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Trends and Predictions of Malnutrition and Obesity in 204 Countries and Territories: an analysis of the Global Burden of Disease Study 2019

Chong, Bryan; Jayabaskaran, Jayanth; Kong, Gwyneth; Huak Chan, Yiong; Han Chin, Yip; Goh, Rachel; Kannan, Shankar; Han Ng, Cheng; Loong, Shaun; Tze Wah Kueh, Martin; Lin, Chaoxing; Vijay Anand, Vickram; Cheng Zhe Lee, Ethan; Jocelyn Chew, H.S.; Jun Hao Tan, Darren; En Chan, Kai; Wang, Jiong-Wei; Muthiah, Mark; Dimitriadis, Georgios K.; Hausenloy, Derek J.; Mehta, Anurag J.; Foo, Roger; Lip, Gregory; Chan, Mark Y.; Mamas, Mamas A.; le Roux, Carel W.; Chew, Nicholas W.S.

Trends and Predictions of Malnutrition and Obesity in 204 Countries and Territories: an analysis of the Global Burden of Disease Study 2019 Thumbnail


Authors

Bryan Chong

Jayanth Jayabaskaran

Gwyneth Kong

Yiong Huak Chan

Yip Han Chin

Rachel Goh

Shankar Kannan

Cheng Han Ng

Shaun Loong

Martin Tze Wah Kueh

Chaoxing Lin

Vickram Vijay Anand

Ethan Cheng Zhe Lee

H.S. Jocelyn Chew

Darren Jun Hao Tan

Kai En Chan

Jiong-Wei Wang

Mark Muthiah

Georgios K. Dimitriadis

Derek J. Hausenloy

Anurag J. Mehta

Roger Foo

Gregory Lip

Mark Y. Chan

Carel W. le Roux

Nicholas W.S. Chew



Abstract

Aims
The effect of the COVID-19 pandemic on care and outcomes across non-COVID-19 cardiovascular (CV) diseases is unknown. A systematic review and meta-analysis was performed to quantify the effect and investigate for variation by CV disease, geographic region, country income classification and the time course of the pandemic.

Methods and results
From January 2019 to December 2021, Medline and Embase databases were searched for observational studies comparing a pandemic and pre-pandemic period with relation to CV disease hospitalisations, diagnostic and interventional procedures, outpatient consultations, and mortality. Observational data were synthesised by incidence rate ratios (IRR) and risk ratios (RR) for binary outcomes and weighted mean differences for continuous outcomes with 95% confidence intervals. The study was registered with PROSPERO (CRD42021265930). A total of 158 studies, covering 49 countries and 6 continents, were used for quantitative synthesis. Most studies (80%) reported information for high-income countries (HICs). Across all CV disease and geographies there were fewer hospitalisations, diagnostic and interventional procedures, and outpatient consultations during the pandemic. By meta-regression, in low-middle income countries (LMICs) compared to HICs the decline in ST-segment elevation myocardial infarction (STEMI) hospitalisations (RR 0.79, 95% confidence interval [CI] 0.66–0.94) and revascularisation (RR 0.73, 95% CI 0.62–0.87) was more severe. In LMICs, but not HICs, in-hospital mortality increased for STEMI (RR 1.22, 95% CI 1.10–1.37) and heart failure (RR 1.08, 95% CI 1.04–1.12). The magnitude of decline in hospitalisations for CV diseases did not differ between the first and second wave.

Conclusions
There was substantial global collateral CV damage during the COVID-19 pandemic with disparity in severity by country income classification.

Journal Article Type Article
Acceptance Date Jan 17, 2023
Online Publication Date Feb 16, 2023
Publication Date Mar 1, 2023
Publicly Available Date Jul 6, 2023
Journal EClinicalMedicine
Print ISSN 2589-5370
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 57
Article Number 101850
Pages 3164-3178
DOI https://doi.org/10.1016/j.eclinm.2023.101850
Keywords Global burden; Obesity; Malnutrition; Mortality; Disability-adjusted life years
Publisher URL https://academic.oup.com/eurheartj/article/43/33/3164/6594507

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