Lancet Regional Health-Europe最新文献

{"title":"Real-world impact of nirsevimab immunisation against respiratory disease on emergency department attendances and admissions among infants: a multinational retrospective analysis","authors":"Aida Perramon-Malavez ,&nbsp;Danilo Buonsenso ,&nbsp;Rosa Morello ,&nbsp;Ermengol Coma ,&nbsp;Steve Foster ,&nbsp;Paul Leonard ,&nbsp;Robin Marlow ,&nbsp;Montserrat Martínez-Marcos ,&nbsp;Jacobo Mendioroz ,&nbsp;Jorgina Vila ,&nbsp;Anna Creus-Costa ,&nbsp;Clara Prats ,&nbsp;Damian Roland ,&nbsp;Thomas C. Williams ,&nbsp;Antoni Soriano-Arandes","doi":"10.1016/j.lanepe.2025.101334","DOIUrl":"10.1016/j.lanepe.2025.101334","url":null,"abstract":"<div><h3>Background</h3><div>Nirsevimab, a novel monoclonal antibody with a long half-life, has received European Union approval to prevent lower respiratory tract infections (LRTIs) caused by respiratory syncytial virus (RSV) during the first season of exposure. It was implemented in Catalonia (Spain) in the 2023–2024 season. Our main objective was to analyse the impact of the nirsevimab on LRTIs presenting to the Emergency Department (ED) in Catalonia (Spain) by comparing presentations to those at five sites in the United Kingdom (UK) and Rome (Italy).</div></div><div><h3>Methods</h3><div>In this multi-national retrospective analysis of emergency department attendances and admissions, we retrospectively collected information for all diagnoses, respiratory diagnoses excluding bronchiolitis, and bronchiolitis, for different age groups from 68 hospitals in Catalonia (Spain), one hospital in Rome (Italy), and four hospitals in the UK (Bristol, Leicester, Glasgow, and Edinburgh), from May 1st, 2018, to April 30th 2024. Applying a generalised linear model (GLM) in Poisson regression, we obtained the risk ratio (RR) and 95% confidence intervals (CI) of bronchiolitis in 2023–2024 season compared to the mean of all previous seasons. We analysed data in annual bins, from May 1st to April 30th, excluding 2020–21 as a COVID year, for a total of 5 years of data.</div></div><div><h3>Findings</h3><div>Data was available for 1,574,392 ED attendances (96,028 for bronchiolitis) and 255,689 hospital admissions (27,691 for bronchiolitis). In the 2023–2024 season, in Catalonia there was a reduction in the RR for bronchiolitis hospital admissions in the youngest infants aged &lt;6 months (0.52, 95% CI: 0.48–0.55). There was also a reduction in Catalonia in the RR for hospital attendances for bronchiolitis in nirsevimab eligible age groups (0–11 months), with a RR of 0.56 (95% CI: 0.54–0.58) for infants &lt;6 m and 0.93 (95% CI: 0.89–0.97) for infants 6–11 m. None of the other sites or age groups showed a significant reduction in the RR for attendances or admissions for the 2023–2024 season compared to previous years.</div></div><div><h3>Interpretation</h3><div>Nirsevimab had a clear impact in reducing attendances and admissions for infants with bronchiolitis aged &lt;6 months in Catalonia. However, the impact on older infants was less clear.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"55 ","pages":"Article 101334"},"PeriodicalIF":13.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term kidney outcomes after COVID-19: a matched cohort study using the OpenSAFELY platform","authors":"Viyaasan Mahalingasivam ,&nbsp;Bang Zheng ,&nbsp;Kevin Wing ,&nbsp;Edward P.K. Parker ,&nbsp;Krishnan Bhaskaran ,&nbsp;Juan Jesús Carrero ,&nbsp;Sandra Jayacodi ,&nbsp;Edith Jumbo ,&nbsp;Tamanna Miah ,&nbsp;Brian Gracey ,&nbsp;John Tazare ,&nbsp;Shalini Santhakumaran ,&nbsp;Rohini Mathur ,&nbsp;Ruth E. Costello ,&nbsp;Emily Herrett ,&nbsp;Qing Wen ,&nbsp;Thomas Hartney ,&nbsp;Ian J. Douglas ,&nbsp;Amelia Green ,&nbsp;Louis Fisher ,&nbsp;Laurie Tomlinson","doi":"10.1016/j.lanepe.2025.101338","DOIUrl":"10.1016/j.lanepe.2025.101338","url":null,"abstract":"<div><h3>Background</h3><div>COVID-19 severe enough to require hospitalisation is commonly associated with acute kidney injury. However, it remains unclear whether COVID-19 leads to long-term kidney outcomes in the broader population.</div></div><div><h3>Methods</h3><div>We undertook a population-based, matched cohort study. With the approval of NHS England, we used primary and secondary care electronic health records from England using the OpenSAFELY-TPP platform. We compared people with and without COVID-19 using fully-adjusted, stratified, cause-specific Cox models for kidney failure, 50% reduction in kidney function, and death.