Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. Funding: Bill & Melinda Gates Foundation.

Schumacher, A.E., Kyu, H.H., Aali, A., Abbafati, C., Abbas, J., Abbasgholizadeh, R., et al. (2024). Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021. THE LANCET, 403(10440), 1989-2056 [10.1016/s0140-6736(24)00476-8].

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Bisulli, Francesca;Golinelli, Davide;Guicciardi, Stefano;Lenzi, Jacopo;Mazzotti, Antonio;Sanmarchi, Francesco;Violante, Francesco S;
2024

Abstract

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. Funding: Bill & Melinda Gates Foundation.
2024
Schumacher, A.E., Kyu, H.H., Aali, A., Abbafati, C., Abbas, J., Abbasgholizadeh, R., et al. (2024). Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021. THE LANCET, 403(10440), 1989-2056 [10.1016/s0140-6736(24)00476-8].
Schumacher, Austin E; Kyu, Hmwe Hmwe; Aali, Amirali; Abbafati, Cristiana; Abbas, Jaffar; Abbasgholizadeh, Rouzbeh; Abbasi, Madineh Akram; Abbasian, Mohammadreza; Abd ElHafeez, Samar; Abdelmasseh, Michael; Abd-Elsalam, Sherief; Abdelwahab, Ahmed; Abdollahi, Mohammad; Abdoun, Meriem; Abdullahi, Auwal; Abdurehman, Ame Mehadi; Abebe, Mesfin; Abedi, Aidin; Abedi, Armita; Abegaz, Tadesse M; Abeldaño Zuñiga, Roberto Ariel; Abhilash, E S; Abiodun, Olugbenga Olusola; Aboagye, Richard Gyan; Abolhassani, Hassan; Abouzid, Mohamed; Abreu, Lucas Guimarães; Abrha, Woldu Aberhe; Abrigo, Michael R M; Abtahi, Dariush; Abu Rumeileh, Samir; Abu-Rmeileh, Niveen ME; Aburuz, Salahdein; Abu-Zaid, Ahmed; Acuna, Juan Manuel; Adair, Tim; Addo, Isaac Yeboah; Adebayo, Oladimeji M; Adegboye, Oyelola A; Adekanmbi, Victor; Aden, Bashir; Adepoju, Abiola Victor; Adetunji, Charles Oluwaseun; Adeyeoluwa, Temitayo Esther; Adeyomoye, Olorunsola Israel; Adha, Rishan; Adibi, Amin; Adikusuma, Wirawan; Adnani, Qorinah Estiningtyas Sakilah; Adra, Saryia; Afework, Abel; Afolabi, Aanuoluwapo Adeyimika; Afraz, Ali; Afyouni, Shadi; Afzal, Saira; Agasthi, Pradyumna; Aghamiri, Shahin; Agodi, Antonella; Agyemang-Duah, Williams; Ahinkorah, Bright Opoku; Ahmad, Aqeel; Ahmad, Danish; Ahmad, Firdos; Ahmad, Muayyad M; Ahmad, Tauseef; Ahmadi, Keivan; Ahmadzade, Amir Mahmoud; Ahmadzade, Mohadese; Ahmed, Ayman; Ahmed, Haroon; Ahmed, Luai A; Ahmed, Muktar Beshir; Ahmed, Syed Anees; Ajami, Marjan; Aji, Budi; Ajumobi, Olufemi; Akalu, Gizachew Taddesse; Akara, Essona Matatom; Akinosoglou, Karolina; Akkala, Sreelatha; Akyirem, Samuel; Al Hamad, Hanadi; Al Hasan, Syed Mahfuz; Al Homsi, Ammar; Al Qadire, Mohammad; Ala, Moein; Aladelusi, Timothy Olukunle; AL-Ahdal, Tareq Mohammed Ali; Alalalmeh, Samer O; Al-Aly, Ziyad; Alam, Khurshid; Alam, Manjurul; Alam, Zufishan; Al-amer, Rasmieh Mustafa; Alanezi, Fahad Mashhour; Alanzi, Turki M; Albashtawy, Mohammed; AlBataineh, Mohammad T; Aldridge, Robert W; Alemi, Sharifullah; Al-Eyadhy, Ayman; Al-Gheethi, Adel Ali Saeed; Alhabib, Khalid F; Alhalaiqa, Fadwa