Increased Mortality Among Young Systemic Sclerosis Patients During the COVID-19 Pandemic: A Nationwide Data Analysis...

Area of Science:

• Epidemiology
• Rheumatology
• Public Health

Background:

• The COVID-19 pandemic may disproportionately affect vulnerable populations, including patients with systemic sclerosis (SSc).
• Healthcare access disruptions during the pandemic raise concerns about increased all-cause mortality in SSc patients.
• Understanding excess mortality in SSc is crucial for assessing pandemic-related health impacts.

Purpose of the Study:

• To determine the excess all-cause mortality among patients with systemic sclerosis (SSc) before and during the COVID-19 pandemic.
• To analyze mortality trends in SSc patients stratified by sex and age group.
• To inform public health strategies and clinical care for SSc patients during health crises.

Main Methods:

• Utilized Thailand's Ministry of Public Health mortality database for adults diagnosed with SSc (ICD-10: M34).
• Employed a negative binomial distribution model based on WHO methodology to estimate expected deaths using pre-pandemic data (2015-2019).
• Compared observed SSc deaths during the pandemic (2020-2022) against projected figures to calculate excess mortality.

Main Results:

• Overall SSc mortality rates decreased during the pandemic compared to pre-pandemic levels.
• Neither male nor female SSc patients exhibited significantly higher excess mortality during the pandemic.
• A notable increase in excess mortality was observed in younger SSc patients (aged 18-29 years).

Conclusions:

• The COVID-19 pandemic did not lead to significantly higher overall mortality in adult systemic sclerosis patients by sex.
• Younger SSc patients (18-29 years) faced a significant increase in excess mortality during the pandemic.
• These findings underscore the necessity for developing tailored therapeutic and support strategies for vulnerable young SSc populations.