</div></div><div><h3>Findings</h3><div>Overall, all outcomes were increased after COVID-19 over the course of follow-up (HR for kidney failure 1.93 [95% CI 1.84–2.03]). Hazards of kidney failure were greatest after hospitalisation (HR 7.74 [95% CI 7.00–8.56]) and remained increased beyond 180 days of follow-up. There was no evidence of increased risk in those not hospitalised (HR 0.85 [95% CI 0.79–0.90]). Increased kidney failure was more pronounced in black ethnicity (HR 4.50 [95% CI 2.92–6.92]) compared to white ethnicity (HR 1.82 [95% CI 1.71–1.94]). Amongst those hospitalised with COVID-19, there was no attenuation of kidney failure between the first wave (HR 8.74 [95% CI 6.88–11.08]) and the Omicron wave (HR 8.36 [95% CI 6.81–10.27]).</div></div><div><h3>Interpretation</h3><div>We observed increased long-term kidney outcomes in people hospitalised with COVID-19, as well as notable ethnic differences. Our results suggest strategies to minimise severe COVID-19 should continue to be optimised among vulnerable groups, and that kidney function should be proactively monitored after hospital discharge.</div></div><div><h3>Funding</h3><div><span>National Institute for Health and Care Research</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"55 ","pages":"Article 101338"},"PeriodicalIF":13.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serbia is in crisis","authors":"The Lancet Regional Health – Europe","doi":"10.1016/j.lanepe.2025.101413","DOIUrl":"10.1016/j.lanepe.2025.101413","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"55 ","pages":"Article 101413"},"PeriodicalIF":13.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Europe's non-communicable diseases agenda through cross-national collaboration: translating WHO-Europe findings into actionable strategies","authors":"Benedetta Armocida ,&nbsp;Knut-Inge Klepp ,&nbsp;Graziano Onder ,&nbsp;Jill Louise Farrington ,&nbsp;Linda Granlund ,&nbsp;Marianne Takki ,&nbsp;Bente Mikkelsen ,&nbsp;Michele Cecchini ,&nbsp;Gauden Galea ,&nbsp;Ivo Rakovac","doi":"10.1016/j.lanepe.2025.101361","DOIUrl":"10.1016/j.lanepe.2025.101361","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"55 ","pages":"Article 101361"},"PeriodicalIF":13.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 infection and severity among childhood cancer survivors in Denmark and Sweden: a register-based cohort study with matched population and sibling comparisons","authors":"Javier Louro ,&nbsp;Christina-Evmorfia Kampitsi ,&nbsp;Hanna Mogensen ,&nbsp;Friederike Erdmann ,&nbsp;Karin Modig ,&nbsp;Anna Nilsson ,&nbsp;Mats Heyman ,&nbsp;Henrik Hasle ,&nbsp;Anja Krøyer ,&nbsp;Line Kenborg ,&nbsp;Henrik Hjalgrim ,&nbsp;Maria Feychting ,&nbsp;Giorgio Tettamanti","doi":"10.1016/j.lanepe.2025.101363","DOIUrl":"10.1016/j.lanepe.2025.101363","url":null,"abstract":"<div><h3>Background</h3><div>During the COVID-19 pandemic, vulnerable groups faced a higher risk of severe COVID-19 outcomes. The effect of the pandemic on adult childhood cancer survivors is a significant public health concern but not sufficiently understood. We aimed to assess whether adult childhood cancer survivors had a higher risk of severe COVID-19 and registered COVID-19 infections compared to the general population.</div></div><div><h3>Methods</h3><div>This Nordic register-based cohort study included 5-year childhood cancer survivors diagnosed before age 20 years in Denmark and Sweden, two countries with very different pandemic responses. As comparisons, we randomly selected individuals from the general population, matched on year of birth, sex, and country, and identified all siblings of the survivors. All individuals at least 20 years old and alive on January 1, 2020, were followed until December 31, 2022. We plotted the cumulative hazard rates of severe COVID-19 and registered COVID-19 infection and fitted Cox proportional hazards models estimating adjusted hazard ratios (aHR) with 95% confidence intervals (95% CI).