According to the Who Organization website on May 5, the latest WHO data estimates that between January 1, 2020 and December 31, 2021, the number of deaths directly or indirectly related to the new crown worldwide was about 14.91 million, and the actual range was between 13.3 million and 16.6 million. But according to official statistics from various countries, the total number of COVID-19 deaths worldwide in the first two years was about 5.4 million.
WHO estimates are based on an analysis of the number of "excess deaths" worldwide. "Excess deaths" refers to the difference between the number of deaths actually occurring globally and the normal number of deaths estimated based on the years in which the pandemic did not occur, including deaths directly attributable to the outbreak and indirectly related deaths due to the pandemic's impact on health systems and society.
Previously, researchers at the Institute of Health Metrics and Evaluation at the University of Washington published a similar assessment in the journal The Lancet in March 2022, arguing that by the end of 2021, the number of "excess deaths" worldwide had reached 18 million. According to one estimate in The Economist, about 21.3 million people worldwide will die from COVID-19 in 2020 and 2021.
According to WHO, 84% of global "excess deaths" occur in Southeast Asia, Europe and the Americas. Of the 14.91 million deaths, middle-income countries accounted for 81%, while high- and low-income countries accounted for 15% and 4%, respectively. Globally, men die more globally than women, with 57 per cent of men and 43 per cent of women, and more deaths of people over 60 years of age, accounting for 82 per cent.
In addition, about 68% of "excess deaths" are concentrated in 10 countries. The countries with the highest number of "excess deaths" include the United States, India, Russia, Indonesia, Brazil, Mexico, Peru and other places.
According to WHO, India has actually died of COVID-19 in the past two years, 10 times the officially reported figure. But the Indian government questioned the WHO, saying it was "concerned" about the way it estimated based on models and some data.
Chart: How many more deaths by country than officially counted by WHO
The report also shows that the proportion of "excess deaths" in many high-income countries relative to the total population is also higher than the global average, including the United States, Germany, the United Kingdom and so on.
In the United States, WHO estimates that the number of "excess deaths" will be approximately 930,000 between 2020 and 2021, compared with about 820,000 official COVID-19 deaths during the same period.
In addition, WHO believes that countries with low "excess mortality" include China, which implements "dynamic clearance", Australia, Japan and Norway, which implement strict travel restrictions.
Chart: WHO counts the number of excess deaths during COVID-19 in different countries
The origins of COVID-19 and diabetes are not far-reaching. Of all the chronic diseases, the "love-hate entanglement" between diabetes and COVID-19 is the most widely studied.
On January 29, 2020, shortly after the outbreak of the new crown epidemic, the Lancet, a top international medical journal, published a paper that counted 41 patients diagnosed with the new coronavirus as of January 2, 2020, of which 32% were chronic diseases such as diabetes, hypertension and coronary heart disease, and 46% died. Among them, the proportion of diabetic patients is as high as 20%, and diabetics are very likely to be susceptible to new coronavirus infection.
At that time, there was not enough evidence-based medical evidence for the blood glucose management of patients with novel coronavirus infection and diabetes mellitus, and with reference to the existing evidence-based medical evidence, the Diabetes Branch of the Chinese Medical Association formulated the "Expert Recommendations for The Management of Diabetes at the Grassroots Level During the Novel Coronavirus Pneumonia Epidemic".
In September 2021, the PNAS study revealed that the intense, persistent "cytokine storm" caused by COVID-19 in people with type 2 diabetes mellitus is responsible for the increase in morbidity and mortality.
On March 21, 2022, the Lancet sub-issue published an article titled Risks and burdens of incident diabetes in long COVID: a cohort study.
The results of the study show that compared with uninfected people, the risk of diabetes in 1 year of covid-19 infection is significantly increased by 40%!
Multiple studies have shown that diabetes is a high risk factor for COVID-19, associated with the severity of COVID-19 and the risk of higher mortality. Based on the current data sample, on April 21, 2022, Diabetes Care released a study on the causes of quarterly changes in diabetes-related mortality in the United States, which is shown below.
Trends in all-cause mortality and specific cause mortality in diabetics before and during the COVID-19 pandemic in the United States
Research background
According to the International Diabetes Alliance, 6.7 million adults with diabetes will die globally in 2021, accounting for 12.2% of all deaths globally.
Recently, however, data from the U.S. National Vital Statistics System (NVSS) showed that during the 2019 coronavirus disease (COVID-19) pandemic, the number of diabetic deaths increased in most states and was once the root cause of death.
Purpose of the study
Diabetes is a potential cause of death, but current data are insufficient to estimate diabetes-related national mortality. During COVID-19, potential causes of death for people with diabetes may include COVID-19, cardiovascular disease (CVD), cancer and kidney disease. Therefore, this study assessed trends in all-cause diabetes-related and specific-cause mortality rates in the United States before and during THE COVID-19 pandemic.
