Poorer outcomes have been reported with COVID-19 and influenza coinfections. As the COVID-19 pandemic rages on, protection against influenza by vaccination is becoming increasingly important. This study examines how COVID-19 has influenced influenza vaccination intentions from a global perspective. A literature search was conducted on Embase, PubMed, and CNKI from 1 January 2019 to 31 December 2021 for articles reporting rates of influenza vaccination pre-COVID-19 (19/20 season), and intention and/or uptake of influenza vaccination post-COVID-19 (20/21 season). The changes in vaccination intention and reasons for changes were reported. Subgroup analyses were performed by region, gender, age, and occupation. Newcastle Ottawa Scale was used for quality assessment of the articles. Twenty-seven studies with 39,193 participants were included. Among 22 studies reporting intention to vaccinate in 20/21, there was increased intention to vaccinate (RR 1.50, 95% CI 1.32–1.69, p < 0.001) regardless of age, gender, and occupation. The remaining five studies reporting vaccination intention and uptake in 20/21 showed a similar increase (RR 1.68, 95%CI 1.20–2.36). Important determinants include historical vaccine acceptance, and perception of influenza severity and vaccine safety. The COVID-19 pandemic has increased intention to vaccinate against influenza internationally. The pandemic could be a window of opportunity to promote influenza vaccination and decrease vaccine hesitancy.

Background: Epicardial adipose tissue (EAT) has garnered attention as a prognostic and risk stratification factor for cardiovascular disease. This study, via meta-analyses, evaluates the associations between EAT and cardiovascular outcomes stratified across imaging modalities, ethnic groups, and study protocols. Methods: Medline and Embase databases were searched without date restriction on May 2022 for articles that examined EAT and cardiovascular outcomes. The inclusion criteria were (1) studies measuring EAT of adult patients at baseline and (2) reporting follow-up data on study outcomes of interest. The primary study outcome was major adverse cardiovascular events. Secondary study outcomes included cardiac death, myocardial infarction, coronary revascularization, and atrial fibrillation. Results: Twenty-nine articles published between 2012 and 2022, comprising 19 709 patients, were included in our analysis. Increased EAT thickness and volume were associated with higher risks of cardiac death (odds ratio, 2.53 [95% CI, 1.17–5.44]; P =0.020; n=4), myocardial infarction (odds ratio, 2.63 [95% CI, 1.39–4.96]; P =0.003; n=5), coronary revascularization (odds ratio, 2.99 [95% CI, 1.64–5.44]; P <0.001; n=5), and atrial fibrillation (adjusted odds ratio, 4.04 [95% CI, 3.06–5.32]; P <0.001; n=3). For 1 unit increment in the continuous measure of EAT, computed tomography volumetric quantification (adjusted hazard ratio, 1.74 [95% CI, 1.42–2.13]; P <0.001) and echocardiographic thickness quantification (adjusted hazard ratio, 1.20 [95% CI, 1.09–1.32]; P <0.001) conferred an increased risk of major adverse cardiovascular events. Conclusions: The utility of EAT as an imaging biomarker for predicting and prognosticating cardiovascular disease is promising, with increased EAT thickness and volume being identified as independent predictors of major adverse cardiovascular events. Registration: URL: https://www.crd.york.ac.uk/prospero ; Unique identifier: CRD42022338075.

Cardiovascular diseases (CVDs) are the leading cause of global mortality. Understanding epidemiologic trends in the modifiable risk factors driving CVDs is essential in designing effective countermeasures. The aim of this study was to forecast geospatial trends of modifiable cardiovascular risk factors, namely high systolic blood pressure (SBP), high fasting plasma glucose, high body mass index (BMI), high low-density lipoprotein cholesterol, and tobacco use from 2025 to 2050. Historical data on disability-adjusted life years (DALYs) and mortality from the GBD (Global Burden of Disease) 2021 study were used to forecast the burden associated with modifiable cardiovascular risk factors from 2025 to 2050. Trends across GBD super-regions, sex, sociodemographic index, and age groups were examined. In 2050, high SBP (1,694.2 [95% uncertainty interval [UI]: 1,454.6-1,933.9] per 100,000 population) will contribute to the highest age-standardized DALYs, followed by high low-density lipoprotein cholesterol (657.6 [95% UI: 511.9-803.3] per 100,000 population), high BMI (495.2 [95% UI: 330.8-659.6] per 100,000 population), tobacco use (493.7 [95% UI: 378.2-609.1] per 100,000 population), and high fasting plasma glucose (466.7 [95% UI: 311.9-621.5] per 100,000 population). Although age-standardized DALY rates will fall across all cardiovascular risk factors from 2025 to 2050, overall crude DALYs associated with cardiovascular risk factors are projected to rise within the same period. High SBP (rising by 99 million DALYs; 44.1% increase), and high BMI (increasing by 44 million DALYs; 88.0% increase) will have the greatest rise in crude DALYs from 2025 to 2050. Although the projected decline in age-standardized DALYs of modifiable cardiovascular risk factors suggest improved management of CVDs, crude DALYs will continue to rise due to population growth and aging.