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Author Spotlight: Advancements in Multiplex Detection of Respiratory Viruses
Published on: November 10, 2023
Coronavirus disease 2019 (COVID-19) excess mortality outcomes associated with pandemic effects study (COPES): A
David Lu1, Sumeet Dhanoa1, Harleen Cheema1
1Faculty of Medicine and Dentistry, Alberta Health Services, University of Alberta, Edmonton, AB, Canada.
Insights
The COVID-19 pandemic increased all-cause mortality, including non-COVID-19 deaths, beyond what was expected from COVID-19 deaths alone. However, the evidence supporting this finding is of very low certainty.
Area of Science:
- Public Health
- Epidemiology
- Healthcare Management
Background:
- The COVID-19 pandemic has strained global healthcare systems, necessitating resource allocation for COVID-19 patients.
- Minimizing overall excess mortality, encompassing both COVID-19 and non-COVID-19 deaths, is a critical challenge for healthcare providers.
- Understanding the pandemic's impact on all-cause mortality is essential for effective public health strategies.
Conclusions:
- The COVID-19 pandemic may have driven a significant increase in all-cause excess mortality.
- This increase appears to be greater than that attributable to COVID-19 mortality alone.
- However, the current evidence base is uncertain, highlighting the need for further high-quality research.
Background And Aim:
With the Coronavirus Disease 2019 (COVID-19) pandemic continuing to impact healthcare systems around the world, healthcare providers are attempting to balance resources devoted to COVID-19 patients while minimizing excess mortality overall (both COVID-19 and non-COVID-19 patients). To this end, we conducted a systematic review (SR) to describe the effect of the COVID-19 pandemic on all-cause excess mortality (COVID-19 and non-COVID-19) during the pandemic timeframe compared to non-pandemic times.
Methods:
We searched EMBASE, Cochrane Database of SRs, MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Cochrane Controlled Trials Register (CENTRAL), from inception (1948) to December 31, 2020. We used a two-stage review process to screen/extract data. We assessed risk of bias using Newcastle-Ottawa Scale (NOS). We used Critical Appraisal and Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology.
Results:
Of 11,581 citations, 194 studies met eligibility. Of these studies, 31 had mortality comparisons (n = 433,196,345 participants). Compared to pre-pandemic times, during the COVID-19 pandemic, our meta-analysis demonstrated that COVID-19 mortality had an increased risk difference (RD) of 0.06% (95% CI: 0.06-0.06% p < 0.00001). All-cause mortality also increased [relative risk (RR): 1.53, 95% confidence interval (CI): 1.38-1.70, p < 0.00001] alongside non-COVID-19 mortality (RR: 1.18, 1.07-1.30, p < 0.00001). There was "very low" certainty of evidence through GRADE assessment for all outcomes studied, demonstrating the evidence as uncertain.
Interpretation:
The COVID-19 pandemic may have caused significant increases in all-cause excess mortality, greater than those accounted for by increases due to COVID-19 mortality alone, although the evidence is uncertain.
Systematic Review Registration:
[https://www.crd.york.ac.uk/prospero/#recordDetails], identifier [CRD42020201256].
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