Research design and methodology
To assess quarterly trends in diabetes-related mortality among U.S. adults 20 years of age and older, the study analyzed national mortality records for NVSS 2017-2020 using death certificates. Defines the potential or cause of death in people with diabetes according to ICD-10 (E10-E14).
Diabetes is recorded using a potential cause of death for people with the following conditions:
Cardiovascular disease ICD-10 I00–I99, cancer ICD-10 C00–C97, diabetes ICD-10 E10–E14, nephropathy ICD-10 N00–N07, N17–N19 and N25–N27, accident V01–X59 and Y85–Y86, and COVID-19 U07.1.
To determine the impact of COVID-19 on diabetes mortality, we calculated quarterly age-specific mortality using the number of deaths divided by the total number of deaths in the United States, calculated quarterly percentage change (QPC) and average QPC, an aggregate measure of trends that explains shifts within each trend segment, and uses connection point regression to determine long-term trends.
outcome
Of the 11750978 deaths in the U.S. from 2017 to 2020, the study population included 1218968 all-cause deaths due to diabetes (listed as a potential or contributing cause of death); 373802 deaths from cardiovascular disease, 358439 deaths from diabetes, 124881 deaths from cancer, 2,310 deaths from kidney disease, and 62,595 deaths from COVID-19 (2020).
The study data showed that the quarterly age-standardized all-cause mortality rate due to diabetes increased by an average QPC of 2.4% (95% CI 0.8–4.1) (Figure 1A), and from Q1 2017 (Q1 2017) to Q3 2019, the all-cause mortality rate for diabetes remained relatively stable (QPC -1.0%, 95% CI 2.5-0.6), a sharp increase from Q3 2019 to Q4 2020 (QPC 9.6%, 95% CI 4.7–14.6)。
Figure 1A Quarterly age-standardized all-cause mortality due to diabetes and specific-cause mortality in patients with diabetes
Cancer-related mortality remained stable before COVID-19 (QPC 0.2%, 95% CI 0.7-0.2), but during COVID-19, it grew by 3.9% (95% CI 1.7-6.2).
During the COVID-19 pandemic, the COVID-19-related mortality rate among people with diabetes increased sharply from 0.4 per 100,000 in the first quarter of 2020 to 9.7 per 100,000 in the fourth quarter of 2020, matching the increasing gap in all-cause mortality from diabetes and explaining the increase in deaths due to diabetes.
Trends in cardiovascular, diabetes, cancer and kidney disease-related mortality rates as potential causes of death for people with diabetes declined during the COVID-19 pandemic, while the annual trend of specific-cause mortality rates remained stable prior to COVID-19 (Figure 1B).
The proportion of COVID-19-related mortality among people with diabetes rose sharply from 1.3% in the first quarter of 2020 to 24.7% in the fourth quarter of 2020, and among people with diabetes, cardiovascular disease (24.0%) or diabetes (24.1%) caused an equal proportion of deaths.
Figure 1B Quarterly trends in the proportion of specific potential causes of death in patients with diabetes mellitus
The mortality rate of people at risk associated with COVID-19, such as those with diabetes who are susceptible to disordered inflammatory responses or cytokine storms, has increased by more than 4 times.
conclusion
Overall, the all-cause mortality rate from diabetes remained stable before COVID-19 but rose sharply during COVID-19. While there was no significant increase in diabetes or cardiovascular disease-related mortality among people with diabetes, covid-19-related mortality among people with diabetes increased dramatically to 25 percent, comparable to the proportion of deaths from cardiovascular disease or diabetes.
Original link: https://diabetesjournals.org/care/article/doi/10.2337/dc22-0348/145033/Trends-in-All-Cause-and-Cause-Specific-Mortality
The "additional deaths" of the epidemic cannot be ignored
Led by the Chinese Center for Disease Control and Prevention as early as February 2021, a study in the British Medical Journal on changes in additional mortality in Wuhan and other parts of China in the three months leading up to the COVID-19 outbreak was published.
The results showed an overall 21% increase in mortality from chronic noncommunicable diseases, including an 83% increase in diabetes mortality.
Since February 2020, the U.S. has recorded more than 1 million "additional deaths" related to the COVID-19 pandemic, according to U.S. federal data.
The reason for such a large number of additional deaths is that the impact and trauma caused by the new crown virus pandemic and the subsequent severe lockdown and other measures have caused psychological and psychological trauma to the people, coupled with the social stagnation and life stoppage caused by strict control, including the suspension of medical treatment, which makes the number of deaths caused by the new crown virus epidemic much higher than the number of people saved by the epidemic prevention measures themselves.
In short, for the new crown epidemic, while adhering to the "dynamic clearance", the "additional deaths" of the epidemic cannot be ignored.
Source| the endocrine front line of the health community
Written by | Liu Xueli