BMC public health · 2025
Excess mortality in COVID-19-negative people with non-communicable disorders during the first pandemic wave.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Vigo Daniel V, Hudec Kristen L, Ferdous Saimoom, Munthali Richard J, Pei Julia, Munro Lonna, Pendakur Krishna, Yatham Lakshmi N, Kessler Ronald C, Ng Raymond T, Puyat Joseph H
Аннотация
BACKGROUND: Estimating the indirect mortality due to COVID-19 is of the utmost importance to develop adequate public health policy during future outbreaks.
METHODS: From province-wide administrative datasets, we identified British Columbians who tested negative for COVID-19 during the first wave and never tested positive throughout 2020. We obtained a pre-pandemic (2018) cohort matched on age, sex, history of non-communicable disorders (NCDs), multimorbidity, and severity/acuity, and implemented a doubly robust estimation of the effect of the first pandemic wave on mortality.
RESULTS: The adjusted odds ratio (AOR) of death was 3.2 times higher for a 2020 cohort who tested negative for COVID-19 (n = 123,133), compared to matched pre-pandemic controls. In both cohorts, a majority (72.5%) experienced at least one pre-existing NCD. Stratification by NCD shows an AOR of death ranges between 2-for people with substance use disorders- and 7-for people previously undiagnosed with NCDs (e.g., incident cases that went untreated). The largest subgroup was composed of people with mental disorders (47,413 people), with an AOR of death of 2.5. Though the COVID-19 direct mortality in the general population remained low (1.9 per 10,000), the excess mortality in this COVID-negative cohort was extremely high - 4,085 of the 123,133- which entails a minimum indirect excess mortality death rate of 6.5 per 10,000 in the general population.
CONCLUSIONS: During the first pandemic year, mortality in COVID-negative adults was several times greater than before COVID-19, in people with matched NCD distribution and severity. Our findings suggest that low direct COVID-19 mortality was accompanied by less visible-but much higher- indirect mortality due to undiagnosed and/or untreated NCDs, highlighting the need to focus not only on mitigating the harms of new agents, but also of continuing service delivery for treatable conditions.
METHODS: From province-wide administrative datasets, we identified British Columbians who tested negative for COVID-19 during the first wave and never tested positive throughout 2020. We obtained a pre-pandemic (2018) cohort matched on age, sex, history of non-communicable disorders (NCDs), multimorbidity, and severity/acuity, and implemented a doubly robust estimation of the effect of the first pandemic wave on mortality.
RESULTS: The adjusted odds ratio (AOR) of death was 3.2 times higher for a 2020 cohort who tested negative for COVID-19 (n = 123,133), compared to matched pre-pandemic controls. In both cohorts, a majority (72.5%) experienced at least one pre-existing NCD. Stratification by NCD shows an AOR of death ranges between 2-for people with substance use disorders- and 7-for people previously undiagnosed with NCDs (e.g., incident cases that went untreated). The largest subgroup was composed of people with mental disorders (47,413 people), with an AOR of death of 2.5. Though the COVID-19 direct mortality in the general population remained low (1.9 per 10,000), the excess mortality in this COVID-negative cohort was extremely high - 4,085 of the 123,133- which entails a minimum indirect excess mortality death rate of 6.5 per 10,000 in the general population.
CONCLUSIONS: During the first pandemic year, mortality in COVID-negative adults was several times greater than before COVID-19, in people with matched NCD distribution and severity. Our findings suggest that low direct COVID-19 mortality was accompanied by less visible-but much higher- indirect mortality due to undiagnosed and/or untreated NCDs, highlighting the need to focus not only on mitigating the harms of new agents, but also of continuing service delivery for treatable conditions.