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. 2020 May 29:78:47.
doi: 10.1186/s13690-020-00433-y. eCollection 2020.

Population vulnerability to COVID-19 in Europe: a burden of disease analysis

Grant M A Wyper  1 , Ricardo Assunção  2 , Sarah Cuschieri  3 , Brecht Devleeschauwer  4   5 , Eilidh Fletcher  6 , Juanita A Haagsma  7 , Henk B M Hilderink  8 , Jane Idavain  9 , Tina Lesnik  10 , Elena Von der Lippe  11 , Marek Majdan  12 , Milena S Milicevic  13 , Elena Pallari  14 , José L Peñalvo  15 , Sara M Pires  16 , Dietrich Plaß  17 , João V Santos  18   19   20 , Diane L Stockton  1 , Sofie Theresa Thomsen  16 , Ian Grant  6
Affiliations

Population vulnerability to COVID-19 in Europe: a burden of disease analysis

Grant M A Wyper et al. Arch Public Health. .

Erratum in

  • Correction to: Population vulnerability to COVID-19 in Europe: a burden of disease analysis.
    Wyper GMA, Assunção R, Cuschieri S, Devleesschauwer B, Fletcher E, Haagsma JA, Hilderink HBM, Idavain J, Lesnik T, Von der Lippe E, Majdan M, Milicevic MS, Pallari E, Peñalvo JL, Pires SM, Plaß D, Santos JV, Stockton DL, Thomsen ST, Grant I. Wyper GMA, et al. Arch Public Health. 2020 Jun 18;78:57. doi: 10.1186/s13690-020-00437-8. eCollection 2020. Arch Public Health. 2020. PMID: 32566224 Free PMC article.

Abstract

Background: Evidence has emerged showing that elderly people and those with pre-existing chronic health conditions may be at higher risk of developing severe health consequences from COVID-19. In Europe, this is of particular relevance with ageing populations living with non-communicable diseases, multi-morbidity and frailty. Published estimates of Years Lived with Disability (YLD) from the Global Burden of Disease (GBD) study help to characterise the extent of these effects. Our aim was to identify the countries across Europe that have populations at highest risk from COVID-19 by using estimates of population age structure and YLD for health conditions linked to severe illness from COVID-19.

Methods: Population and YLD estimates from GBD 2017 were extracted for 45 countries in Europe. YLD was restricted to a list of specific health conditions associated with being at risk of developing severe consequences from COVID-19 based on guidance from the United Kingdom Government. This guidance also identified individuals aged 70 years and above as being at higher risk of developing severe health consequences. Study outcomes were defined as: (i) proportion of population aged 70 years and above; and (ii) rate of YLD for COVID-19 vulnerable health conditions across all ages. Bivariate groupings were established for each outcome and combined to establish overall population-level vulnerability.

Results: Countries with the highest proportions of elderly residents were Italy, Greece, Germany, Portugal and Finland. When assessments of population-level YLD rates for COVID-19 vulnerable health conditions were made, the highest rates were observed for Bulgaria, Czechia, Croatia, Hungary and Bosnia and Herzegovina. A bivariate analysis indicated that the countries at high-risk across both measures of vulnerability were: Bulgaria; Portugal; Latvia; Lithuania; Greece; Germany; Estonia; and Sweden.

Conclusion: Routine estimates of population structures and non-fatal burden of disease measures can be usefully combined to create composite indicators of vulnerability for rapid assessments, in this case to severe health consequences from COVID-19. Countries with available results for sub-national regions within their country, or national burden of disease studies that also use sub-national levels for burden quantifications, should consider using non-fatal burden of disease estimates to estimate geographical vulnerability to COVID-19.

Keywords: Burden of disease; COVID-19; Coronavirus; DALY; European burden of disease network; GBD; Summary measures of population health; Vulnerability; YLD.

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Conflict of interest statement

Competing interestsAll other authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Scatter plot of percentage of elderly population versus rate of YLD for COVID-19 vulnerable health conditions for European countries. Rates described are crude rates per 100,000 population. White vertical and horizontal gridlines indicate the tertile dividing lines for the measures: percentage of elderly population; and rate of YLD for COVID-19 vulnerable health conditions, respectively
See this image and copyright information in PMC

References

    1. Murray CJL, Lopez AD. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. Cambridge: Harvard University Press on behalf of the World Health Organization and the World Bank; 1996.
    1. Klijs B, Nusselder WJ, Looman CW, Mackenbach JP. Contribution of chronic disease to the burden of disability. PLoS One. 2011;6(9):e25325. - PMC - PubMed
    1. Ebrahim SH, Ahmed QA, Gozzer E, Schlagenhauf P, Memish ZA. Covid-19 and community mitigation strategies in a pandemic. BMJ. 2020;368:m1066. - PubMed
    1. Matsushita K, Ding N, Kou M, Hu X, Chen M, Gao Y, et al. The relationship of COVID-19 severity with cardiovascular disease and its traditional risk factors: A systematic review and meta-analysis. medRxiv. 2020:20054155 10.1101/2020.04.05.20054155. - PMC - PubMed
    1. Clark A, Jit M, Warren-Gash C, Guthrie B, Wang HHX, Mercer SW, et al. How many are at increased risk of severe COVID-19 disease? Rapid global, regional and national estimates for. 2020. - PMC - PubMed

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