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Fursa O, Bannister W, Neesgaard B, Podlekareva D, Kowalska J, Benfield T, Gerstoft J, Reekie J, Rasmussen LD, Aho I, Guaraldi G, Staub T, Miro JM, Laporte JM, Elbirt D, Trofimova T, Sedlacek D, Matulionyte R, Oprea C, Bernasconi E, Hadžiosmanović V, Mocroft A, Peters L. SARS-CoV-2 testing, positivity, and factors associated with COVID-19 among people with HIV across Europe in the multinational EuroSIDA cohort. HIV Med 2024; 25:711-724. [PMID: 38433476 DOI: 10.1111/hiv.13620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 01/31/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Although people with HIV might be at risk of severe outcomes from infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; coronavirus 2019 [COVID-19]), regional and temporal differences in SARS-CoV-2 testing in people with HIV across Europe have not been previously described. METHODS We described the proportions of testing, positive test results, and hospitalizations due to COVID-19 between 1 January 2020 and 31 December 2021 in the EuroSIDA cohort and the factors associated with being tested for SARS-CoV-2 and with ever testing positive. RESULTS Of 9012 participants, 2270 (25.2%, 95% confidence interval [CI] 24.3-26.1) had a SARS-CoV-2 polymerase chain reaction test during the study period (range: 38.3% in Northern to 14.6% in Central-Eastern Europe). People from Northern Europe, women, those aged <40 years, those with CD4 cell count <350 cells/mm3, and those with previous cardiovascular disease or malignancy were significantly more likely to have been tested, as were people with HIV in 2021 compared with those in 2020. Overall, 390 people with HIV (4.3%, 95% CI 3.9-4.8) tested positive (range: 2.6% in Northern to 7.1% in Southern Europe), and the odds of testing positive were higher in all regions than in Northern Europe and in 2021 than in 2020. In total, 64 people with HIV (0.7%, 95% CI 0.6-0.9) were hospitalized, of whom 12 died. Compared with 2020, the odds of positive testing decreased in all regions in 2021, and the associations with cardiovascular disease, malignancy, and use of tenofovir disoproxil fumarate disappeared in 2021. Among study participants, 58.9% received a COVID-19 vaccine (range: 72.0% in Southern to 14.8% in Eastern Europe). CONCLUSIONS We observed large heterogeneity in SARS-CoV-2 testing and positivity and a low proportion of hospital admissions and deaths across the regions of Europe.
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Affiliation(s)
- O Fursa
- Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, Copenhagen, Denmark
| | - W Bannister
- Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, Copenhagen, Denmark
| | - B Neesgaard
- Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, Copenhagen, Denmark
| | - D Podlekareva
- Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, Copenhagen, Denmark
- Department of Respiratory and Infectious Diseases, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - J Kowalska
- Department of Adults' Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | - T Benfield
- Department of Infectious Diseases, Copenhagen University Hospital-Amager and Hvidovre, Hvidovre, Denmark
| | - J Gerstoft
- Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - J Reekie
- Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, Copenhagen, Denmark
| | - L D Rasmussen
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
| | - I Aho
- Division of Infectious Diseases, Helsinki University Hospital, Helsinki, Finland
| | - G Guaraldi
- Modena HIV Cohort, Università degli Studi di Modena, Modena, Italy
| | - T Staub
- Centre Hospitalier de Luxembourg, Service des Maladies Infectieuses, Luxembourg City, Luxembourg
| | - J M Miro
- Infectious Diseases Service, Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - J M Laporte
- Hospital Universitario de Alava, Vitoria-Gasteiz, Spain
| | - D Elbirt
- Allergy, Immunology and HIV Unit, Kaplan Medical Center, Rehovot, Israel
| | - T Trofimova
- Novgorod Centre for AIDS prevention and control, Veliky Novgorod, Russian Federation
| | - D Sedlacek
- Department of Infectious Diseases and Travel Medicine, Medical Faculty and Teaching Hospital Plzen, Charles University Prague, Plzen, Czech Republic
| | - R Matulionyte
- Department of Infectious Diseases and Dermatovenerology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Vilnius University Hospital, Vilnius, Lithuania
| | - C Oprea
- Victor Babes Clinical Hospital for Infectious and Tropical Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - E Bernasconi
- Division of Infectious Diseases, Ente Ospedaliero Cantonale Lugano, University of Geneva and University of Southern Switzerland, Lugano, Switzerland
| | - V Hadžiosmanović
- Infectious Diseases Clinic, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - A Mocroft
- Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, Copenhagen, Denmark
