背景:基于残疾调整生命年(DALYs)的疾病负担是评估疾病或损伤对人群健康影响的国际公认指标之一。这项研究旨在根据伊朗健康保险组织(IHIO)的医院层面数据,提供COVID-19对伊朗健康造成负担的证据。这几乎覆盖了全国一半的人口。
方法:从医院信息处理系统中提取从COVID-19大流行开始(2020年2月)至2021年12月30日在全国范围内转诊的所有IHIO参与者的数据,指定诊断代码为COVID-19。COVID-19导致的DALY是使用世界卫生组织的标准方法和欧洲疾病负担网络指南进行估计的。
结果:在2020年和2021年,在大约4200万人的人口中,1,040,367人因感染COVID-19而入院,其中73%住院(760,963例)。这两年的估计DALY总数分别为665,823和928,393(每100,000人口1,603和2,234)。99.7%的DALYs归因于过早死亡(YLL)导致的寿命损失。20岁以下年龄组的疾病负担份额,20-49年,50-80年,超过80年是6.6%,26.4%,58.4%,和8.6%,分别。
结论:根据医院层面的数据估计,COVID-19对伊朗的健康造成了沉重负担。在研究期间,COVID-19被确定为伊朗疾病负担的第五大原因,排在心血管疾病之后,心理障碍,肿瘤,和肌肉骨骼疾病。此外,COVID-19是第三大死因,跟随心血管疾病和肿瘤。制定政策和实施全面计划以加强卫生系统和社会对新出现和重新出现的传染病爆发的反应至关重要。
BACKGROUND: The burden of disease based on disability-adjusted life years (DALYs) is one of the internationally accepted metrics for assessing the impact of a disease or injury on population health. This study aimed to provide evidence of the burden of COVID-19 on health in Iran based on hospital-level data from the Iran Health Insurance Organization (IHIO), which covers almost half of the country\'s population.
METHODS: The data of all IHIO enrollees who were referred to hospitals across the country from the beginning of the COVID-19 pandemic (February 2020) to December 30, 2021, with assigned diagnosis codes of COVID-19, were extracted from the hospital information processing system. The DALYs due to COVID-19 were estimated using the standard approach of the World Health Organization and the European Burden of Disease Network guideline.
RESULTS: In the years 2020 and 2021, among a population of about 42 million people, 1,040,367 individuals were admitted to the hospital due to COVID-19 infection, of whom 73% were hospitalized (760,963 patients). The total estimated DALYs for these two years were 665,823 and 928,393, respectively (1,603 and 2,234 per 100,000 population). 99.7% of DALYs were attributed to years of life lost due to premature death (YLLs). The share of the disease burden in the age groups of under 20 years, 20-49 years, 50-80 years, and over 80 years was 6.6%, 26.4%, 58.4%, and 8.6%, respectively.
CONCLUSIONS: Based on the hospital-level data estimates, COVID-19 has had a significant burden on health in Iran. COVID-19 was identified as the fifth leading cause of disease burden in Iran during the study period, ranking after cardiovascular diseases, psychological disorders, neoplasms, and musculoskeletal disorders. Additionally, COVID-19 was the third major cause of death, following cardiovascular diseases and neoplasms. Policymaking and the implementation of comprehensive programs to enhance the response of the health system and society to outbreaks of emerging and re-emerging infectious diseases are of utmost importance.