COVID-19 Pandemic and Burden of Non-Communicable Diseases: An Ecological Study on Data of 185 Countries.,Journal of Stroke & Cerebrovascular Diseases

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COVID-19 Pandemic and Burden of Non-Communicable Diseases: An Ecological Study on Data of 185 Countries.
Journal of Stroke & Cerebrovascular Diseases ( IF 2.0 ) Pub Date : 2020-06-25 , DOI: 10.1016/j.jstrokecerebrovasdis.2020.105089
M Reza Azarpazhooh ₁ , Negar Morovatdar ₂ , Abolfazl Avan ₃ , Thanh G Phan ₄ , Afshin A Divani ₅ , Nawaf Yassi ₆ , Saverio Stranges ₇ , Brian Silver ₈ , José Biller ₉ , Masoud Tokazebani Belasi ₁₀ , Sepideh Kazemi Neya ₁₀ , Bita Khorram ₁₁ , Asher Frydman ₁₂ , Yongchai Nilanont ₁₃ , Elisa Onorati ₁₄ , Mario Di Napoli ₁₅

Affiliation

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.
Department of Public Health, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Neurology Monash Health, Clinical Trials, Imaging and Informatics division of Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia.
Department of Neurology, School of Medicine, University of New Mexico, Albuquerque, NM, USA.
Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia; Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.
Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Family Medicine, Schulich School of Medicine and Dentistry Western University, London, ON, Canada; Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg.
Department of Neurology, University of Massachusetts Medical School, Worcester, MA, USA.
Department of Neurology, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA.
Research centre for Prevention of cardiovascular disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
Dalla Lana School of Public Health, University of Toronto; Toronto, ON, Canada.
Stroke Prevention and Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Ontario, Canada.
Siriraj Stroke Center, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Department of Neurology and Stroke Unit, San Camillo de' Lellis General District Hospital, Rieti, Italy.
Department of Neurology and Stroke Unit, San Camillo de' Lellis General District Hospital, Rieti, Italy; Neurological Section, Neuro-epidemiology Unit, SMDN-Centre for Cardiovascular Medicine and Cerebrovascular Disease Prevention, Sulmona, L'Aquila, Italy.

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.

中文翻译：

COVID-19 流行病和非传染性疾病的负担：对 185 个国家数据的生态学研究。

背景

2019 年冠状病毒病 (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 与衰老和非传染性疾病的关联。

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，特别是心血管疾病、死亡、伤残调整生命年 (DALY) 和健康预期寿命 (HALE) 的数据。截至 2020 年 5 月 28 日，我们的世界数据数据库中有 19 例病例、死亡和检测。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 等级相关和调整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。

发现

高收入地区每百万人口病例数最高，东南亚、东亚和大洋洲地区每百万人口病例数最少（3050.60 vs. 63.86）。撒哈拉以南地区报告的 COVID-19 死亡率最低（1.9）。在拉丁美洲和加勒比地区，封锁启动的中位延迟时间从第一例病例出现后一天到东南亚、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。HALE 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，HALE 与 COVID-19 病例率独立相关，游客数量与 COVID-19 死亡率相关。