Lancet Regional Health-Europe最新文献

{"title":"Bivalent RSV prefusion vaccine effectiveness against hospitalisation in older adults: meta-analysis of case–control studies in England, Wales, Scotland, and Northern Ireland","authors":"Magda Bucholc ,&nbsp;Safraj Shahul Hameed ,&nbsp;Simon Cottrell ,&nbsp;Anna A. Mensah ,&nbsp;Kirsty Morrison ,&nbsp;Heather J. Whitaker ,&nbsp;Jaime Borjas-Howard ,&nbsp;Alec Cobbold ,&nbsp;Kimberly Marsh ,&nbsp;Ross McQueenie ,&nbsp;Nick Andrews ,&nbsp;Mark G. O'Doherty ,&nbsp;Emma Dickson ,&nbsp;Chris Robertson ,&nbsp;Victoria McClure ,&nbsp;Polani Rubeshkumar ,&nbsp;Clare Brown ,&nbsp;Joshua Menadue ,&nbsp;Christopher Johnson ,&nbsp;Malorie Perry ,&nbsp;Declan T. Bradley","doi":"10.1016/j.lanepe.2026.101620","DOIUrl":"10.1016/j.lanepe.2026.101620","url":null,"abstract":"<div><h3>Background</h3><div>Respiratory syncytial virus (RSV) causes substantial morbidity and mortality in older adults. In 2023, the RSVpreF vaccine was licenced and recommended for adults through the UK's national immunisation programmes. Real-world evidence on vaccine effectiveness (VE) across different populations and healthcare settings is limited.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, multi-nation, test-negative design analysis to evaluate RSVpreF VE against hospitalisation in adults aged 74–79 years across England, Wales, Scotland, and Northern Ireland during the 2024–25 RSV season. Laboratory testing, admission, and vaccination data were linked at the individual patient level. Eligible cases were hospitalised individuals with laboratory-confirmed RSV, and controls were RSV-negative hospitalised patients; SARS-CoV-2- and influenza-positive controls were excluded in the primary analysis. Nation-specific VE estimates were derived using multivariable logistic regression, adjusted for epidemiological week of specimen collection, and combined using fixed-effects meta-analysis with inverse-variance weighting. Sensitivity analyses included redefinition of controls and leave-one-nation-out analyses.</div></div><div><h3>Findings</h3><div>A total of 11,117 adults were included (6528 in England, 942 in NI, 1462 in Scotland, 2185 in Wales). Overall, 3896 (35.0%) had received RSVpreF. Across nations, 826 RSV-positive cases were identified, of whom 726 (87.9%) were unvaccinated. Adjusted VE against RSV-related hospitalisation was 74% (95% confidence interval [CI] 68–80) in England, 77% (30–95) in NI, 81% (60–91) in Scotland, and 82% (43–94) in Wales. Pooled fixed-effects VE was 75% (69–80; <em>I</em>^<em>2</em> = 0%). VE estimates from sensitivity analyses were robust to the inclusion of vaccine-preventable respiratory infection controls and adjustment for vaccination status. Leave-one-nation-out sensitivity analysis showed that excluding England increased pooled VE to 81% (66–89), whereas exclusion of NI, Scotland, or Wales had minimal impact (75%, 68–80 to 69–80).</div></div><div><h3>Interpretation</h3><div>RSVpreF vaccination provides high real-world protection against RSV-related hospitalisation in adults across the UK.</div></div><div><h3>Funding</h3><div>This study received no specific funding.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"64 ","pages":"Article 101620"},"PeriodicalIF":13.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845949","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":"Time to diagnosis and treatment of obstructive sleep apnoea using mandibular jaw movement monitoring versus polysomnography: an open-label, multicentre, randomised, controlled trial","authors":"Jean-Louis Pépin ,&nbsp;Renaud Tamisier ,&nbsp;Marc Manceau ,&nbsp;Katleen Denoncin ,&nbsp;Arnaud Prigent ,&nbsp;Maxime Patout ,&nbsp;Hervé Pégliasco ,&nbsp;Frédéric Gagnadoux ,&nbsp;Jean-Benoît Martinot ,&nbsp;Matthieu Roustit","doi":"10.1016/j.lanepe.2026.101637","DOIUrl":"10.1016/j.lanepe.2026.101637","url":null,"abstract":"<div><h3>Background</h3><div>Obstructive sleep apnoea (OSA) is often underdiagnosed, highlighting the need for scalable diagnostic alternatives. The SUNSAS study compared a new device for at-home diagnosis of OSA (artificial intelligence [AI]-supported analysis of mandibular jaw movements [MJM]) with polysomnography (PSG) for time to diagnosis and treatment, and patient-reported outcomes.