Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

The Lancet, Journal Year: 2024, Volume and Issue: 403(10440), P. 2133 - 2161

Published: April 17, 2024

Detailed, comprehensive, and timely reporting on population health by underlying causes of disability premature death is crucial to understanding responding complex patterns disease injury burden over time across age groups, sexes, locations. The availability estimates can promote evidence-based interventions that enable public researchers, policy makers, other professionals implement strategies mitigate diseases. It also facilitate more rigorous monitoring progress towards national international targets, such as the Sustainable Development Goals. For three decades, Global Burden Diseases, Injuries, Risk Factors Study (GBD) has filled need. A global network collaborators contributed production GBD 2021 providing, reviewing, analysing all available data. are updated routinely with additional data refined analytical methods. presents, for first time, loss due COVID-19 pandemic.

Language: Английский

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Development of a Definition of Postacute Sequelae of SARS-CoV-2 Infection

JAMA, Journal Year: 2023, Volume and Issue: 329(22), P. 1934 - 1934

Published: May 25, 2023

Importance SARS-CoV-2 infection is associated with persistent, relapsing, or new symptoms other health effects occurring after acute infection, termed postacute sequelae of (PASC), also known as long COVID . Characterizing PASC requires analysis prospectively and uniformly collected data from diverse uninfected infected individuals. Objective To develop a definition using self-reported describe frequencies across cohorts, vaccination status, number infections. Design, Setting, Participants Prospective observational cohort study adults without at 85 enrolling sites (hospitals, centers, community organizations) located in 33 states plus Washington, DC, Puerto Rico. who were enrolled the RECOVER adult before April 10, 2023, completed symptom survey 6 months more onset test date. Selection included population-based, volunteer, convenience sampling. Exposure infection. Main Outcomes Measures 44 participant-reported (with severity thresholds). Results A total 9764 participants (89% infected; 71% female; 16% Hispanic/Latino; 15% non-Hispanic Black; median age, 47 years [IQR, 35-60]) met selection criteria. Adjusted odds ratios 1.5 greater (infected vs participants) for 37 symptoms. Symptoms contributing to score postexertional malaise, fatigue, brain fog, dizziness, gastrointestinal symptoms, palpitations, changes sexual desire capacity, loss change smell taste, thirst, chronic cough, chest pain, abnormal movements. Among 2231 first on December 1, 2021, within 30 days 224 (10% [95% CI, 8.8%-11%]) positive months. Conclusions Relevance was developed based prospective study. As step providing framework investigations, iterative refinement that further incorporates clinical features needed support actionable definitions PASC.

Language: Английский

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Risk Factors Associated With Post−COVID-19 Condition

JAMA Internal Medicine, Journal Year: 2023, Volume and Issue: 183(6), P. 566 - 566

Published: March 23, 2023

Post-COVID-19 condition (PCC) is a complex heterogeneous disorder that has affected the lives of millions people globally. Identification potential risk factors to better understand who at developing PCC important because it would allow for early and appropriate clinical support.To evaluate demographic characteristics comorbidities have been found be associated with an increased PCC.Medline Embase databases were systematically searched from inception December 5, 2022.The meta-analysis included all published studies investigated and/or predictors in adult (≥18 years) patients.Odds ratios (ORs) each factor pooled selected studies. For factor, random-effects model was used compare between individuals without factor. Data analyses performed 2022, February 10, 2023.The patient age; sex; body mass index, calculated as weight kilograms divided by height meters squared; smoking status; comorbidities, including anxiety depression, asthma, chronic kidney disease, obstructive pulmonary diabetes, immunosuppression, ischemic heart disease; previous hospitalization or ICU (intensive care unit) admission COVID-19; vaccination against COVID-19.The initial search yielded 5334 records which 255 articles underwent full-text evaluation, identified 41 total 860 783 patients included. The findings showed female sex (OR, 1.56; 95% CI, 1.41-1.73), age 1.21; 1.11-1.33), high BMI 1.15; 1.08-1.23), 1.10; 1.07-1.13) PCC. In addition, presence 2.48; 1.97-3.13 OR, 2.37; 2.18-2.56, respectively). Patients had vaccinated COVID-19 2 doses significantly lower compared not 0.57; 0.43-0.76).This systematic review demonstrated certain (eg, sex), severe PCC, whereas protective role sequelae. These may enable understanding develop provide additional evidence benefits vaccination.PROSPERO Identifier: CRD42022381002.

Language: Английский

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Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

The Lancet Neurology, Journal Year: 2024, Volume and Issue: 23(4), P. 344 - 381

Published: March 14, 2024

Summary

Background

Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from Global Burden of Disease, Injuries, Risk Factor Study estimated burden 15 neurological conditions in 2015 2016, but these analyses did not defined by International Classification Diseases (ICD)-11, or a subset cases congenital, neonatal, infectious that cause damage. Here, we estimate health loss caused 37 unique their associated risk factors globally, regionally, nationally 1990 to 2021.

Methods

We mortality, prevalence, years lived with disability (YLDs), life lost (YLLs), disability-adjusted life-years (DALYs), corresponding 95% uncertainty intervals (UIs), age sex 204 countries territories, included morbidity deaths due for which is directly damage CNS peripheral system. also isolated consequence, primary feature, including congenital (ie, chromosomal anomalies birth defects), neonatal jaundice, preterm birth, sepsis), diseases COVID-19, cystic echinococcosis, malaria, syphilis, Zika virus disease), diabetic neuropathy. By conducting sequela-level analysis outcomes only where occurred were included, YLDs recalculated isolate non-fatal attributable loss. A comorbidity correction was used calculate total prevalence all affect combined.

