COVID-19 caused the second largest death by infection
Covid-19 caused the second largest infection disaster in Switzerland, Sweden and Spain since 1918
Abstract: https://www.acpjournals.org/doi/10.7326/M21-3824
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A study of continuous monthly mortality data for more than 100 years in Switzerland, Sweden and Spain found that the number of deaths associated with the covid-19 pandemic reached higher peaks than most other periods of overdose since 1918. The results are published in Annals of Internal Medicine.
Switzerland, Sweden and Spain are particularly suited to an overtime perspective on excess mortality as they have reliable continuous data on death rates and were militarily neutral during both world wars. Historical data can help support planning and preparation for current and future pandemics.
In collaboration with the Swiss Federal Statistical Office, researchers from the universities of Zurich, Bern and Oslo estimated age-specific, monthly deaths from all causes for Switzerland, Sweden and Spain for 2020 to 2021 and other pandemic periods since the end of the 19th century in chronological order. The authors collected data on monthly deaths from all causes from each country’s statistics office and used annual data on population size and age structure to take into account demographic changes over time. After performing statistical analysis, the authors found that for all three countries, 2020 was the highest number of deaths since 1918. However, the number of deaths in 1918 was still estimated to be six to seven times higher than in 2020. The relative number of deaths in 2020 was 12.5 percent in Switzerland. 8.5 percent in Sweden and 17.3 percent in Spain. According to the authors, the excess mortality rate in 2020 could have been even higher if it had not been for strong public health initiatives around the world.
Media contacts: Contact Angela Collom at [email protected] for a PDF covered by the embargo. Corresponding authors, Kaspar Staub ([email protected]) and Marcel Zwahlen ([email protected]) can be reached directly.
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2. Long-acting injectable PrEP is too expensive for payers compared to generic daily oral formulation
Even at a higher cost, injectable PrEP can have high value and usefulness for vulnerable minority populations
Abstract: https://www.acpjournals.org/doi/10.7326/M21-1548
Editorial: https://www.acpjournals.org/doi/10.7326/M22-0057
A cost-effectiveness analysis found that the long-acting injectable form of HIV PrEP (pre-exposure prophylaxis), cabotegravir (CAB-LA), is too expensive at its current price given the alternative alternative to generic daily oral emtricitabine tenofovir disoproxil fumarate (F) / TDF). According to the authors, injectable PrEP would have the highest value and greatest utility in environments and for individuals who find it challenging or impossible to use daily oral PrEP. The results are published in Annals of Internal Medicine.
An international clinical trial, HIV Prevention Trials Network (HPTN) 083, which compared CAB-LA and F / TDF, found that the use of CAB-LA was associated with a more significant reduction in the incidence of HIV infections. However, the cost of F / TDF is much lower than other available HIV PrEP drugs.
Researchers from Harvard Medical School used the Cost-Effectiveness of Preventing AIDS Complications model to simulate a population prescribed PrEP with HIV risk factors similar to participants in HPTN 083. The authors then created a 10-year planning horizon for four strategies: no PrEP use, generic F / TDF use, trademark F / TAF use and CAB-LA use. The estimated clinical benefits, including primary HIV transmission, quality-adjusted life years (QALYs) and mortality. They also calculated the costs of HIV care and PrEP as well as incremental cost-effectiveness ratios over the same 10-year period. The authors found that after calculating 10-year clinical outcomes, total primary HIV transmissions were highest for no PrEP use and lowest for CAB-LA use. The authors found that at a range of willingness to pay ($ 50,000- $ 300,000 / QALY) thresholds, CAB-LA for PrEP among those at high risk for HIV would only provide good value for money if its annual price was less than $ 6,600 higher than generic oral PrEP, which is less than half of CAB-LA’s current cost. They suggest that effective oral PrEP limits the extra price payers should be willing to pay for long-acting injectable PrEP. For people who cannot take oral PrEP, a higher price would be justified, but still lower than the current pricing. In addition, the authors note that for individuals at increased risk of HIV infection (such as eligible men who have sex with men), any PrEP strategy would lead to significant clinical improvements, life years gained, and reductions in HIV transmission compared to no PrEP. -use.
According to the authors of an accompanying editorial from The State University of New York at Albany and Emory University, this analysis provides important results on the economic aspects of long-term injectable PrEP and lays the groundwork for addressing pressing issues related to politics, programs, and social justice related to HIV management and prevention.
Media contacts: Contact Angela Collom at [email protected] for a PDF covered by the embargo. To speak with the corresponding author, Anne M. Neilan, MD, MPH, contact Noah Brown at [email protected].
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3. Electrocardiographic artifacts synchronized with the heart rhythm may indicate pathological condition in healthy patients
Abstract: https://www.acpjournals.org/doi/10.7326/L21-0660
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A case report published in this issue of Annals of Internal Medicine shows that electrocardiographic artifacts that are synchronized with heart rhythm may indicate a pathological condition in a healthy patient. The authors describe how identification and movement of the suspected electrode away from the pulsation and repetition of the electrocardiogram gave a normal result in the patient.
Author of the Cardiovascular Institute of the First Affiliated Hospital at Jinzhou Medical University, Jinzhou, China describes the case of a 34-year-old formerly healthy man who received a cardiological evaluation. His electrocardiogram showed an abnormal U-wave and an extended QTU interval. However, the patient denied family history of tachycardia or syncope, did not take medication and had laboratory and echocardiogram results within normal limits. The authors also noted that in lead I the abnormal U-wave was missing and the QT interval was normal.
The authors suspected that the patient’s abnormal electrocardiogram was caused by an electrocardiographic artifact due to these conditions and the overall different abnormalities between electrodes. They chose to examine the left leg electrocardiogram electrode because most other extremity leads and precordial electrodes depend on the left leg electrocardiogram electrode. After observing and reporting an arterial pulsation in the left leg, timed with heart rhythm, they recorded a normal electrocardiogram. According to the authors, this case shows that it is possible for doctors to mistake electrocardiogram artifacts that are synchronized with the heart rhythm for pathological conditions.
Media connectors: Contact Angela Collom at [email protected] for a PDF covered by the embargo. To speak with the corresponding author, Renguang Liu, MD, please email [email protected].
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New covid-19 content this week:
Efficacy of inactivated covid-19 vaccines against disease caused by the B.1.617.2 (Delta) variant during an outbreak in Guangdong, China
Min Kang, MMed *; Yao Yi, MMed *; Yan Li, PhD; Limei Sun, BM; Aiping Deng, MMed; Ting Hu, MMed; Jiayi Zhang, MMed; Jun Liu, MPAM; Mingji Cheng, MMed; Shen Xie, MMed; Min Luo, MMed; Jing Jiang, MMed; Yawen Jiang, PhD; Shixing Tang, PhD; Jianfeng He, BSc
Original research
Abstract: https://www.acpjournals.org/doi/10.7326/M21-3509
Links go live when the embargo ends
A study from Sun Yat-sen University, Guangzhou, Guangdong, China found that complete vaccination with inactivated covid-19 vaccines is effective against variant B.1.617.2 (Delta). The findings are based on the first outbreak of the B.1.617.2 variant on mainland China that was discovered and tracked in Guangdong in May and June 2021. The study is published in Annals of Internal Medicine.
Media contacts: Contact Angela Collom at [email protected] for a PDF file and the author’s contact information.
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Newspaper
Annals of Internal Medicine
Method of research
Observation study
Research topic
people
Article title
Historically high excess mortality during the covid-19 pandemic in Switzerland, Sweden and Spain
Date of publication of the article
February 1, 2022