Excess Deaths of Gastrointestinal, Liver, and Pancreatic Diseases During the COVID-19 Pandemic in the United States

作者：Han, Lefei; Shi, Haoting; Li, Yongxuan; Qi, Hongchao; Wang, Yuhua; Gu, Jiawei; Wu, Jiayin; Zhao, Shi; Cao, Peihua; Xu, Lan; Deng, Xiaobei; Yao, Xiaoxin I.^*; Ran, Jinjun^*

来源：International Journal of Public Health, 2023, 68: 1606305.

DOI：10.3389/ijph.2023.1606305

• excess mortality
• GI hemorrhage
• liver disorder
• disparity
• COVID-19

Objectives: To evaluate excess deaths of gastrointestinal, liver, and pancreatic diseases in the United States during the COVID-19 pandemic.Methods: We retrieved weekly death counts from National Vital Statistics System and fitted them with a quasi-Poisson regression model. Cause-specific excess deaths were calculated by the difference between observed and expected deaths with adjustment for temporal trend and seasonality. Demographic disparities and temporal-spatial patterns were evaluated for different diseases.Results: From March 2020 to September 2022, the increased mortality (measured by excess risks) for Clostridium difficile colitis, gastrointestinal hemorrhage, and acute pancreatitis were 35.9%; 24.8%; and 20.6% higher than the expected. For alcoholic liver disease, fibrosis/cirrhosis, and hepatic failure, the excess risks were 1.4-2.8 times higher among younger inhabitants than older inhabitants. The excess deaths of selected diseases were persistently observed across multiple epidemic waves with fluctuating trends for gastrointestinal hemorrhage and fibrosis/cirrhosis and an increasing trend for C. difficile colitis.Conclusion: The persistently observed excess deaths of digestive diseases highlights the importance for healthcare authorities to develop sustainable strategies in response to the long-term circulating of SARS-CoV-2 in the community.

• 单位
  南方医科大学; 上海交通大学; 中山大学