Findings

Globally, collectively ranked leading group DALYs 2021 (443 million, UI 378–521), 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 global population); DALY counts attributed increased 18·2% (8·7–26·7) between Age-standardised rates per 100 000 people decreased 33·6% (27·6–38·8), age-standardised 27·0% (21·5–32·4). almost stable, change 1·5% (0·7–2·4). The ten highest stroke, encephalopathy, migraine, Alzheimer's disease other dementias, neuropathy, meningitis, epilepsy, complications autism spectrum disorder, cancer.

Interpretation

As overall world, increasing counts, effective prevention, treatment, rehabilitation strategies disorders needed.

Funding

Bill & Melinda Gates Foundation.

Language: Английский

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Therapeutic strategies for COVID-19: progress and lessons learned

Nature Reviews Drug Discovery, Journal Year: 2023, Volume and Issue: 22(6), P. 449 - 475

Published: April 19, 2023

Language: Английский

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Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

The Lancet, Journal Year: 2024, Volume and Issue: 403(10440), P. 1989 - 2056

Published: March 11, 2024

Language: Английский

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The immunology of long COVID

Nature reviews. Immunology, Journal Year: 2023, Volume and Issue: 23(10), P. 618 - 634

Published: July 11, 2023

Language: Английский

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Postacute sequelae of COVID-19 at 2 years

Nature Medicine, Journal Year: 2023, Volume and Issue: 29(9), P. 2347 - 2357

Published: Aug. 21, 2023

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can lead to postacute sequelae in multiple organ systems, but evidence is mostly limited the first year postinfection. We built a cohort of 138,818 individuals with SARS-CoV-2 and 5,985,227 noninfected control group from US Department Veterans Affairs followed them for years estimate risks death 80 prespecified COVID-19 (PASC) according care setting during phase infection. The increased risk was not significant beyond 6 months after among nonhospitalized remained significantly elevated through hospitalized individuals. Within sequelae, 69% 35% became at individuals, respectively. Cumulatively years, PASC contributed 80.4 (95% confidence interval (CI): 71.6-89.6) 642.8 CI: 596.9-689.3) disability-adjusted life (DALYs) per 1,000 persons individuals; 25.3% (18.9-31.0%) 21.3% (18.2-24.5%) cumulative 2-year DALYs were second year. In sum, while many declined infection, substantial burden health loss due calls attention needs people long-term effects

Language: Английский

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Association of Treatment With Nirmatrelvir and the Risk of Post–COVID-19 Condition

JAMA Internal Medicine, Journal Year: 2023, Volume and Issue: 183(6), P. 554 - 554

Published: March 23, 2023

Importance Post–COVID-19 condition (PCC), also known as long COVID, affects many individuals. Prevention of PCC is an urgent public health priority. Objective To examine whether treatment with nirmatrelvir in the acute phase COVID-19 associated reduced risk PCC. Design, Setting, and Participants This cohort study used care databases US Department Veterans Affairs (VA) to identify patients who had a SARS-CoV-2 positive test result between January 3, 2022, December 31, were not hospitalized on day result, at least 1 factor for progression severe illness, survived first 30 days after diagnosis. Those treated oral within 5 (n = 35 717) those received no antiviral or antibody during infection (control group, n 246 076) identified. Exposures Treatment receipt based prescription records. Main Outcomes Measures Inverse probability weighted survival models estimate association (vs control) post–acute death, hospitalization, prespecified panel 13 sequelae (components PCC) reported relative scale (RR) hazard ratio (HR) absolute reduction percentage 180 (ARR). Results A total 281 793 (mean [SD] age, 61.99 [14.96]; 242 383 [86.01%] male) illness studied. Among them, 076 infection, 717 result. Compared control was (RR, 0.74; 95% CI, 0.72-0.77; ARR, 4.51%; 4.01-4.99), including 10 cardiovascular system (dysrhythmia ischemic heart disease), coagulation hematologic disorders (pulmonary embolism deep vein thrombosis), fatigue malaise, kidney disease, muscle pain, neurologic (neurocognitive impairment dysautonomia), shortness breath. Nirmatrelvir death (HR, 0.53; 0.46-0.61); 0.65%; 0.54-0.77), hospitalization 0.76; 0.73-0.80; 1.72%; 1.42-2.01). people unvaccinated, vaccinated, boosted, primary reinfection. Conclusions Relevance found that across spectrum this regardless vaccination status history prior infection; totality findings suggests may reduce adverse outcomes.

Language: Английский

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Persistent complement dysregulation with signs of thromboinflammation in active Long Covid

Science, Journal Year: 2024, Volume and Issue: 383(6680)

Published: Jan. 18, 2024

Long Covid is a debilitating condition of unknown etiology. We performed multimodal proteomics analyses blood serum from COVID-19 patients followed up to 12 months after confirmed severe acute respiratory syndrome coronavirus 2 infection. Analysis >6500 proteins in 268 longitudinal samples revealed dysregulated activation the complement system, an innate immune protection and homeostasis mechanism, individuals experiencing Covid. Thus, active was characterized by terminal system dysregulation ongoing alternative classical pathways, latter associated with increased antibody titers against several herpesviruses possibly stimulating this pathway. Moreover, markers hemolysis, tissue injury, platelet activation, monocyte-platelet aggregates were Machine learning thromboinflammatory as top biomarkers, warranting diagnostic therapeutic interrogation these systems.

Language: Английский

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