- UCL Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), London, UK
| | - L Peters
- Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, Copenhagen, Denmark
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Rahota D, Rahota RG, Camarasan A, Muresan MM, Magheru S, Rahota D, Andreescu G, Maghiar F, Pop O. Premature Mortality Excess Rates Before and During the COVID-19 Pandemic: A Comparative Analysis Conducted in Bihor County, Romania. Cureus 2024; 16:e60403. [PMID: 38883066 PMCID: PMC11179132 DOI: 10.7759/cureus.60403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2024] [Indexed: 06/18/2024] Open
Abstract
BACKGROUND Estimating the excess of premature deaths (before the age of 75 years) and Potential Years of Life Lost allows ranking causes of death as an expression of the burden of disease in a population. We statistically analysed the impact of the coronavirus disease 2019 (COVID-19) pandemic on excess premature mortality in the total population and specifically, by sexes, compared to the pre-pandemic period, through Potential Years of Life Lost. MATERIAL AND METHOD In this retrospective descriptive observational study, we counted excess of premature mortality in the years 2020, 2021, and 2022 by cause of death (cardiovascular diseases, cancer, digestive diseases, injury, COVID-19, and other causes) and by sexes compared to the period average from 2017-2019, based on the deaths registered in Bihor County (48,948 people). RESULTS Premature deaths due to COVID-19 (1,745 people of both sexes) contributed 71.3% to excess mortality, the population being similar for both sexes (71.4% in men and 71.2% in women). The Potential Years of Life Lost/death due to COVID-19 was 11.84 years for both sexes (11.76 years in men and 12.02 years in women). Potential Years of Life Lost/all-cause heath was lower during the pandemic (13.42 years for both sexes, 14.06 years for men and 12.32 years for women) compared to the pre-pandemic period (14.6 years for both sexes, 15.1 years for men and 13.5 years for women). CONCLUSIONS The excess of premature mortality and decreased Potential Years of Life Lost/death during the pandemic, shows an increase in the proportion of deaths at ages closer to the established limit for premature mortality (75 years) compared to the pre-pandemic period.
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Affiliation(s)
- Diana Rahota
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, ROU
| | - Razvan G Rahota
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, ROU
| | - Andreea Camarasan
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, ROU
| | - Mihaela M Muresan
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, ROU
| | - Sorina Magheru
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, ROU
| | - Daniela Rahota
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, ROU
| | - Gineta Andreescu
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, ROU
| | - Florin Maghiar
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, ROU
| | - Ovidiu Pop
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, ROU
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Giovanetti M, Cella E, Ivanov I, Grigorova L, Stoikov I, Donchev D, Dimitrova R, Slavov SN, Mavian C, Fonseca V, Scarpa F, Borsetti A, Korsun N, Trifonova I, Dobrinov V, Kantardjiev T, Christova I, Ciccozzi M, Alexiev I. Genomic Epidemiology and Lineage Dynamics of SARS-CoV-2 in Bulgaria: Insights from a Three-Year Pandemic Analysis. Viruses 2023; 15:1924. [PMID: 37766330 PMCID: PMC10536935 DOI: 10.3390/v15091924] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/05/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
The COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has brought about significant challenges worldwide. In this study, we present a comprehensive analysis of the genomic epidemiology and lineage dynamics of SARS-CoV-2 in Bulgaria over a three-year period. Through extensive genomic sequencing and data analysis, we investigated the evolution of the virus, the emergence of variants of concern (VOCs), and their impact on the country's pandemic trajectory. We also assessed the relationship between viral diversity and COVID-19 morbidity and mortality in Bulgaria. Our findings shed light on the temporal and spatial distribution of SARS-CoV-2 lineages and provide crucial insights into the dynamics of the pandemic in the country. The interplay between international travel and viral transmission plays a significant role in the emergence and dissemination of different SARS-CoV-2 variants. The observed proportions of exportation to various continents provide insights into the potential pathways through which these lineages spread globally. Understanding the genomic epidemiology of SARS-CoV-2 in Bulgaria is essential for formulating targeted public health strategies, enhancing vaccination efforts, and effectively managing future outbreaks.
