Diabetes and COVID-19: Global and regional perspectives.
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ABSTRACT:
SUBMITTER: Jeong IK
PROVIDER: S-EPMC7332438 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundA growing literature has documented the high global morbidity, mortality and mental health burden associated with the current Covid-19 pandemic. In this paper, we aimed to quantify the total utility and quality of life loss resulting from Covid-19-related government restrictions imposed at the national, regional and global levels.MethodsWe conducted quality of life online surveys in France, India, Italy, UK and the United States of America between June 21st and September 13th 2021, and used regression models to estimate the average quality of life loss due to light and severe restrictions in these countries. We then combined estimated disutility weights from the pooled sample with the latest data on Covid-19 restrictions exposure in each country to estimate the total disutility generated by restrictions at the national, regional and global level. We also embedded a discrete choice experiment (DCE) into the online survey to estimate average willingness to pay to avoid specific restrictions.FindingsA total of 947 surveys were completed. Thirty-five percent of respondents were female, and 69.5% were between 18 and 39 years old. The weighted average utility weight was 0.71 (95% CIs 0.69-0.74) for light restrictions, and 0.65 (0.63-0.68) for severe restrictions. At the global scale, this implies a total loss of 3259 million QALYs (95% 3021, 3496) as of September 6th, 2021, with the highest burden in lower and upper middle-income countries. Utility losses appear to be particularly large for closures of schools and daycares as well as restaurants and bars, and seem relatively small for wearing masks and travel restrictions.InterpretationThe results presented here suggest that the QALY losses due to restrictions are substantial. Future mitigation strategies should try to balance potential reductions in disease transmission achievable through specific measures against their respective impact on quality of life. Additional research is needed to determine differences in restriction-specific disutilities across countries, and to determine optimal policy responses to similar future disease threats.FundingNo funding was received for this project.
| S-EPMC8856030 | biostudies-literature
Project description:Early in the COVID-19 pandemic, type 2 diabetes (T2D) was marked as a risk-factor for severe disease. Inflammation is central to the aetiology of both conditions where immune responses influence disease course. Identifying at-risk groups through immuno-inflammatory signatures can direct personalised care and help develop potential targets for precision therapy. This observational study characterised immunophenotypic variation associated with COVID-19 severity in T2D. Broad-spectrum immunophenotyping quantified 15 leukocyte populations in circulation from a cohort of 45 hospitalised COVID-19 patients with and without T2D. Lymphocytopenia, of CD8+ lymphocytes, was associated with severe COVID-19 and intensive care admission in non-diabetic and T2D patients. A morphological anomaly of increased monocyte size and monocytopenia of classical monocytes were specifically associated with severe COVID-19 in patients with T2D requiring intensive care. Over-expression of inflammatory markers reminiscent of the type-1 interferon pathway underlaid the immunophenotype associated with T2D. These changes may contribute to severity of COVID-19 in T2D. These findings show characteristics of severe COVID-19 in T2D as well as provide evidence that type-1 interferons may be actionable targets for future studies.
| S-SCDT-EMM-2020-13038 | biostudies-other
Project description:The repercussions of the COVID-19 pandemic and climate change - two major current global crises - are far-reaching, the parallels between the two are striking, and their influence on one another are significant. Based on the wealth of evidence that has emerged from the scientific literature during the first two years of the pandemic, this study argues that these two global crises require holistic multisectoral mitigation strategies. Despite being different in nature, neither crisis can be effectively mitigated without considering their interdependencies. Herein, significant interactions between these two crises are highlighted and discussed. Major implications related to the economy, energy, technology, environment, food systems and agriculture sector, health systems, policy, management, and communities are detailed via a review of existing joint literature. Based on these outcomes, practical recommendations for future research and management are provided. While the joint timing of these crises has created a global conundrum, the COVID-19 pandemic has demonstrated opportunities and lessons for devising sustainable recovery plans in relation to the climate crisis. The findings indicated that governments should work collaboratively to develop durable and adjustable strategies in line with long-term, global decarbonisation targets, promote renewable energy resources, integrate climate change into environmental policies, prioritise climate-smart agriculture and local food systems, and ensure public and ecosystem health. Further, differences in geographic distributions of climate change and COVID-19 related death cases revealed that these crises pose different threats to different parts of the world. These learnings provide insights to address the climate emergency - and potential future global problems with similar characteristics - if international countries act urgently and collectively.
