CHANGES IN STRUCTURE OF MORTALITY FROM DIGESTIVE DISEASES DURING THE COVID-19 PANDEMIC IN MOSCOW

Significance. Coronavirus SARS-CoV-2 and the drugs used to treat it affect the course of gastroenterological diseases. Does this change the population mortality structure? Purpose: the purpose of the study was to determine changes in the structure of mortality from diseases of the digestive system against the background of the COVID-19 pandemic. Material and Methods. The study was conducted using the database Registration of the Facts of Death - "The Unified Medical Information and Analytical System of the City of Moscow" on people who died from digestive diseases in 2019 - 2021. Death dynamics among the Muscovites was analysed using Rosstat data for 2010-2020. The share of individual diseases in the structure of death causes, frequency of digestive disease indication in the second part of the medical death certificate in case of death from COVID-19 and average age of death were analysed. Comparison of shares of individual causes in different years was carried out on four-field tables using the Chi-square test. Significance level of the test was p < 0.05. The odds ratio (OR) and its confidence interval (CI) were determined. Results. The average annual growth rate of mortality from digestive diseases in 2010-2019 equalled to -3.5% in men and -1.7% in women; in 2020 it added up to 14.9% and 8.9%, respectively. In 2020, the average age of death from digestive diseases decreased by 3.9 years in men and 3.4 years in women. In the cause of death structure, the share of other specified noninfective gastroenteritis and colitis (K52) (OR = 1.52, CI = 1.07–2.17), liver fibrosis and cirrhosis (OR = 1.35, CI = 1.22–1.50), acute pancreatitis (OR = 1.32, CI = 1.15 - 1.52) has increased. In 2021, in case of death from COVID-19, the frequency of reporting diverticular disease of intestine (OR = 2.35, CI = 1.22 - 4.64) as well as acute pancreatitis in men (OR = 2.87, CI = 1, 04 - 8.53) increased. Conclusion. During the pandemic, the structure of mortality from diseases of the digestive system has changed. A significant decrease in the average age of death from digestive diseases among the Muscovites is mainly determined by the increased mortality in age group of 35-49 years. The obtained results suggest that infection with SARS-CoV-2 virus not only adversely affects the existing digestive diseases, but also triggers the development of new pathological processes: noninfective gastroenteritis and colitis, fibrosis and cirrhosis of liver. It should be also hypothesized that diverticular disease of intestine increases the risk of dying from COVID-19.