</div></div><div><h3>Findings</h3><div>The cohort included 13,659 cancer survivors, 58,803 matched comparisons, and 17,531 siblings. Childhood cancer survivors had a lower risk of registered COVID-19 infection (aHR = 0·91; 95% CI = 0·89–0·94) compared to their comparisons but a higher risk of severe COVID-19 (aHR = 1·58; 95% CI = 1·25–1·98). The latter was particularly evident during periods of widespread viral transmission, as reflected in differences between Denmark and Sweden.</div></div><div><h3>Interpretation</h3><div>These findings underscore the heightened vulnerability of childhood cancer survivors, even many years after their cancer diagnosis, and emphasize the need for closer monitoring and tailored interventions to safeguard this population during future health crises.</div></div><div><h3>Funding</h3><div><span>Danish and Swedish Childhood Cancer Foundation</span>, <span>Danish National Research Centre for Childhood Cancer</span>, <span>Swedish Research Council</span>, and <span>NordForsk</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"55 ","pages":"Article 101363"},"PeriodicalIF":13.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of vaccination strategies to control future mpox outbreaks in England: a modelling study","authors":"Xu-Sheng Zhang ,&nbsp;Siwaporn Niyomsri ,&nbsp;Sema Mandal ,&nbsp;Hamish Mohammed ,&nbsp;Miranda Mindlin ,&nbsp;Bennet Dugbazah ,&nbsp;Solomon Adjei ,&nbsp;Bukky Owoseni ,&nbsp;Andre Charlett ,&nbsp;Jessica I’Anson ,&nbsp;Elliot Sugars ,&nbsp;Merav Kliner ,&nbsp;Trish Mannes ,&nbsp;Ellie Jewitt ,&nbsp;Lorna Gilbert ,&nbsp;Samihah Moazam ,&nbsp;Claire Dewsnap ,&nbsp;David Phillips ,&nbsp;Gayatri Amirthalingam ,&nbsp;Mary E. Ramsay ,&nbsp;Josephine G. Walker","doi":"10.1016/j.lanepe.2025.101364","DOIUrl":"10.1016/j.lanepe.2025.101364","url":null,"abstract":"<div><h3>Background</h3><div>In 2022, a global mpox outbreak occurred among gay and bisexual men who have sex with men (GBMSM). In England, the outbreak was controlled through reductions in sexual risk behaviour and vaccination of high-risk GBMSM. However, mpox continues to circulate, including an expanding outbreak in Africa. We evaluated the most cost-effective vaccination strategy to minimise future mpox outbreaks among GBMSM in England.</div></div><div><h3>Methods</h3><div>A mathematical model of mpox transmission among GBMSM was developed to estimate the costs per quality-adjusted-life-year (QALY) gained for different vaccination strategies starting in 2024 (10-year time-horizon; 3.5% discount rate; willingness-to-pay threshold £20,000/QALY). Reactive vaccination (only during outbreaks) and/or pre-emptive vaccination (continuous routine) strategies targeting high-risk GBMSM were compared to no vaccination. Baseline projections assumed importation of new mpox cases, and a vaccine effectiveness following 1/2 doses of 78%/89% for 5/10 years at £160/dose. Costs were estimated for case management, vaccination and public health responses during an outbreak.</div></div><div><h3>Findings</h3><div>All vaccination strategies reduced future outbreaks, gained QALYs and reduced costs compared to no vaccination. Continuous pre-emptive vaccination (daily rate 54 doses) with reactive vaccination (daily rate 81 doses) if there is an outbreak was most cost-effective, saving £8.8 million and gaining 108.6 QALYs over 10-years. Vaccination remains cost-effective if the vaccine costs less than £330/dose. Pre-emptive with reactive vaccination remains the preferred strategy across many sensitivity analyses, with just pre-emptive vaccination at a higher rate becoming the preferred strategy in some sensitivity analyses. Just reactive vaccination only becomes the preferred strategy when public health response costs are not included, and in this case the vaccine has to cost less than £110 per dose for vaccination to be cost-effective.</div></div><div><h3>Interpretation</h3><div>Vaccination of high-risk GBMSM is likely to be a cost-saving strategy for preventing future mpox outbreaks.</div></div><div><h3>Funding</h3><div><span>NIHR</span> and <span>Wellcome Trust</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"55 ","pages":"Article 101364"},"PeriodicalIF":13.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prioritising wellbeing of health workers at the heart of recovery efforts in Ukraine","authors":"Alisa Ladyk-Bryzghalova ,&nbsp;Ganna Legkova ,&nbsp;Iryna Mykychak ,&nbsp;Aiysha Malik ,&nbsp;Natasha Azzopardi Muscat ,&nbsp;Jarno Habicht","doi":"10.1016/j.lanepe.2025.101360","DOIUrl":"10.1016/j.lanepe.2025.101360","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"55 ","pages":"Article 101360"},"PeriodicalIF":13.