</div></div><div><h3>Methods</h3><div>This prospective, multicentre, randomised, controlled, open-label study was conducted in France (October 2021–October 2024). Adults aged 18–80 years with suspected OSA were randomised (1:1) to undergo diagnostic testing using MJM monitoring (Sunrise) or PSG. Primary endpoints were assessed using hierarchical testing: 1. daytime sleepiness (Epworth Sleepiness Scale [ESS] score) at 3 months post-diagnosis and time to diagnosis; 2. time to treatment; and 3. daytime sleepiness at 3 months post-randomisation. Secondary endpoints included quality of life (Short Form-36, Quebec Sleep Questionnaire), work productivity (Work Productivity and Activity Impairment questionnaire), and positive airway pressure therapy adherence at 3 months after treatment initiation.</div></div><div><h3>Findings</h3><div>Of 849 participants randomised (58·7% male, median age 50 years, body mass index 28·0 kg/m², apnoea-hypopnoea index 15·2/h), 774 received a diagnosis: 133 no OSA, 239 mild OSA, 220 moderate OSA, and 182 severe OSA. Median time to diagnosis (15 vs. 106 days) and to treatment initiation (50 vs. 124 days) were significantly shorter with MJM analysis versus PSG (both p &lt; 0·01). MJM-based diagnosis was noninferior to PSG in reducing ESS at 3 months after diagnosis (−2·26 vs. −2·29; 95% confidence interval [CI] for difference −0·85, 0·79; p = 0·01), and superior at 3 months post-randomisation (between-group difference: −1·51 (95% CI −2·17, −0·85); p &lt; 0·01). Secondary endpoints also favoured the MJM group.</div></div><div><h3>Interpretation</h3><div>OSA diagnosis based on MJM monitoring with AI-supported analysis is noninferior to PSG in reducing daytime sleepiness at 3 months after diagnosis, while significantly accelerating time to diagnosis and treatment initiation, resulting in earlier improvement in daytime sleepiness.</div></div><div><h3>Funding</h3><div>Sunrise, with support from the <span>French Ministry of Health</span> through the <span><em>Forfait Innovation</em> programme</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"64 ","pages":"Article 101637"},"PeriodicalIF":13.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845962","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":"Lung aeration and gas exchange in preterm infants developing moderate-to-severe bronchopulmonary dysplasia: a multicentre prospective study from the PATH-BPD cohort","authors":"Daniele De Luca ,&nbsp;Luca Bonadies ,&nbsp;Costanza Neri ,&nbsp;Barbara Loi ,&nbsp;Teresa Maria Silva-Garcia ,&nbsp;Guillermo Ramos Noguera ,&nbsp;Laura Vivalda ,&nbsp;Giulia Res ,&nbsp;Maria de las Nieves Cidoncha-Fuertes ,&nbsp;Carlos Baena-Palomino ,&nbsp;Lorenzo Zanetto ,&nbsp;Luca Vedovelli ,&nbsp;Dario Gregori ,&nbsp;Eugenio Baraldi ,&nbsp;Almudena Alonso-Ojembarrena","doi":"10.1016/j.lanepe.2025.101584","DOIUrl":"10.1016/j.lanepe.2025.101584","url":null,"abstract":"<div><h3>Background</h3><div>We lack data about the early evolution of lung pathophysiology in infants developing moderate-to-severe broncho-pulmonary dysplasia (msBPD). We aimed to describe lung aeration and gas exchange during the early phase of msBPD development and identify the critical moments at which they change.