PDF(Pubmed)
Abstract：
Objectives: To evaluate excess deaths of gastrointestinal, liver, and pancreatic diseases in the United States during the COVID-19 pandemic. Methods: We retrieved weekly death counts from National Vital Statistics System and fitted them with a quasi-Poisson regression model. Cause-specific excess deaths were calculated by the difference between observed and expected deaths with adjustment for temporal trend and seasonality. Demographic disparities and temporal-spatial patterns were evaluated for different diseases. Results: From March 2020 to September 2022, the increased mortality (measured by excess risks) for Clostridium difficile colitis, gastrointestinal hemorrhage, and acute pancreatitis were 35.9%; 24.8%; and 20.6% higher than the expected. For alcoholic liver disease, fibrosis/cirrhosis, and hepatic failure, the excess risks were 1.4-2.8 times higher among younger inhabitants than older inhabitants. The excess deaths of selected diseases were persistently observed across multiple epidemic waves with fluctuating trends for gastrointestinal hemorrhage and fibrosis/cirrhosis and an increasing trend for C. difficile colitis. Conclusion: The persistently observed excess deaths of digestive diseases highlights the importance for healthcare authorities to develop sustainable strategies in response to the long-term circulating of SARS-CoV-2 in the community.
摘要：
目标：评估胃肠道的过量死亡，肝脏,以及COVID-19大流行期间美国的胰腺疾病。方法：我们从国家生命统计系统中检索每周死亡计数，并使用准泊松回归模型进行拟合。根据观察到的死亡人数与预期死亡人数之间的差异，并根据时间趋势和季节性进行调整，计算出特定原因的超额死亡人数。对不同疾病的人口统计学差异和时空格局进行了评估。结果：从2020年3月到2022年9月，艰难梭菌结肠炎的死亡率（以超额风险衡量）增加，消化道出血,和急性胰腺炎分别为35.9%;24.8%;和20.6%高于预期。对于酒精性肝病，纤维化/肝硬化，和肝功能衰竭,年轻居民的超额风险是老年居民的1.4-2.8倍。在多个流行波中持续观察到选定疾病的过量死亡，胃肠道出血和纤维化/肝硬化的趋势波动，艰难梭菌结肠炎的趋势增加。结论：持续观察到的消化系统疾病过量死亡凸显了医疗机构制定可持续策略以应对SARS-CoV-2在社区中的长期传播的重要性。
