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Covid-19 Pandemic and Burden of Non-Communicable Diseases: An Ecological Study on Data of 185 Countries Publisher Pubmed



Azarpazhooh MR1, 2, 3 ; Morovatdar N4 ; Avan A5 ; Phan TG6 ; Divani AA7 ; Yassi N8, 9 ; Stranges S3, 10 ; Silver B11 ; Biller J12 ; Tokazebani Belasi M13 ; Kazemi Neya S13 ; Khorram B14 ; Frydman A1 ; Nilanont Y15 Show All Authors
Authors
  1. Azarpazhooh MR1, 2, 3
  2. Morovatdar N4
  3. Avan A5
  4. Phan TG6
  5. Divani AA7
  6. Yassi N8, 9
  7. Stranges S3, 10
  8. Silver B11
  9. Biller J12
  10. Tokazebani Belasi M13
  11. Kazemi Neya S13
  12. Khorram B14
  13. Frydman A1
  14. Nilanont Y15
  15. Onorati E16
  16. Di Napoli M16, 17
Show Affiliations
Authors Affiliations
  1. 1. Stroke Prevention and Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, ON, Canada
  2. 2. Department of Clinical Neurological Sciences, Western University, London, ON, Canada
  3. 3. Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
  4. 4. Clinical Research Development Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
  5. 5. Department of Public Health, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
  6. 6. Department of Neurology Monash Health, Clinical Trials, Imaging and Informatics division of Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia
  7. 7. Department of Neurology, School of Medicine, University of New Mexico, Albuquerque, NM, United States
  8. 8. Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
  9. 9. Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
  10. 10. Department of Family Medicine, Schulich School of Medicine and Dentistry Western University, London, ON, Canada
  11. 11. Department of Neurology, University of Massachusetts Medical School, Worcester, MA, United States
  12. 12. Department of Neurology, Loyola University Chicago Stritch School of Medicine, Maywood, IL, United States
  13. 13. Research centre for Prevention of cardiovascular disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
  14. 14. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
  15. 15. Siriraj Stroke Center, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
  16. 16. Department of Neurology and Stroke Unit, San Camillo de’ Lellis General District Hospital, Rieti, Italy
  17. 17. Neurological Section, Neuro-epidemiology Unit, SMDN-Centre for Cardiovascular Medicine and Cerebrovascular Disease Prevention, Sulmona, L'Aquila, Italy

Source: Journal of Stroke and Cerebrovascular Diseases Published:2020


Abstract

Background: The interaction between coronavirus disease 2019 (COVID-19) and non-communicable diseases may increase the global burden of disease. We assessed the association of COVID-19 with ageing and non-communicable diseases. Methods: We extracted data regarding non-communicable disease, particularly cardiovascular disease, deaths, disability-adjusted life years (DALYs), and healthy life expectancy (HALE) from the Global Burden of Disease Study (GBD) 2017. We obtained data of confirmed COVID-19 cases, deaths, and tests from the Our World in Data database as of May 28, 2020. Potential confounders of pandemic outcomes analyzed include institutional lockdown delay, hemispheric geographical location, and number of tourists. We compared all countries according to GBD classification and World Bank income level. We assessed the correlation between independent variables associated with COVID-19 caseload and mortality using Spearman's rank correlation and adjusted mixed model analysis. Findings: High-income had the highest, and the Southeast Asia, East Asia, and Oceania region had the least cases per million population (3050.60 vs. 63.86). Sub-saharan region has reported the lowest number of COVID-19 mortality (1.9). Median delay to lockdown initiation varied from one day following the first case in Latin America and Caribbean region, to 34 days in Southeast Asia, East Asia, and Oceania. Globally, non-communicable disease DALYs were correlated with COVID-19 cases (r = 0.32, p<0.001) and deaths (r = 0.37, p<0.001). HALE correlated with COVID-19 cases (r = 0.63, p<0.001) and deaths (r = 0.61, p<0.001). HALE was independently associated with COVID-19 case rate and the number of tourists was associated with COVID-19 mortality in the adjusted model. Interpretation: Preventive measures against COVID-19 should protect the public from the dual burden of communicable and non-communicable diseases, particularly in the elderly. In addition to active COVID-19 surveillance, policymakers should utilize this evidence as a guide for prevention and coordination of health services. This model is timely, as many countries have begun to reduce social isolation. © 2020 Elsevier Inc.
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