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Relative Risk of Death in Bulgarian Cancer Patients during the Initial Waves of the COVID-19 Pandemic

Background: The COVID-19 pandemic has led to millions of documented deaths worldwide, with diverse distribution among countries. Surprisingly, Bulgaria, a middle-income European Union member state, ranked highest in COVID-19 mortality. This study aims to assess whether Bulgarian cancer patients expe...

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Autores principales: Shivarov, Velizar, Grigorova, Denitsa, Yordanov, Angel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10531457/
https://www.ncbi.nlm.nih.gov/pubmed/37761791
http://dx.doi.org/10.3390/healthcare11182594
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author Shivarov, Velizar
Grigorova, Denitsa
Yordanov, Angel
author_facet Shivarov, Velizar
Grigorova, Denitsa
Yordanov, Angel
author_sort Shivarov, Velizar
collection PubMed
description Background: The COVID-19 pandemic has led to millions of documented deaths worldwide, with diverse distribution among countries. Surprisingly, Bulgaria, a middle-income European Union member state, ranked highest in COVID-19 mortality. This study aims to assess whether Bulgarian cancer patients experienced a higher relative risk (RR) of death compared to the general Bulgarian population during the pandemic. Materials and Methods: Data from the Bulgarian National Statistical Institute and the Bulgarian National Cancer Registry were analyzed to estimate monthly RR of death in cancer patients compared to the general population before and during the first two years of the pandemic. The impact of the COVID-19 waves and predominant SARS-CoV-2 variants on RR was evaluated on various cancer types and age groups using a multiple linear regression approach. Results: During the COVID-19 waves, both the general population and cancer patients experienced a significant increase in mortality rates. Surprisingly, the RR of death in cancer patients was lower during pandemic waves. The results from the statistical modeling revealed a significant association between the COVID-19 waves and reduced RR for all cancer patients. Notably, the effect was more pronounced during waves associated with the Alpha and Delta variants. The results also showed varying impacts of the COVID-19 waves on RR when we analyzed subsamples of data grouped depending on the cancer type, age and sex. Conclusions: Despite increased overall mortality in Bulgarian cancer patients during the pandemic, the RR of death was lower compared to the Bulgarian general population, indicating that protective measures were relatively effective in this vulnerable group. This study underscores the importance of implementing and encouraging preventive measures, especially in cancer patients, to mitigate the impact of future viral pandemics and reduce excess mortality.
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spelling pubmed-105314572023-09-28 Relative Risk of Death in Bulgarian Cancer Patients during the Initial Waves of the COVID-19 Pandemic Shivarov, Velizar Grigorova, Denitsa Yordanov, Angel Healthcare (Basel) Article Background: The COVID-19 pandemic has led to millions of documented deaths worldwide, with diverse distribution among countries. Surprisingly, Bulgaria, a middle-income European Union member state, ranked highest in COVID-19 mortality. This study aims to assess whether Bulgarian cancer patients experienced a higher relative risk (RR) of death compared to the general Bulgarian population during the pandemic. Materials and Methods: Data from the Bulgarian National Statistical Institute and the Bulgarian National Cancer Registry were analyzed to estimate monthly RR of death in cancer patients compared to the general population before and during the first two years of the pandemic. The impact of the COVID-19 waves and predominant SARS-CoV-2 variants on RR was evaluated on various cancer types and age groups using a multiple linear regression approach. Results: During the COVID-19 waves, both the general population and cancer patients experienced a significant increase in mortality rates. Surprisingly, the RR of death in cancer patients was lower during pandemic waves. The results from the statistical modeling revealed a significant association between the COVID-19 waves and reduced RR for all cancer patients. Notably, the effect was more pronounced during waves associated with the Alpha and Delta variants. The results also showed varying impacts of the COVID-19 waves on RR when we analyzed subsamples of data grouped depending on the cancer type, age and sex. Conclusions: Despite increased overall mortality in Bulgarian cancer patients during the pandemic, the RR of death was lower compared to the Bulgarian general population, indicating that protective measures were relatively effective in this vulnerable group. This study underscores the importance of implementing and encouraging preventive measures, especially in cancer patients, to mitigate the impact of future viral pandemics and reduce excess mortality. MDPI 2023-09-20 /pmc/articles/PMC10531457/ /pubmed/37761791 http://dx.doi.org/10.3390/healthcare11182594 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Shivarov, Velizar
Grigorova, Denitsa
Yordanov, Angel
Relative Risk of Death in Bulgarian Cancer Patients during the Initial Waves of the COVID-19 Pandemic
title Relative Risk of Death in Bulgarian Cancer Patients during the Initial Waves of the COVID-19 Pandemic
title_full Relative Risk of Death in Bulgarian Cancer Patients during the Initial Waves of the COVID-19 Pandemic
title_fullStr Relative Risk of Death in Bulgarian Cancer Patients during the Initial Waves of the COVID-19 Pandemic
title_full_unstemmed Relative Risk of Death in Bulgarian Cancer Patients during the Initial Waves of the COVID-19 Pandemic
title_short Relative Risk of Death in Bulgarian Cancer Patients during the Initial Waves of the COVID-19 Pandemic
title_sort relative risk of death in bulgarian cancer patients during the initial waves of the covid-19 pandemic
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10531457/
https://www.ncbi.nlm.nih.gov/pubmed/37761791
http://dx.doi.org/10.3390/healthcare11182594
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