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评估新冠疫情对婴儿潮一代超额死亡率的影响:台湾奥密克戎零经验队列。

Assessing Excess Mortality of Baby Boomers from the COVID-19 Pandemic: Taiwan Omicron-naïve Cohort.

机构信息

Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Room 533, No. 17, Xu-Zhou Road, Taipei, 100, Taiwan.

Department of Emergency, Dachung Hospital, Miaoli, Taiwan.

出版信息

J Epidemiol Glob Health. 2024 Sep;14(3):1113-1121. doi: 10.1007/s44197-024-00262-0. Epub 2024 Jun 20.

Abstract

BACKGROUND

Asia's elderly Baby Boomer demographic (born between 1946 and 1964) faced a huge problem during the COVID-19 pandemic due to increased all-cause mortality. We aimed to provide a unique Taiwan situation regarding the impact of Baby Boomers on excess mortalities from all causes relative to non-Baby Boomers throughout distinct times of SARS-CoV-2 mutations during the COVID-19 pandemic.

METHODS

We used the Poisson time series design with a Bayesian directed acyclic graphic approach to build the background mortality prior to the COVID-19 pandemic between 2015 and 2019. It was then used for predicting the expected all-cause deaths compared to the reported figures during the COVID-19 pandemic period based on Taiwan residents, an Omicron-naïve cohort.

RESULTS

Baby Boomers experienced a 2% negative excess mortality in 2020 (Wuhan/D614G) and a 4% excess mortality in 2021 (Alpha/Delta) with a rising background mortality trend whereas non-Baby Boomers showed the corresponding figures of 4% negative excess and 1% excess with a stable trend. Baby Boomer and non-Baby Boomer excess mortality soared to 9% (95% CI: 7-10%) and 10% (95% CI: 9-11%), respectively, during the epidemic Omicron period from January to June 2022. Surprisingly, Baby Boomers aged 58-76 experienced the same 9% excess mortality as non-Baby Boomers aged 77 and beyond. Non-COVID-19 deaths were more prevalent among Baby Boomers than non-Baby Boomers (33% vs. 29%).

CONCLUSION

Baby Boomers were more likely to die from COVID-19 in early pandemic and had more non-COVID-19 deaths in late pandemic than older non-Baby Boomers demonstrated in Taiwan Omicron-naïve cohort. For this vulnerable population, adequate access to medical care and medical capacity require more consideration.

摘要

背景

亚洲的老年婴儿潮一代(出生于 1946 年至 1964 年之间)在 COVID-19 大流行期间由于全因死亡率增加而面临巨大问题。我们旨在提供有关婴儿潮一代对 SARS-CoV-2 突变期间 COVID-19 大流行期间全因超额死亡率相对于非婴儿潮一代的影响的独特台湾情况。

方法

我们使用泊松时间序列设计和贝叶斯有向无环图方法,构建了 COVID-19 大流行前 2015 年至 2019 年期间的背景死亡率。然后,我们使用该方法根据台湾居民(奥密克戎-naive 队列),预测 COVID-19 大流行期间的全因死亡预期与报告数字之间的差异。

结果

婴儿潮一代在 2020 年(武汉/D614G)经历了 2%的负超额死亡率,在 2021 年(Alpha/Delta)经历了 4%的超额死亡率,同时背景死亡率呈上升趋势,而非婴儿潮一代则分别显示出 4%的负超额死亡率和 1%的稳定趋势。婴儿潮一代和非婴儿潮一代的超额死亡率在 2022 年 1 月至 6 月期间的奥密克戎疫情期间飙升至 9%(95%CI:7-10%)和 10%(95%CI:9-11%)。令人惊讶的是,58-76 岁的婴儿潮一代经历了与 77 岁及以上的非婴儿潮一代相同的 9%的超额死亡率。非 COVID-19 死亡在婴儿潮一代中比非婴儿潮一代更为普遍(33%比 29%)。

结论

在台湾奥密克戎-naive 队列中,婴儿潮一代在早期大流行期间更有可能死于 COVID-19,在后期大流行期间死于非 COVID-19 的可能性比老年非婴儿潮一代更大。对于这一脆弱人群,需要更多地考虑他们获得医疗保健和医疗能力的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94de/11444035/c8edf91d6b6e/44197_2024_262_Fig1_HTML.jpg

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