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"European Medicines Agency approvals of new medicines in May and June 2025","authors":"Bruno Sepodes ,&nbsp;Juan Garcia Burgos ,&nbsp;Steffen Thirstrup","doi":"10.1016/j.lanepe.2025.101389","DOIUrl":"10.1016/j.lanepe.2025.101389","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"55 ","pages":"Article 101389"},"PeriodicalIF":13.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Royal College of Obstetricians and Gynaecologists (RCOG) World Congress 2025","authors":"Stephanie Becker","doi":"10.1016/j.lanepe.2025.101391","DOIUrl":"10.1016/j.lanepe.2025.101391","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"55 ","pages":"Article 101391"},"PeriodicalIF":13.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nasogastric tube after oesophagectomy and risk of anastomotic leak: a Nordic, multicentre, open-label, randomised, controlled, non-inferiority trial","authors":"Jakob Hedberg ,&nbsp;Joonas Kauppila ,&nbsp;Eirik Kjus Aahlin ,&nbsp;David Edholm ,&nbsp;Gjermund Johnsen ,&nbsp;Jan Johansson ,&nbsp;Pernilla Lagergren ,&nbsp;Mats Lindblad ,&nbsp;Fredrik Lindberg ,&nbsp;Olli Helminen ,&nbsp;Per Löfdahl ,&nbsp;Dag Tidemann Førland ,&nbsp;Mads Vikhammer ,&nbsp;Pieter de Heer ,&nbsp;Magnus Sundbom ,&nbsp;Eva Szabo ,&nbsp;Oscar Åkesson ,&nbsp;Magnus Nilsson ,&nbsp;Albert Nilsson ,&nbsp;Michael Achiam ,&nbsp;Tom Mala","doi":"10.1016/j.lanepe.2025.101411","DOIUrl":"10.1016/j.lanepe.2025.101411","url":null,"abstract":"<div><h3>Background</h3><div>Oesophagectomy, a corner stone in curative treatment of oesophageal cancer, is a complex procedure with high complication rates. Postoperative gastric tube decompression is debated and some centres are abandoning routine nasogastric (NG) tube use. We hypothesised that postoperative NG tube removal is non-inferior to five days of NG tube decompression, with regard to the risk of anastomotic leak.</div></div><div><h3>Methods</h3><div>In this open-label, non-inferiority randomised controlled trial across 12 hospitals in Sweden, Norway, Denmark and Finland, participants treated for oesophageal or gastroesophageal junctional cancer with oesophagectomy were randomly assigned (1:1) to no postoperative NG tube or five days of NG tube decompression. Anastomotic leak was the primary outcome and secondary outcomes included pneumonia and length of hospital stay. Analyses were performed on the intention to treat and per protocol populations and non-inferiority for anastomotic leak was defined as a risk difference below 9%. <span><span>ISRCTN.com</span><svg><path></path></svg></span> registration ISRCTN39935085.</div></div><div><h3>Findings</h3><div>Between January 1st 2022 and March 27th 2024, 448 patients were randomly assigned, 217 to no postoperative NG tube and 231 to five days NG tube treatment. The mean age was 67.5 (standard deviation (SD) 9.8) years and 367 (81.9%) were males. Non-inferiority with regard to anastomotic leak for no NG tube decompression could not be shown with 48 patients (22.1% (95% confidence interval (CI) 16.8%, 28.2%)) having anastomotic leak compared to 35 (15.2% (95% CI 10.8%, 20.4%)) with five days of NG tube decompression, a risk difference of −7.0% (95% CI −14.4%, 0.00%), p_{non-inferiority} 0.30. In a <span><span>Supplementary analysis</span></span>, patients had a lower risk of anastomotic leak if postoperative NG decompression was used. Rate of other complications, e.g., pneumonia, were similar between groups. In a per-protocol analysis, the risk difference was −11.3% to the advantage of NG tube (95% CI, −19.1, −0.3%).</div></div><div><h3>Interpretation</h3><div>We could not establish safety (increased risk of anastomotic leak) and therefore do not support omission of NG tube after oesophagectomy.</div></div><div><h3>Funding</h3><div>This trial was funded by the <span>Swedish Cancer Society</span> and the <span>Nordic Cancer Union</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"57 ","pages":"Article 101411"},"PeriodicalIF":13.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}