</div></div><div><h3>Methods</h3><div>Prospective, multicentre, cohort study performed in three European centres enrolling preterm (≤30 weeks’ gestation) infants evaluated at 10, 21, 28 days (D) of life and 34 and 36 weeks (W) post-menstrual age, while receiving as little invasive ventilation as possible. Lung aeration was assessed with quantitative lung ultrasound. Pulse oximetry and transcutaneous blood gas measurements were used to calculate the SpO₂/FiO₂ and PtcO₂/FiO₂ ratios. msBPD was defined using NIH-2001, NICHD-2018 and Jensen definitions.</div></div><div><h3>Findings</h3><div>347 infants were studied, of which 80, 79 and 89 had msBPD, using the three definitions, respectively. Lung aeration and oxygenation were always poorer, since D10, in patients with msBPD than in those without it. The difference in lung aeration (β ranging from +0.009 (95% CI: 0; 0.01) to +0.012 (95% CI: 0.01; 0.02), depending on the used definition, <em>p</em> &lt; 0.001) and carbon dioxide (β ranging from +0.01 (95% CI: 0; 0.02) to +0.014 (95% CI: 0.01; 0.02), depending on the used definition, <em>p</em> &lt; 0.001) between patients with and without msBPD increased overtime. Results were similar regardless of the BPD definition. The strongest discrimination was obtained by the lung aeration evolution (β(t) = 0.227 (95% CI: 0.152, 0.302), <em>p</em> &lt; 0.001) with a peak at 26 days.</div></div><div><h3>Interpretation</h3><div>Patients who develop msBPD consistently demonstrate early and typical pathophysiological phenotypes regardless of the BPD definition. These data highlight critical moments in the development of msBPD and are not captured by currently available BPD definitions.</div></div><div><h3>Funding</h3><div>Only institutional funding to support the author's working time was used.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"63 ","pages":"Article 101584"},"PeriodicalIF":13.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927917","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 Code Against Cancer 5th edition: 14 ways you can help prevent cancer","authors":"Carolina Espina ,&nbsp;David Ritchie ,&nbsp;Elio Riboli ,&nbsp;Hans Kromhout ,&nbsp;Silvia Franceschi ,&nbsp;Iris Lansdorp-Vogelaar ,&nbsp;Theresa M. Marteau ,&nbsp;Ioanna Bakogianni ,&nbsp;Nadia Vilahur ,&nbsp;Catherina J. Alberts ,&nbsp;Urska Ivanus ,&nbsp;Ariadna Feliu ,&nbsp;Erica D'Souza ,&nbsp;Hajo Zeeb ,&nbsp;Giota Mitrou ,&nbsp;Tit Albreht ,&nbsp;Joakim Dillner ,&nbsp;Jérôme Foucaud ,&nbsp;Marta Manczuk ,&nbsp;Jose María Martin-Moreno ,&nbsp;Joachim Schüz","doi":"10.1016/j.lanepe.2026.101592","DOIUrl":"10.1016/j.lanepe.2026.101592","url":null,"abstract":"<div><div>Despite the growing cancer burden in the European Union, public awareness of effective prevention is low. In response, Europe's Beating Cancer Plan has supported the development of the 5th edition of the European Code Against Cancer (ECAC5). Using a transparent, stepwise decision-making process, around 80 experts reviewed the latest scientific evidence on cancer prevention and used modern communication strategies to update the previous edition. An innovation in ECAC5 is the inclusion of population-level recommendations, aiming to structurally influence the systems that shape individual choices and improve environmental conditions to which all citizens are involuntarily exposed. ECAC5 includes 14 actionable, evidence-based recommendations for individuals to reduce their cancer risk alongside their respective policy recommendations. All are presented through equity lens, with attention to co-benefits for preventing other non-communicable diseases and tailoring messages to diverse audiences. Clear evidence-based statements on cancer risks factors and effective preventive interventions will empower citizens to make healthier choices, call policymakers to act, foster public support for effective policies, and contribute to more effective cancer prevention.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"63 ","pages":"Article 101592"},"PeriodicalIF":13.