Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States.
Department of Infectious Disease, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China.
World J Gastroenterol. 2024 May 28;30(20):2677-2688. doi: 10.3748/wjg.v30.i20.2677.
The coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare in the United States.
To investigate COVID-19-related and non-COVID-19-related death and characteristics associated with excess death among inflammatory bowel disease (IBD) decedents.
We performed a register-based study using data from the National Vital Statistics System, which reports death data from over 99% of the United States population, from January 1, 2006 through December 31, 2021. IBD-related deaths among adults 25 years and older were stratified by age, sex, race/ethnicity, place of death, and primary cause of death. Predicted and actual age-standardized mortality rates (ASMRs) per 100000 persons were compared.
49782 IBD-related deaths occurred during the study period. Non-COVID-19-related deaths increased by 13.14% in 2020 and 18.12% in 2021 [2020 ASMR: 1.55 actual 1.37 predicted, 95% confidence interval (CI): 1.26-1.49; 2021 ASMR: 1.63 actual 1.38 predicted, 95%CI: 1.26-1.49]. In 2020, non-COVID-19-related mortality increased by 17.65% in ulcerative colitis (UC) patients between the ages of 25 and 65 and 36.36% in non-Hispanic black (NHB) Crohn's disease (CD) patients. During the pandemic, deaths at home or on arrival and at medical facilities as well as deaths due to neoplasms also increased.
IBD patients suffered excess non-COVID-19-related death during the pandemic. Excess death was associated with younger age among UC patients, and with NHB race among CD patients. Increased death at home or on arrival and due to neoplasms suggests that delayed presentation and difficulty accessing healthcare may have led to increased IBD mortality.
2019 年冠状病毒病（COVID-19）大流行扰乱了美国的医疗保健。
调查 COVID-19 相关和非 COVID-19 相关死亡以及与炎症性肠病（IBD）死者超额死亡相关的特征。
我们使用国家生命统计系统的数据进行了一项基于登记的研究，该系统报告了美国 99%以上人口的死亡数据，时间范围为 2006 年 1 月 1 日至 2021 年 12 月 31 日。对 25 岁及以上成年人的 IBD 相关死亡进行了分层，按年龄、性别、种族/族裔、死亡地点和主要死因进行分层。比较了每 100000 人实际和预测的年龄标准化死亡率（ASMR）。
在研究期间发生了 49782 例 IBD 相关死亡。非 COVID-19 相关死亡在 2020 年增加了 13.14%，在 2021 年增加了 18.12%[2020 年 ASMR：实际 1.55 预测 1.37，95%置信区间（CI）：1.26-1.49；2021 年 ASMR：实际 1.63 预测 1.38，95%CI：1.26-1.49]。在 2020 年，25 至 65 岁的溃疡性结肠炎（UC）患者中非 COVID-19 相关死亡率增加了 17.65%，非西班牙裔黑人（NHB）克罗恩病（CD）患者增加了 36.36%。在大流行期间，在家中或在抵达时以及在医疗设施中的死亡以及因肿瘤导致的死亡也有所增加。
IBD 患者在大流行期间遭受了非 COVID-19 相关的超额死亡。超额死亡与 UC 患者年龄较小有关，与 CD 患者的 NHB 种族有关。在家中或在抵达时以及因肿瘤导致的死亡增加表明，延迟就诊和难以获得医疗保健可能导致 IBD 死亡率增加。
