PDF(Pubmed)
Abstract：
UNASSIGNED: In view of anecdotal reports of sudden unexplained deaths in India\'s apparently healthy young adults, linking to coronavirus disease 2019 (COVID-19) infection or vaccination, we determined the factors associated with such deaths in individuals aged 18-45 years through a multicentric matched case-control study.
METHODS: This study was conducted through participation of 47 tertiary care hospitals across India. Cases were apparently healthy individuals aged 18-45 years without any known co-morbidity, who suddenly (<24 h of hospitalization or seen apparently healthy 24 h before death) died of unexplained causes during 1 st October 2021-31 st March 2023. Four controls were included per case matched for age, gender and neighborhood. We interviewed/perused records to collect data on COVID-19 vaccination/infection and post-COVID-19 conditions, family history of sudden death, smoking, recreational drug use, alcohol frequency and binge drinking and vigorous-intensity physical activity two days before death/interviews. We developed regression models considering COVID-19 vaccination ≤42 days before outcome, any vaccine received anytime and vaccine doses to compute an adjusted matched odds ratio (aOR) with 95 per cent confidence interval (CI).
RESULTS: Seven hundred twenty nine cases and 2916 controls were included in the analysis. Receipt of at least one dose of COVID-19 vaccine lowered the odds [aOR (95% CI)] for unexplained sudden death [0.58 (0.37, 0.92)], whereas past COVID-19 hospitalization [3.8 (1.36, 10.61)], family history of sudden death [2.53 (1.52, 4.21)], binge drinking 48 h before death/interview [5.29 (2.57, 10.89)], use of recreational drug/substance [2.92 (1.1, 7.71)] and performing vigorous-intensity physical activity 48 h before death/interview [3.7 (1.36, 10.05)] were positively associated. Two doses lowered the odds of unexplained sudden death [0.51 (0.28, 0.91)], whereas single dose did not.
UNASSIGNED: COVID-19 vaccination did not increase the risk of unexplained sudden death among young adults in India. Past COVID-19 hospitalization, family history of sudden death and certain lifestyle behaviors increased the likelihood of unexplained sudden death.
METHODS: This study was conducted through participation of 47 tertiary care hospitals across India. Cases were apparently healthy individuals aged 18-45 years without any known co-morbidity, who suddenly (<24 h of hospitalization or seen apparently healthy 24 h before death) died of unexplained causes during 1 st October 2021-31 st March 2023. Four controls were included per case matched for age, gender and neighborhood. We interviewed/perused records to collect data on COVID-19 vaccination/infection and post-COVID-19 conditions, family history of sudden death, smoking, recreational drug use, alcohol frequency and binge drinking and vigorous-intensity physical activity two days before death/interviews. We developed regression models considering COVID-19 vaccination ≤42 days before outcome, any vaccine received anytime and vaccine doses to compute an adjusted matched odds ratio (aOR) with 95 per cent confidence interval (CI).
RESULTS: Seven hundred twenty nine cases and 2916 controls were included in the analysis. Receipt of at least one dose of COVID-19 vaccine lowered the odds [aOR (95% CI)] for unexplained sudden death [0.58 (0.37, 0.92)], whereas past COVID-19 hospitalization [3.8 (1.36, 10.61)], family history of sudden death [2.53 (1.52, 4.21)], binge drinking 48 h before death/interview [5.29 (2.57, 10.89)], use of recreational drug/substance [2.92 (1.1, 7.71)] and performing vigorous-intensity physical activity 48 h before death/interview [3.7 (1.36, 10.05)] were positively associated. Two doses lowered the odds of unexplained sudden death [0.51 (0.28, 0.91)], whereas single dose did not.
UNASSIGNED: COVID-19 vaccination did not increase the risk of unexplained sudden death among young adults in India. Past COVID-19 hospitalization, family history of sudden death and certain lifestyle behaviors increased the likelihood of unexplained sudden death.
摘要：
■鉴于有关印度看似健康的年轻人突然死亡的传闻，与2019年冠状病毒病（COVID-19）感染或疫苗接种有关，我们通过一项多中心配对病例对照研究,确定了18~45岁人群中与此类死亡相关的因素.
方法：这项研究是由印度47家三级医院参与进行的。病例显然是18-45岁的健康个体，没有任何已知的合并症，在2021年10月1日至2023年3月31日期间突然（住院<24小时或死亡前24小时明显健康）死于无法解释的原因。每个病例包括四个对照，年龄相匹配，性别和邻里。我们采访/浏览记录，以收集有关COVID-19疫苗接种/感染和COVID-19后状况的数据，家族猝死史,吸烟,娱乐性药物使用,饮酒频率和暴饮暴食和剧烈运动前两天死亡/访谈。我们建立了考虑COVID-19疫苗接种≤42天前的回归模型，任何时间接种的疫苗和疫苗剂量以95%置信区间(CI)计算调整匹配比值比(aOR).
结果：分析中包括7129例病例和2916例对照。接受至少一剂COVID-19疫苗降低了原因不明的猝死[0.58（0.37，0.92）]的几率[aOR（95%CI）]，而过去的COVID-19住院[3.8（1.36，10.61）]，猝死家族史[2.53（1.52，4.21）]，死亡/面试前48小时暴饮暴食[5.29（2.57，10.89）]，使用娱乐性药物/物质[2.92(1.1,7.71)]和在死亡/访谈前48小时进行高强度体力活动[3.7(1.36,10.05)]呈正相关.两个剂量降低了不明原因猝死的几率[0.51（0.28，0.91）]，而单剂量没有。
■COVID-19疫苗接种并没有增加印度年轻人不明原因猝死的风险。过去的COVID-19住院，猝死家族史和某些生活方式行为增加了不明原因猝死的可能性.
方法：这项研究是由印度47家三级医院参与进行的。病例显然是18-45岁的健康个体，没有任何已知的合并症，在2021年10月1日至2023年3月31日期间突然（住院<24小时或死亡前24小时明显健康）死于无法解释的原因。每个病例包括四个对照，年龄相匹配，性别和邻里。我们采访/浏览记录，以收集有关COVID-19疫苗接种/感染和COVID-19后状况的数据，家族猝死史,吸烟,娱乐性药物使用,饮酒频率和暴饮暴食和剧烈运动前两天死亡/访谈。我们建立了考虑COVID-19疫苗接种≤42天前的回归模型，任何时间接种的疫苗和疫苗剂量以95%置信区间(CI)计算调整匹配比值比(aOR).
结果：分析中包括7129例病例和2916例对照。接受至少一剂COVID-19疫苗降低了原因不明的猝死[0.58（0.37，0.92）]的几率[aOR（95%CI）]，而过去的COVID-19住院[3.8（1.36，10.61）]，猝死家族史[2.53（1.52，4.21）]，死亡/面试前48小时暴饮暴食[5.29（2.57，10.89）]，使用娱乐性药物/物质[2.92(1.1,7.71)]和在死亡/访谈前48小时进行高强度体力活动[3.7(1.36,10.05)]呈正相关.两个剂量降低了不明原因猝死的几率[0.51（0.28，0.91）]，而单剂量没有。
■COVID-19疫苗接种并没有增加印度年轻人不明原因猝死的风险。过去的COVID-19住院，猝死家族史和某些生活方式行为增加了不明原因猝死的可能性.