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023193","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":"Short-term effects of cannabis legalisation in Germany on driving under the influence of cannabis: a difference-in-differences analysis using Austria as a control","authors":"Anna Schranz ,&nbsp;Anja Knoche-Becker ,&nbsp;Moritz Rosenkranz ,&nbsp;Uwe Verthein ,&nbsp;Jakob Manthey","doi":"10.1016/j.lanepe.2026.101593","DOIUrl":"10.1016/j.lanepe.2026.101593","url":null,"abstract":"<div><h3>Background</h3><div>In April 2024, Germany legalised adult cannabis possession and cultivation, and in August 2024 established legal THC-limits for driving. This study aimed to examine short-term impacts on (1) cannabis use and (2) driving under the influence of cannabis (DUIC), and (3) investigates the extent of DUIC involving cannabis combined with alcohol or other drugs (DUIC(+)).</div></div><div><h3>Methods</h3><div>Data came from two cross-sectional population surveys in Germany and Austria (control) before (t₀: Nov–Dec 2023) and after legalisation (t₁: Nov 2024–Jan 2025). We assessed 12-month cannabis use among adults aged 18–64 (Germany: n_t0 = 6670, n_t1 = 9692; Austria: n_t0 = 2132, n_t1 = 2102) and DUIC among at least monthly cannabis users (excluding medical use; Germany: n_t0 = 393, n_t1 = 589; Austria: n_t0 = 86, n_t1 = 92) using a difference-in-differences (DiD) approach. For t₁, we compared the proportion of DUIC(+) and cannabis-only DUIC(−) episodes among all DUIC episodes by use frequency.</div></div><div><h3>Findings</h3><div>In Germany, cannabis use rose from 12·1% to 14·4%, but this trend did not significantly differ from Austria (DiD-effect: <em>OR</em> = 1·18, 95% CI 0·95–1·48, <em>p</em> = 0·141, weighted). Among at least monthly users, DUIC decreased slightly from 28·5% to 26·8% (unweighted), with no significant difference compared with Austria (DiD-effect: <em>aOR</em> = 0·68, 95% <em>CI</em> 0·27–1·68, <em>p</em> = 0·408). Results held across sensitivity analyses including additional confounders and negative controls. At t₁, DUIC(+) accounted for 21·5% of episodes. DUIC(−) was most common among daily users, DUIC(+) among weekly users.</div></div><div><h3>Interpretation</h3><div>Eight months after legalisation, no significant short-term effects on cannabis use or DUIC were observed. DUIC(+), associated with higher traffic risk, was most common among weekly users. A comprehensive evaluation of the cannabis reform requires further monitoring of DUIC and traffic data.</div></div><div><h3>Funding</h3><div><span>Federal Highway</span> and <span>Transport Research Institute</span> (FE 82.0816/2023).</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"63 ","pages":"Article 101593"},"PeriodicalIF":13.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023191","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":"Stigma from healthcare professionals and care-limiting behaviors in individuals with substance use disorders: a mixed-methods study","authors":"Mathias Luderer ,&nbsp;Dorothea Stockreiter ,&nbsp;Annette Binder ,&nbsp;Laura Müller ,&nbsp;Franca Burger ,&nbsp;Nathalie Stüben ,&nbsp;Andreas Reif","doi":"10.1016/j.lanepe.2025.101587","DOIUrl":"10.1016/j.lanepe.2025.101587","url":null,"abstract":"<div><h3>Background</h3><div>Stigmatization of individuals with substance use disorders (SUDs) by healthcare professionals (HCPs) is a recognized problem, but its direct impact on patient treatment choices has not been systematically quantified. We aimed to provide first robust, quantitative metrics of non-disclosure, treatment avoidance, and treatment discontinuation for any medical treatment directly attributable to HCP stigma and to explore the lived experiences underpinning these behaviors.