| S-EPMC9252874 | biostudies-literature
Project description:In the backdrop of upward trend in anthropogenic aerosols over global hotspot regions, the air quality had improved worldwide post declaration of the Corona virus disease-2019 (COVID-19) as a global pandemic in mid-March-2020. Present study using Moderate Resolution Imaging Spectroradiometer (MODIS) satellite derived aerosol optical depth (AOD) and the Modern-Era Retrospective analysis for Research and Applications (MERRA) version-2 datasets however, demonstrates the regional variation in aerosol loading during peak of the lockdown period. Reduction in aerosol loading over majority of the aerosol hotspots is observed from mid-March/April-2020 with highest percentage reduction in the month of May. Reduction in aerosol loading over global hotspots resulted in positive surface aerosol radiative forcing (ARF, up to 6 Wm-2). Albeit reduction in aerosol loading observed worldwide, the considerable above normal aerosol burden was identified during April-May 2020 over the Amazon river basin, northern parts of the South America, Mexico region, South-West parts of the Africa and South East Asian region. Analysis revealed that the wildfire emission contributed significantly in anomalous aerosol burden over these regions during the lockdown period. An appropriate mitigation measures to reduce wildfire emissions is essential in addition to controlled anthropogenic emissions as far as air quality, deforestation and ecosystem is concerned.
| S-EPMC7722495 | biostudies-literature
Project description:BackgroundReal-time surveillance of search behavior on the internet has achieved accessibility in measuring disease activity. In this study, we systematically assessed the associations between internet search trends of gastrointestinal (GI) symptom terms and daily newly confirmed COVID-19 cases at both global and regional levels.MethodsRelative search volumes (RSVs) of GI symptom terms were derived from internet search engines. Time-series analyses with autoregressive integrated moving average models were conducted to fit and forecast the RSV trends of each GI symptom term before and after the COVID-19 outbreak. Generalized additive models were used to quantify the effects of RSVs of GI symptom terms on the incidence of COVID-19. In addition, dose-response analyses were applied to estimate the shape of the associations.ResultsThe RSVs of GI symptom terms could be characterized by seasonal variation and a high correlation with symptoms of "fever" and "cough" at both global and regional levels; in particular, "diarrhea" and "loss of taste" were abnormally increased during the outbreak period of COVID-19, with elevated point changes of 1.31 and 8 times, respectively. In addition, these symptom terms could effectively predict a COVID-19 outbreak in advance, underlying the lag correlation at 12 and 5 days, respectively, and with mutual independence. The dose-response curves showed a consistent increase in daily COVID-19 risk with increasing search volumes of "diarrhea" and "loss of taste".ConclusionThis is the first and largest epidemiologic study that comprehensively revealed the advanced prediction of COVID-19 outbreaks at both global and regional levels via GI symptom indicators.
| S-EPMC8625285 | biostudies-literature
Project description:AimsThe risk of mortality from the coronavirus disease that emerged in 2019 (COVID-19) is increased by comorbidity from cardiovascular and pulmonary diseases. Air pollution also causes excess mortality from these conditions. Analysis of the first severe acute respiratory syndrome coronavirus (SARS-CoV-1) outcomes in 2003, and preliminary investigations of those for SARS-CoV-2 since 2019, provide evidence that the incidence and severity are related to ambient air pollution. We estimated the fraction of COVID-19 mortality that is attributable to the long-term exposure to ambient fine particulate air pollution.Methods and resultsWe characterized global exposure to fine particulates based on satellite data, and calculated the anthropogenic fraction with an atmospheric chemistry model. The degree to which air pollution influences COVID-19 mortality was derived from epidemiological data in the USA and China. We estimate that particulate air pollution contributed ∼15% (95% confidence interval 7-33%) to COVID-19 mortality worldwide, 27% (13 - 46%) in East Asia, 19% (8-41%) in Europe, and 17% (6-39%) in North America. Globally, ∼50-60% of the attributable, anthropogenic fraction is related to fossil fuel use, up to 70-80% in Europe, West Asia, and North America.ConclusionOur results suggest that air pollution is an important cofactor increasing the risk of mortality from COVID-19. This provides extra motivation for combining ambitious policies to reduce air pollution with measures to control the transmission of COVID-19.