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Affiliation(s)
- Marta Giovanetti
- Instituto Rene Rachou Fundação Oswaldo Cruz, Belo Horizonte 30190-009, Brazil
- Sciences and Technologies for Sustainable Development and One Health, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
- Climate Amplified Diseases and Epidemics (CLIMADE), Brazil
| | - Eleonora Cella
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL 32816, USA
| | - Ivan Ivanov
- National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (I.I.); (L.G.); (I.S.); (D.D.); (R.D.); (N.K.); (I.T.); (V.D.); (T.K.); (I.C.); (I.A.)
| | - Lyubomira Grigorova
- National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (I.I.); (L.G.); (I.S.); (D.D.); (R.D.); (N.K.); (I.T.); (V.D.); (T.K.); (I.C.); (I.A.)
| | - Ivan Stoikov
- National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (I.I.); (L.G.); (I.S.); (D.D.); (R.D.); (N.K.); (I.T.); (V.D.); (T.K.); (I.C.); (I.A.)
| | - Deyan Donchev
- National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (I.I.); (L.G.); (I.S.); (D.D.); (R.D.); (N.K.); (I.T.); (V.D.); (T.K.); (I.C.); (I.A.)
| | - Reneta Dimitrova
- National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (I.I.); (L.G.); (I.S.); (D.D.); (R.D.); (N.K.); (I.T.); (V.D.); (T.K.); (I.C.); (I.A.)
| | - Svetoslav Nanev Slavov
- Butantan Institute, São Paulo 05508-040, Brazil;
- Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14051-140, Brazil
| | - Carla Mavian
- Emerging Pathogens Institute, Department of Pathology, Immunology and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL 32610, USA;
| | - Vagner Fonseca
- Department of Exact and Earth Sciences, University of the State of Bahia, Salvador 40285-001, Brazil;
- Coordenação de Vigilância, Preparação e Resposta à Emergências e Desastres (PHE), Organização Pan-Americana da Saúde/Organização Mundial da Saúde (OPAS/OMS), Brasilia 70312-970, Brazil
| | - Fabio Scarpa
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy;
| | - Alessandra Borsetti
- National HIV/AIDS Research Center (CNAIDS), National Institute of Health, 00118 Rome, Italy;
| | - Neli Korsun
- National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (I.I.); (L.G.); (I.S.); (D.D.); (R.D.); (N.K.); (I.T.); (V.D.); (T.K.); (I.C.); (I.A.)
| | - Ivelina Trifonova
- National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (I.I.); (L.G.); (I.S.); (D.D.); (R.D.); (N.K.); (I.T.); (V.D.); (T.K.); (I.C.); (I.A.)
| | - Veselin Dobrinov
- National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (I.I.); (L.G.); (I.S.); (D.D.); (R.D.); (N.K.); (I.T.); (V.D.); (T.K.); (I.C.); (I.A.)
| | - Todor Kantardjiev
- National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (I.I.); (L.G.); (I.S.); (D.D.); (R.D.); (N.K.); (I.T.); (V.D.); (T.K.); (I.C.); (I.A.)
| | - Iva Christova
- National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (I.I.); (L.G.); (I.S.); (D.D.); (R.D.); (N.K.); (I.T.); (V.D.); (T.K.); (I.C.); (I.A.)
| | - Massimo Ciccozzi
- Unit of Medical Statistics and Molecular Epidemiology, Universita Campus Bio-Medico di Roma, 00128 Rome, Italy;
| | - Ivailo Alexiev
- National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria; (I.I.); (L.G.); (I.S.); (D.D.); (R.D.); (N.K.); (I.T.); (V.D.); (T.K.); (I.C.); (I.A.)
