understanding the severity of the disease. People infected with severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) with underlying medical conditions have shown higher levels of unfavorable outcomes including mortality. We assessed the association of SARS-CoV-2 CFR with disability-adjusted life years (DALY) of various comorbidities in the low-middle income countries (LMIC) and high-income countries (HIC) to study the relationship of coronavirus disease-19 (COVID-19) mortality with GBDs and to understand the linkage between COVID-19 mortality and comorbidities.
This was an ecological study with secondary data analysis comparing the DALY of various morbidities from GBD with CFR of COVID-19. Gross domestic product was the basis of stratifying 177 countries into low-middle income (LMIC) and high-income groups (HIC). The mortality was analyzed using Pearson correlation and linear regression.
The median global CFR of SARS-CoV-2 was 2.15. The median CFR among LMIC ( = 60) and HIC ( = 117) was 2.01 (0.00-28.20) and 2.29 (0.00-17.26), respectively. The regression analysis found that, in both LMIC and HIC, maternal disorders were associated with higher SARS-CoV-2 CFR, while tuberculosis, mental health disorders, and were associated with lower CFR. Further, in LMIC, musculoskeletal disorders and nutritional deficiencies were associated with higher CFR, while respiratory disorders were associated with lower CFR.
SARS-CoV-2 infection appears to be a systemic disease. Individuals with comorbidities, such as maternal disorders, neurological diseases, musculoskeletal disorders, and nutritional deficiencies, have poorer outcomes with COVID-19, leading to higher mortality.
全球疾病负担（GBD）提供了死亡率和发病率的估计值，而病死率（CFR）有助于了解疾病的严重程度。感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）且有基础疾病的人出现包括死亡在内的不良结局的水平更高。我们评估了低收入和中等收入国家（LMIC）及高收入国家（HIC）中SARS-CoV-2病死率与各种合并症的伤残调整生命年（DALY）之间的关联，以研究冠状病毒病19（COVID-19）死亡率与全球疾病负担之间的关系，并了解COVID-19死亡率与合并症之间的联系。
这是一项生态研究，通过二次数据分析比较了GBD中各种疾病的DALY与COVID-19的病死率。国内生产总值是将177个国家分为低收入和中等收入（LMIC）组及高收入组（HIC）的依据。使用Pearson相关性和线性回归分析死亡率。
SARS-CoV-2的全球病死率中位数为2.15。LMIC（n = 60）和HIC（n = 117）中的病死率中位数分别为2.01（0.00 - 28.20）和2.29（0.00 - 17.26）。回归分析发现，在LMIC和HIC中，孕产妇疾病均与较高的SARS-CoV-2病死率相关，而结核病、精神健康障碍则与较低的病死率相关。此外，在LMIC中，肌肉骨骼疾病和营养缺乏与较高的病死率相关，而呼吸系统疾病与较低的病死率相关。
SARS-CoV-2感染似乎是一种全身性疾病。患有合并症的个体，如孕产妇疾病、神经系统疾病、肌肉骨骼疾病和营养缺乏，在感染COVID-19时预后较差，导致更高的死亡率。
