Assessment of COVID-19 pandemic-related detrimental impact on the population of nuclear city: two-year results

Background - Since the announcement of the global coronavirus infection disease (COVID-19) pandemic, the attempts to assess the pandemic-related detrimental impact are of particular interest. The methodology of assessing the overall mortality attributed to COVID-19 pandemic, unlike the use of specific indicators that are sensitive to different methods of accounting the number of infected and deaths, provides more clear understanding of the pandemic-related impact. Objective - Quantitative assessment of the pandemic-related detrimental impact caused by the novel coronavirus infection in a small nuclear city, which is relevant for evaluating the effectiveness of anti-epidemic measures. Methods and Results - The population changes in a small urban district located in the South Ural Region of the Russian Federation were retrospectively analyzed for the decade, based on the open-source demographic data. The pandemic-related detrimental impact was calculated as overall excess mortality rate, compared with the previous non-pandemic years by using the additive model of excess absolute risk. The number of absolute excess deaths, adjusted for gender, age, population size, and number of diseased, was modeled using multivariate linear regression. The pandemic-related detriment was calculated based on the number of predicted excess deaths attributed to COVID-19. The relationship between the total number of deaths and the number of COVID-19 cases was analyzed. The total predicted two-year excess of pandemic-related deaths was 557.9. The pandemic-related total excess mortality per 1, 000 patients infected with SARSCov-2 was 50.2 (95% CI 38.4;62.0). Conclusion - The analyses revealed significant impact of the COVID-19 pandemic on the overall excess mortality in the nuclear city population in 2020 and 2021 implemented in both direct and indirect way. The population size was a major significant risk factor confounding the overall mortality. In order to develop an effective strategy to control and prevent the consequences of a pandemic, further monitoring of the epidemic situation in a nuclear city is required.Copyright © 2022, Russian Open Medical Journal.

[The COVID-19 epidemic and total mortality: missed data and the incoming epidemiology]. / L'epidemia di COVID-19 e la mortalità totale: i dati che sono mancati e l'epidemiologia che verrà.

The generation of rapid information has been an important novelty in the COVID-19 pandemic and a challenge for epidemiology. The methodological frailty and uncertainty of rapid data use has been a consequence. We are talking about an 'intermezzo' epidemiology between the event and the production of consolidated data that opens up great opportunities to the use epidemiology for rapid public health decisions, provided a careful work to be done before emergencies. In Italy, an ad hoc national COVID-19 information system producing daily data that quickly became essential for public decision-making. Total and all-cause mortality data are derived from the traditional information system of the Italian National Institute of Statistics (Istat), which, at the onset of the pandemic, was unable to provide rapid total and all-causes mortality data at the national level and still produces them with a one- to two-month delay. National cause and place mortality data referred to the first epidemic wave (March and April 2020) was in May 2021 and recently updated (October 2022) for the whole year 2020. Nearly three years after the onset of the epidemic, we have no nationwide rapid information on the distribution of deaths by place of death (hospitals, nursing homes and other care facilities, home) neither on their breakdown in 'by COVID-19', 'with COVID-19', and 'non-COVID-19' deaths. The pandemic being still in progress, new problems arise (the long-term impact of COVID-19, the impact of lockdown policies, etcetera), whose solution cannot be postponed until peer reviewed papers are available. A fine-tuning of the rapid processing of interim data certainly requires the development of national and regional information systems, but first of all a methodologically robust 'intermezzo' epidemiology.

Blood omega-3 fatty acids and death from COVID-19: A pilot study.

Very-long chain omega-3 fatty acids (EPA and DHA) have anti-inflammatory properties that may help reduce morbidity and mortality from COVID-19 infection. We conducted a pilot study in 100 patients to test the hypothesis that RBC EPA+DHA levels (the Omega-3 Index, O3I) would be inversely associated with risk for death by analyzing the O3I in banked blood samples drawn at hospital admission. Fourteen patients died, one of 25 in quartile 4 (Q4) (O3I ≥5.7%) and 13 of 75 in Q1-3. After adjusting for age and sex, the odds ratio for death in patients with an O3I in Q4 vs Q1-3 was 0.25, p = 0.07. Although not meeting the classical criteria for statistical significance, this strong trend suggests that a relationship may indeed exist, but more well-powered studies are clearly needed.