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4
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Lebanova H, Stoev S, Naseva E, Getova V, Wang W, Sabale U, Petrova E. Economic Burden of Cervical Cancer in Bulgaria. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2746. [PMID: 36768109 PMCID: PMC9915037 DOI: 10.3390/ijerph20032746] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
Bulgaria is among the European Union (EU) countries with the highest burden of cervical cancers and life expectancy below the EU average. The majority of cervical cancer cases (more than 95%) are caused by the human papillomavirus (HPV). The aim of this retrospective, cost of illness study is to identify direct healthcare costs of cervical cancer in Bulgaria from the payer perspective and to calculate indirect costs and the associated years of life lost. Costs data were sourced from the National Health Insurance Fund from January 2018 to December 2020. Years of life lost were calculated based on the country and gender-specific life expectancy. Indirect costs due to productivity loss were calculated using the human capital approach. The total treatment costs for 3540 patients with cervical cancer are EUR 5,743,657 (2018), EUR 6,377,508 (2019), and EUR 6,751,182 (2020). The costs associated with drug acquisition and administration accounted for the majority (63%) of total healthcare costs followed by hospital management costs (14%). An estimated total of 20,446 years of life were lost due to cervical cancer for the period 2018-2020. The costs of productivity losses are estimated at EUR 7,578,014. Our study showed that the economic burden of cervical cancer in Bulgaria is substantial. Focus on cervical cancer prevention via vaccination against the human papillomavirus, timely screening, early diagnosis, and higher vaccine coverage rates could reduce its economic burden in Bulgaria.
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Affiliation(s)
- Hristina Lebanova
- Faculty of Pharmacy, Medical University-Pleven, 5800 Pleven, Bulgaria
| | - Svetoslav Stoev
- Faculty of Pharmacy, Medical University-Pleven, 5800 Pleven, Bulgaria
| | - Emilia Naseva
- Faculty of Public Health “Prof. Tsekomir Vodenicharov, MD, DSc”, Medical University of Sofia, 1527 Sofia, Bulgaria
| | - Violeta Getova
- Faculty of Pharmacy, Medical University of Sofia, 1000 Sofia, Bulgaria
| | - Wei Wang
- Center for Observational and Real-World Evidence, Merck & Co., Inc., Rahway, NJ 07065, USA
| | - Ugne Sabale
- Center for Observational and Real-World Evidence, Merck Sharp & Dohme, 11330 Stockholm, Sweden
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Muacevic A, Adler JR. The Prevalence of COVID-19 in Europe by the End of November 2022: A Cross-Sectional Study. Cureus 2023; 15:e33546. [PMID: 36779135 PMCID: PMC9907732 DOI: 10.7759/cureus.33546] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2023] [Indexed: 01/11/2023] Open
Abstract
Background The world has been affected differently by the coronavirus disease 2019 (COVID-19), and Europe reaped the largest number of cases and deaths. Moreover, COVID-19 statistics are dynamic. Objectives The current study aimed to use COVID-19 data to examine the COVID-19 prevalence in Europe by the end of November 2022 and compare the findings globally. Methods The primary data on COVID-19 for each European country were obtained from the "Worldometer" website. The data include the cumulative incidence of COVID-19 per country, the cumulative number of deaths, the total number of tests performed, the number of cases per million population, the number of deaths per million, the number of tests per million, and the total population. The case-fatality rate was calculated (number of deaths/number of cases). In addition, the median age and the vaccination coverage rate (people who received two doses) for each European country were extracted from the "United Nations" website and the "Our World in Data" website, respectively. To compare European countries to the globe, COVID-19 data for each continent were obtained. The analysis of variance (ANOVA) test was used to compare variances across the means of the four parts of Europe based on the geographic division. An independent sample t-test was also used to compare the means between the European Union (EU) states and non-EU states. The Spearman correlation coefficient was used