</div></div><div><h3>Methods</h3><div>We conducted a prospective mixed-methods study with 119 adult inpatients with SUDs at a German university hospital (2021–2024). A self-developed questionnaire assessed stigma-related behaviors and their association with self-stigmatization. Qualitative data were analyzed using reflexive thematic analysis (RTA). A person with lived experiences contributed to writing up the manuscript.</div></div><div><h3>Findings</h3><div>49.6% (95% CI 40.3–58.9; n = 59/119) reported non-disclosure of substance use, 36.1% (95% CI 27.5–45.5; n = 43/119) avoided necessary medical treatment, and 29.4% (95% CI 21.4–38.5; n = 35/119) discontinued treatment due to stigma. Internalized stigma significantly predicted all three outcomes (aORs 1.055–1.075, p ≤ .001). RTA identified “Institutional Stigma” (addiction as a “moral failing”), “Barriers to Care” (obstacles to respectful treatment), and “Cost of Disclosure” (negative consequences such as hostility after revealing substance use).</div></div><div><h3>Interpretation</h3><div>Stigma from HCPs is a quantifiable contributor of treatment disengagement, representing a direct threat to patient safety and a major contributor to the SUD treatment gap. These findings underscore the urgent need for evidence-based interventions, including training HCPs across all specialties in non-stigmatizing communication, to improve healthcare engagement for this vulnerable population and narrow the substantial treatment gap.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"63 ","pages":"Article 101587"},"PeriodicalIF":13.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978785","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":"Comorbidities, medication use, and overall survival in eight cancers: a multinational cohort study of 1.7 million patients across Europe","authors":"Irene López-Sánchez ,&nbsp;Anna Palomar-Cros ,&nbsp;Ravinder Claire ,&nbsp;Laura Pérez-Crespo ,&nbsp;Agustina Giuliodori ,&nbsp;Ian Koblbauer ,&nbsp;Jeremy Dietz ,&nbsp;Jamie Elvidge ,&nbsp;James Koh ,&nbsp;Asieh Golozar ,&nbsp;Juan Manuel Ramirez-Anguita ,&nbsp;Angela Leis ,&nbsp;Miguel-Angel Mayer ,&nbsp;Nicola Symmers ,&nbsp;Mahéva Vallet ,&nbsp;Colin McLean ,&nbsp;Peter S. Hall ,&nbsp;Mees Mosseveld ,&nbsp;Katia Verhamme ,&nbsp;Espen Enerly ,&nbsp;Danielle Newby","doi":"10.1016/j.lanepe.2025.101585","DOIUrl":"10.1016/j.lanepe.2025.101585","url":null,"abstract":"<div><h3>Background</h3><div>Real-world evidence provides valuable insights into cancer burden, presentation, and care variations. Through a large-scale federated approach, this study aims to explore patient characteristics and overall survival for eight cancers using data from 11 electronic health records and cancer registries from eight European countries, mapped to the Observational Medical Outcomes Partnership Common Data Model (OMOP-CDM).</div></div><div><h3>Methods</h3><div>Patients aged 18 years or older with a primary cancer diagnosis between 2000 and 2019 were included. Patients were followed from cancer diagnosis until death, database exit, or study end. Mortality data was sourced from linked national or subnational death registries for most databases. Patient characteristics, including comorbidities, and medication use, were summarised. Age-standardised overall survival (OS) at one, five, and ten years were calculated using the Kaplan–Meier method and stratified by cancer type, age group and sex.