| S-EPMC7797754 | biostudies-literature
Project description: Not available
| S-BSST563 | biostudies-other
Project description:ObjectiveTo provide global, regional, and national estimates of target population sizes for coronavirus disease 2019 (covid-19) vaccination to inform country specific immunisation strategies on a global scale.DesignDescriptive study.Setting194 member states of the World Health Organization.PopulationTarget populations for covid-19 vaccination based on country specific characteristics and vaccine objectives (maintaining essential core societal services; reducing severe covid-19; reducing symptomatic infections and stopping virus transmission).Main outcome measureSize of target populations for covid-19 vaccination. Estimates use country specific data on population sizes stratified by occupation, age, risk factors for covid-19 severity, vaccine acceptance, and global vaccine production. These data were derived from a multipronged search of official websites, media sources, and academic journal articles.ResultsTarget population sizes for covid-19 vaccination vary markedly by vaccination goal and geographical region. Differences in demographic structure, presence of underlying conditions, and number of essential workers lead to highly variable estimates of target populations at regional and country levels. In particular, Europe has the highest share of essential workers (63.0 million, 8.9%) and people with underlying conditions (265.9 million, 37.4%); these two categories are essential in maintaining societal functions and reducing severe covid-19, respectively. In contrast, South East Asia has the highest share of healthy adults (777.5 million, 58.9%), a key target for reducing community transmission. Vaccine hesitancy will probably impact future covid-19 vaccination programmes; based on a literature review, 68.4% (95% confidence interval 64.2% to 72.6%) of the global population is willing to receive covid-19 vaccination. Therefore, the adult population willing to be vaccinated is estimated at 3.7 billion (95% confidence interval 3.2 to 4.1 billion).ConclusionsThe distribution of target groups at country and regional levels highlights the importance of designing an equitable and efficient plan for vaccine prioritisation and allocation. Each country should evaluate different strategies and allocation schemes based on local epidemiology, underlying population health, projections of available vaccine doses, and preference for vaccination strategies that favour direct or indirect benefits.
| S-EPMC7736995 | biostudies-literature
Project description:ObjectivesTo develop a practical solution for modeling diabetes progression and account for the variations in risks of diabetes complications in different regions of the world, which is critical for model-based evaluations on the value of diabetes intervention across populations from different regions globally.MethodsA literature search was conducted to identify eligible clinical trials to support calibration. The Building, Relating, Assessing, and Validating Outcomes (BRAVO) model was employed to simulate diabetes complications using the baseline characteristics of each clinical trial cohort. We utilized regression methods to estimate regional variations across the United States, Europe, Asia, and other regions (eg, Latin America, Africa) in 6 outcomes: myocardial infarction (MI), congestive heart failure (CHF), stroke, angina, revascularization, and mortality.ResultsRegional variations were detected in 4 outcomes. Compared with other regions, individuals from the United States had higher risks of MI (hazard ratio [HR] 1.64; 95% confidence interval [CI]1.41-1.91) and revascularization (HR 3.6; 95% CI 2.94-4.41). Individuals from Europe had a lower risk of stroke (HR 0.61; 95% CI 0.46-0.81), and individuals from other regions outside of the United States, Europe, and Asia had a lower risk of CHF (HR 0.18; 95% CI 0.06-0.58). Finally, the simulated outcomes were regressed on observed outcomes using an ordinary least squares model, with an intercept (0.026), slope (1.005), and R-squared value (0.789) indicating good prediction accuracy.ConclusionRecalibrating the BRAVO model's diabetes risk engine to account for regional differences shows improved prediction accuracy when the model is applied to multi-region populations commonly recruited for clinical trials.
| S-EPMC9115837 | biostudies-literature
Project description:In the turbulent year 2020, overshadowed by the global COVID-19 pandemic, Austria experienced multiple waves of increased case incidence. While governmental measures to curb the numbers were based on current knowledge of infection risk factors, a retrospective analysis of incidence and lethality at the district level revealed correlations of relative infection risk with socioeconomic, geographical, and behavioral population parameters. We identified unexpected correlations between political orientation and smoking behavior and COVID-19 infection risk and/or mortality. For example, a decrease in daily smokers by 2.3 percentage points would be associated with an increase in cumulative incidence by 10% in the adjusted model, and an increase in voters of the right-wing populist party by 1.6 percentage points with an increase in cumulative mortality by 10%. While these parameters are apparently only single elements of complex causal chains that finally lead to individual susceptibility and vulnerability levels, our findings might have identified ecological parameters that can be utilized to develop fine-tuned communications and measures in upcoming challenges of this and other pandemics.
| S-EPMC8835493 | biostudies-literature