to determine the relationship between different variables across Europe. Results As of December 1, 2022, about 648 million COVID-19 cases and 6.6 million deaths have been recorded worldwide. Europe accounted for nearly 36.8% and 29.5% of all cases and deaths, respectively. Based on the number of deaths per million, Europe was the most affected continent after South America. Nearly 6.8 billion tests have been conducted worldwide, 41% done in Europe; 43 European countries have performed tests more than their population. However, COVID-19 statistics were inconsistent across the four parts of Europe. A significant difference was noticed between Eastern Europe and others, especially Northern Europe and Western Europe. By affiliation with the EU, there was no significant difference. For global comparison, the mean deaths per million, the mean cases per million, and the mean tests per population for European countries were higher than those of the world's countries, although they recorded a lower mean case-fatality rate (CFR). Thirteen European countries were among the 15 most affected countries worldwide based on the number of deaths per million, most located in Eastern and Southern Europe. The number of cases and the number of deaths were significantly proportional to the number of tests performed. Conclusions By the end of November 2022, Europe had the most cases of COVID-19, the most deaths, and the most tests performed, even though it accounts for 9.4% of the world's population. However, COVID-19 data were inconsistent across the four parts of Europe, especially between Eastern Europe and others. Given the natural immunity acquired during the three years and the excellent vaccine coverage in Europe, it is essential to reconsider the definition of a suspected case and establish more specific criteria for testing.
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Gavazova E, Grekova- Kafalova D. Pharmacy practice in the light of the COVID-19 pandemic- a pilot project from Bulgaria. MAKEDONSKO FARMACEVTSKI BILTEN 2022. [DOI: 10.33320/maced.pharm.bull.2022.68.03.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Affiliation(s)
- Evelina Gavazova
- Department of Pharmaceutical sciences, Faculty of Pharmacy, Medical university of Plovdiv, 4000 Bulgaria
| | - Daniela Grekova- Kafalova
- Department of Pharmaceutical sciences, Faculty of Pharmacy, Medical university of Plovdiv, 4000 Bulgaria
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7
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Rangachev A, Marinov GK, Mladenov M. The Impact and Progression of the COVID-19 Pandemic in Bulgaria in Its First Two Years. Vaccines (Basel) 2022; 10:vaccines10111901. [PMID: 36366409 PMCID: PMC9696094 DOI: 10.3390/vaccines10111901] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/03/2022] [Accepted: 11/06/2022] [Indexed: 11/12/2022] Open
Abstract
After initially having low levels of SARS-CoV-2 infections for much of the year, Bulgaria experienced a major epidemic surge at the end of 2020, which caused the highest recorded excess mortality in Europe, among the highest in the word (Excess Mortality Rate, or EMR ∼0.25%). Two more major waves followed in 2021, followed by another one in early 2022. In this study, we analyze the temporal and spatial patterns of excess mortality at the national and local levels and across different demographic groups in Bulgaria and compare those to the European levels. Bulgaria has continued to exhibit the previous pattern of extremely high excess mortality, as measured both by crude mortality metrics (an EMR of ∼1.05%, up to the end of March 2022) and by standardized ones—Potential Years of Life Lost (PYLL) and Aged-Standardized Years of life lost Rate (ASYR). Unlike Western Europe, the bulk of excess mortality in Bulgaria, as well as in several other countries in Eastern Europe, occurred in the second year of the pandemic, likely related to the differences in the levels of vaccination coverage between these regions. We also observe even more extreme levels of excess mortality at the regional level and in some subpopulations (e.g., total EMR values for males ≥ 2% and EMR values for males aged 40–64 ≥ 1% in certain areas). We discuss these observations in light of the estimates of infection fatality rate (IFR) and eventual population fatality rate (PFR) made early in the course of the pandemic.
