Impact of disasters, including pandemics, on cardiometabolic outcomes across the life-course: a systematic review

Abstract

BackgroundDisasters are events that disrupt the daily functioning of a community or society, and may increase long-term risk of adverse cardiometabolic outcomes, including cardiovascular disease, obesity and diabetes. The objective of this study was to conduct a systematic review to determine the impact of disasters, including pandemics, on cardiometabolic outcomes across the life-course.DesignA systematic search was conducted in May 2020 using two electronic databases, EMBASE and Medline. All studies were screened in duplicate at title and abstract, and full-text level. Studies were eligible for inclusion if they assessed the association between a population-level or community disaster and cardiometabolic outcomes ≥1 month following the disaster. There were no restrictions on age, year of publication, country or population. Data were extracted on study characteristics, exposure (eg, type of disaster, region, year), cardiometabolic outcomes and measures of effect. Study quality was evaluated using the Joanna Briggs Institute critical appraisal tools.ResultsA total of 58 studies were included, with 24 studies reporting the effects of exposure to disaster during pregnancy/childhood and 34 studies reporting the effects of exposure during adulthood. Studies included exposure to natural (n=35; 60%) and human-made (n=23; 40%) disasters, with only three (5%) of these studies evaluating previous pandemics. Most studies reported increased cardiometabolic risk, including increased cardiovascular disease incidence or mortality, diabetes and obesity, but not all. Few studies evaluated the biological mechanisms or high-risk subgroups that may be at a greater risk of negative health outcomes following disasters.ConclusionsThe findings from this study suggest that the burden of disasters extend beyond the known direct harm, and attention is needed on the detrimental indirect long-term effects on cardiometabolic health. Given the current COVID-19 pandemic, these findings may inform public health prevention strategies to mitigate the impact of future cardiometabolic risk.PROSPERO registration numberCRD42020186074.

Impact of COVID-19 Lockdown on Non-Alcoholic Fatty Liver Disease and Insulin Resistance in Adults: A before and after Pandemic Lockdown Longitudinal Study

“…With the parameters and results described above, we can affirm that lockdown caused a statistically significant deterioration in different health parameters, causing a worsening of cardiovascular and metabolic risk factors [ 72 ] and the appearance of new chronic pathologies that have resulted in increased morbidity and mortality. This is in agreement with other studies [ 73 ].…”

Impact of COVID-19 Lockdown on Anthropometric Variables, Blood Pressure, and Glucose and Lipid Profile in Healthy Adults: A before and after Pandemic Lockdown Longitudinal Study

“…With all this, it can be stated that the COVID-19 pandemic has increased the risk of developing pathologies derived from lifestyle modifications, in addition to raising the risk of COVID-19 infection by altering parameters that increase the risk of illness [ 54 , 69 , 78 ].…”

Chronic Diseases and Associated Risk Factors Among Adults in Puerto Rico After Hurricane Maria

“…However, existing evidence of similar increases in chronic conditions after natural disasters supports that hurricanes and other disasters may trigger or exacerbate disease state. 58 , 59 Notably, we restricted the PROSPECT sample to individuals recruited before COVID-19 to avoid potential changes in health conditions and risk factors during the pandemic. Future studies should analyze the compounding effect of concurrent public health emergencies on the health of Puerto Rico residents.…”