Chong, B, Jayabaskaran, J, Kong, G, Huak Chan, Y, Han Chin, Y, Goh, R, Kannan, S, Ng, CH, Loong, S, Kueh, MTW, Lin, C, Anand, VV, Zhe, ELC, Chan, KE, Wang, JW, Muthiah, M, Dimitriadis, G, Hausenloy, D, Mehta, A, Foo, R, Lip, G, Chan, M, Mamas, M, Le Roux, C and Chew, N (2023) Trends and Predictions of Malnutrition and Obesity in 204 Countries and Territories: an analysis of the Global Burden of Disease Study 2019. EClinicalMedicine, 43 (33). pp. 3164-3178. ISSN 2589-5370

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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.

Item Type: Article
Additional Information: The final version of this article and all relevant information related to it, including copyrights, can be found on the publisher website.
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Faculty of Medicine and Health Sciences > School of Medicine
Related URLs:
Depositing User: Symplectic
Date Deposited: 01 Feb 2023 09:16
Last Modified: 14 Apr 2023 10:49
URI: https://eprints.keele.ac.uk/id/eprint/11879

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