</div></div><div><h3>Findings</h3><div>There were 1,796,278 eligible cancer patients included with most diagnoses in individuals aged 60–79 years. Top comorbidities and medications were relatively consistent across databases, with certain variations observed by cancer type, possibly indicative of early cancer signs and risk factors. For instance, anaemia was frequent in colorectal (9% [HUS]–23% [IMASIS]; 791/8395–730/3141 individuals) and stomach cancers (10% [HUS]–34% [IMASIS]; 130/1277–225/670), while chronic obstructive pulmonary disease (18% [SIDIAP]–34% [HUVM], 5310/29,009–1039/3063) and pneumonia (5% [CPRD GOLD]–33% [UTARTU], 1904/34,990–1001/3063) were common in lung cancer patients. Breast and prostate cancers had the highest one, five and ten-year overall survival, with 5-year OS ranging from 76% [ECi]–85% [IMASIS] and 75% [HUVM]–83% [SIDIAP], respectively. Pancreatic cancer showed the lowest survival ranging from 3% [NCR]–25% [IMASIS] 5-year OS. Variations in cancer survival estimates were observed across data sources and countries.</div></div><div><h3>Interpretation</h3><div>Federated analysis of diverse European real-world databases, standardised to OMOP-CDM, offer a valuable benchmark for future cancer research, particularly in understanding prodromes and risk factors, often recorded in routinely collected healthcare data prior to cancer onset.</div></div><div><h3>Funding</h3><div>The <span>European Health Data &amp; Evidence Network</span> has received funding from the Innovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement No 806968. The JU receives support from the <span>European Union’s Horizon 2020</span> research and innovation programme and the European Federation of Pharmaceutical Industries and Associations partners.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"63 ","pages":"Article 101585"},"PeriodicalIF":13.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023190","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":"Humanity first, not country first","authors":"The Lancet Regional Health – Europe","doi":"10.1016/j.lanepe.2026.101664","DOIUrl":"10.1016/j.lanepe.2026.101664","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"63 ","pages":"Article 101664"},"PeriodicalIF":13.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147650001","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":"SARS-CoV-2 reinfections and subsequent risk of hospital-diagnosed post-acute sequelae in Denmark (2020–2022): a nationwide cohort study","authors":"Mark P. Khurana ,&nbsp;Mathilde Marie Brünnich Sloth ,&nbsp;Neil Scheidwasser ,&nbsp;Jacob Curran-Sebastian ,&nbsp;Christian Morgenstern ,&nbsp;Nicolas Banholzer ,&nbsp;David Thein ,&nbsp;Laust H. Mortensen ,&nbsp;Morten Rasmussen ,&nbsp;Pikka Jokelainen ,&nbsp;Frederik Trier Møller ,&nbsp;Marc Stegger ,&nbsp;Tyra G. Krause ,&nbsp;Ewan Cameron ,&nbsp;David A. Duchêne ,&nbsp;Alexandros Katsiferis ,&nbsp;Samir Bhatt","doi":"10.1016/j.lanepe.2026.101601","DOIUrl":"10.1016/j.lanepe.2026.101601","url":null,"abstract":"<div><h3>Background</h3><div>Post-acute sequelae of COVID-19 (PASC), or long COVID, are a public health concern. While most recover from SARS-CoV-2 infections within weeks, some experience persistent symptoms. Here, we quantified the association between repeated SARS-CoV-2 infections and the risk of hospital-diagnosed PASC.</div></div><div><h3>Methods</h3><div>We conducted a nationwide register-based cohort study of all adults in Denmark (≥18 years) with at least one SARS-CoV-2 PCR or antigen test between April 1, 2020, and December 31, 2022. Participants were followed from first test until long COVID diagnosis (ICD-10: B948A), death, emigration, three SARS-CoV-2 infections, or end of study. Risk of long COVID diagnosis was estimated at three timepoints after study entry (180 days, 1 year, 2 years) and the outcomes were assessed during the 180 days after each timepoint. Cause-specific Cox models treated death as a competing risk, with number of infections and vaccination status as time-varying covariates. Absolute risks and differences were estimated using G-computation. Analyses were stratified by sex, income, and vaccination status. Secondary analyses assessed fatigue and headache (ICD-10), excluding individuals with prior diagnoses.