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Affiliation(s)
- Antoni Rangachev
- Institute of Mathematics and Informatics, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria
- International Center for Mathematical Sciences-Sofia, 1113 Sofia, Bulgaria
| | - Georgi K. Marinov
- Department of Genetics, Stanford University, Stanford, CA 94305, USA
- Correspondence:
| | - Mladen Mladenov
- Tilburg University, Warandelaan 2, 5037 AB Tilburg, The Netherlands
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Nuutinen M, Haavisto I, Niemi AJ, Rissanen A, Ikivuo M, Leskelä RL. Statistical model for factors correlating with COVID-19 deaths. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2022; 82:103333. [PMID: 36277812 PMCID: PMC9557215 DOI: 10.1016/j.ijdrr.2022.103333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/20/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The COVID-19 pandemic has caused major disruption in societies globally. Our aim is to understand, what factors were associated with the impact of the pandemic on death rates. This will help countries to better prepare for and respond in future pandemics. METHODS We modeled with a linear mixed effect model the impact of COVID-19 with the dependent variable "Daily mortality change" (DMC) with country features variables and intervention (containment measurement) data. We tested both country characteristics consisting of demographic, societal, health related, healthcare system specific, environmental and cultural feature as well as COVID-19 specific response in the form of social distancing interventions. RESULTS A statistically significant country feature was Geert Hofstede's masculinity, i.e., the extent to which the use of force is endorsed socially, correlating positively with a higher DMC. The effects of different interventions were stronger that those of country features, particularly cancelling public events, controlling international travel and closing workplaces. CONCLUSION Social distancing interventions and the country feature: Geert Hofstede's masculinity dimension had a significant impact on COVID-19 mortality change. However other country features, such as development and population health did not show significance. Thus, the crises responders and scholars could revisit the concept and understanding of preparedness for and response to pandemics.
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Affiliation(s)
| | - Ira Haavisto
- NHG Finland and Hanken School of Economics, Finland
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9
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Global Excess Mortality during COVID-19 Pandemic: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10:vaccines10101702. [PMID: 36298567 PMCID: PMC9607451 DOI: 10.3390/vaccines10101702] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 09/29/2022] [Accepted: 10/10/2022] [Indexed: 11/19/2022] Open
Abstract
Background: Currently, reported COVID-19 deaths are inadequate to assess the impact of the pandemic on global excess mortality. All-cause excess mortality is a WHO-recommended index for assessing the death burden of COVID-19. However, the global excess mortality assessed by this index remains unclear. We aimed to assess the global excess mortality during the COVID-19 pandemic. Methods: We searched PubMed, EMBASE, and Web of Science for studies published in English between 1 January 2020, and 21 May 2022. Cross-sectional and cohort studies that reported data about excess mortality during the pandemic were included. Two researchers independently searched the published studies, extracted data, and assessed quality. The Mantel–Haenszel random-effects method was adopted to estimate pooled risk difference (RD) and their 95% confidence intervals (CIs). Results: A total of 79 countries from twenty studies were included. During the COVID-19 pandemic, of 2,228,109,318 individuals, 17,974,051 all-cause deaths were reported, and 15,498,145 deaths were expected. The pooled global excess mortality was 104.84 (95% CI 85.56–124.13) per 100,000. South America had the highest pooled excess mortality [134.02 (95% CI: 68.24–199.80) per 100,000], while Oceania had the lowest [−32.15 (95% CI: −60.53–−3.77) per 100,000]. Developing countries had higher excess mortality [135.80 (95% CI: 107.83–163.76) per 100,000] than developed countries [68.08 (95% CI: 42.61–93.55) per 100,000]. Lower middle-income countries [133.45 (95% CI: 75.10–191.81) per 100,000] and upper-middle-income countries [149.88 (110.35–189.38) per 100,000] had higher excess mortality than high-income countries [75.54 (95% CI: 53.44–97.64) per 100,000]. Males had higher excess mortality [130.10 (95% CI: 94.15–166.05) per 100,000] than females [102.16 (95% CI: 85.76–118.56) per 100,000]. The population aged ≥ 60 years had the highest excess mortality [781.74 (95% CI: 626.24–937.24) per 100,000]. Conclusions: The pooled global excess mortality was 104.84 deaths per 100,000, and the number of reported all-cause deaths was higher than expected deaths during the global COVID-19 pandemic. In South America, developing and middle-income countries, male populations, and individuals aged ≥ 60 years had a heavier excess mortality burden.
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