</div></div><div><h3>Findings</h3><div>Of 4,418,544 individuals, 6942 (0.16%) were diagnosed with long COVID. The absolute risk of a diagnosis increased following reinfection (0.73% [95% CI 0.69–0.77] after one infection vs. 1.16% [1.05–1.30] after two infections at 180 days), but differences were small and decreased over time. Risks following reinfection were similar across sex and income strata. Absolute risk decreased with prior vaccinations. Secondary analyses showed no increased risk of fatigue or headache after primary infection. A small increase in fatigue risk was observed after reinfection at 1 year (RD 0.03% [0.01–0.05]), but not for headache.</div></div><div><h3>Interpretation</h3><div>Reinfection increases long COVID risk; however, the absolute increase after reinfection is smaller than that observed after a primary infection. Vaccination offers substantial protection against long COVID.</div></div><div><h3>Funding</h3><div><span>Danish National Research Foundation</span> (DNRF).</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"63 ","pages":"Article 101601"},"PeriodicalIF":13.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078393","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":"Air temperature and all-cause emergency hospital admissions in people with and without diabetes in Germany (2005–2022): a time-series analysis","authors":"Thaddäus Tönnies ,&nbsp;Marielle Wirth ,&nbsp;Katharina Piedboeuf-Potyka ,&nbsp;Oliver Kuss","doi":"10.1016/j.lanepe.2026.101591","DOIUrl":"10.1016/j.lanepe.2026.101591","url":null,"abstract":"<div><h3>Background</h3><div>People with diabetes may be more vulnerable to temperature extremes due to impaired thermoregulation and higher prevalence of comorbidities, but evidence is limited. We aimed to compare short-term effects of extreme heat and cold on all-cause emergency hospital admissions in Germany among people with and without diabetes.</div></div><div><h3>Methods</h3><div>We applied space- and time-stratified conditional quasi-Poisson regression with distributed lag non-linear models (up to 21 days) to estimate short-term effects of daily average temperature. We chose the reference temperature (20 °C) such that it approximates the minimum morbidity temperature in most subgroups. Analyses were stratified by sex, age, and diabetes status using data from all emergency hospital admissions in Germany, 2005–2022 (N = 132,243,083) at the level of 400 administrative districts, enabling an ecological study.</div></div><div><h3>Findings</h3><div>Both heat and cold increased hospital admissions. Heat-related relative risks (RR) were broadly similar between people with and without diabetes. Considering all ages, heat-related RRs (95% confidence interval) were 1.03 (1.03–1.04), 1.07 (1.00–1.13), and 1.02 (1.01–1.03) in males without, with type 1, and with type 2 diabetes. Age-specific RRs for heat and cold were similar between people without and with type 2 diabetes but higher for type 1 diabetes in some subgroups; e.g. cold-related RRs were 1.13 (1.12–1.15) and 1.51 (1.14–2.01) in men aged ≥80 years without and with type 1 diabetes.</div></div><div><h3>Interpretation</h3><div>Contrary to prior hypotheses, diabetes was not associated with greater vulnerability. This may reflect good healthcare access and increased awareness of heat and cold-related risks among people with diabetes. Nevertheless, given the higher baseline risk of hospital admission in diabetes, similar RR may still translate into larger absolute effects of extreme temperatures. Hence, clinical practice and policies aimed at mitigating temperature-related effects should continue to consider diabetes as a potential vulnerability factor.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"63 ","pages":"Article 101591"},"PeriodicalIF":13.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023192","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}