Alhalaiqa Naji; Al-Hanawi, Mohammed Khaled; Ali, Abid; Ali, Akhtar; Ali, Beriwan Abdulqadir; Ali, Hassam; Ali, Mohammed Usman; Ali, Rafat; Ali, Syed Shujait Shujait; Ali, Zahid; Alian Samakkhah, Shohreh; Alicandro, Gianfranco; Alif, Sheikh Mohammad; Aligol, Mohammad; Alimi, Rasoul; Aliyi, Ahmednur Adem; Al-Jumaily, Adel; Aljunid, Syed Mohamed; Almahmeed, Wael; Al-Marwani, Sabah; Al-Maweri, Sadeq Ali Ali; Almazan, Joseph Uy; Al-Mekhlafi, Hesham M; Almidani, Omar; Alomari, Mahmoud A; Alonso, Nivaldo; Alqahtani, Jaber S; Alqutaibi, Ahmed Yaseen; Al-Sabah, Salman Khalifah; Altaf, Awais; Al-Tawfiq, Jaffar A; Altirkawi, Khalid A; Alvi, Farrukh Jawad; Alwafi, Hassan; Al-Worafi, Yaser Mohammed; Aly, Hany; Alzoubi, Karem H; Amare, Azmeraw T; Ameyaw, Edward Kwabena; Amhare, Abebe Feyissa; Amin, Tarek Tawfik; Amindarolzarbi, Alireza; Aminian Dehkordi, Javad; Amiri, Sohrab; Amu, Hubert; Amugsi, Dickson A; Amzat, Jimoh; Ancuceanu, Robert; Anderlini, Deanna; Andrade, Pedro Prata; Andrei, Catalina Liliana; Andrei, Tudorel; Angappan, Dhanalakshmi; Anil, Abhishek; Anjum, Afifa; Antony, Catherine M; Antriyandarti, Ernoiz; Anuoluwa, Iyadunni Adesola; Anwar, Sumadi Lukman; Anyasodor, Anayochukwu Edward; Appiah, Seth Christopher Yaw; Aqeel, Muhammad; Arabloo, Jalal; Arabzadeh Bahri, Razman; Arab-Zozani, Morteza; Arafat, Mosab; Araújo, Ana Margarida; Aravkin, Aleksandr Y; Aremu, Abdulfatai; Ariffin, Hany; Aripov, Timur; Armocida, Benedetta; Arooj, Mahwish; Artamonov, Anton A; Artanti, Kurnia Dwi; Arulappan, Judie; Aruleba, Idowu Thomas; Aruleba, Raphael Taiwo; Arumugam, Ashokan; Asaad, Malke; Asgary, Saeed; Ashemo, Mubarek Yesse; Ashraf, Muhammad; Asika, Marvellous O; Athari, Seyyed Shamsadin; Atout, Maha Moh'd Wahbi; Atreya, Alok; Attia, Sameh; Aujayeb, Avinash; Avan, Abolfazl; Awotidebe, Adedapo Wasiu; Ayala Quintanilla, Beatriz Paulina; Ayanore, Martin Amogre; Ayele, Getnet Melaku; Ayuso-Mateos, Jose L; Ayyoubzadeh, Seyed Mohammad; Azadnajafabad, Sina; Azhar, Gulrez Shah; Aziz, Shahkaar; Azzam, Ahmed Y; Babashahi, Mina; Babu, Abraham Samuel; Badar, Muhammad; Badawi, Alaa; Badiye, Ashish D; Baghdadi, Soroush; Bagheri, Nasser; Bagherieh, Sara; Bah, Sulaiman; Bahadorikhalili, Saeed; Bai, Jianjun; Bai, Ruhai; Baker, Jennifer L; Bakkannavar, Shankar M; Bako, Abdulaziz T; Balakrishnan, Senthilkumar; Balogun, Saliu A; Baltatu, Ovidiu Constantin; Bam, Kiran; Banach, Maciej; Bandyopadhyay, Soham; Banik, Biswajit; Banik, Palash Chandra; Bansal, Hansi; Barati, Shirin; Barchitta, Martina; Bardhan, Mainak; Barker-Collo, Suzanne Lyn; Barone-Adesi, Francesco; Barqawi, Hiba Jawdat; Barr, Ronald D; Barrero, Lope H; Basharat, Zarrin; Bashir, Asma'u I J; Bashiru, Hameed Akande; Baskaran, Pritish; Basnyat, Buddha; Bassat, Quique; Basso, João Diogo; Basu, Saurav; Batra, Kavita; Batra, Ravi; Baune, Bernhard T; Bayati, Mohsen; Bayileyegn, Nebiyou Simegnew; Beaney, Thomas; Bedi, Neeraj; Begum, Tahmina; Behboudi, Emad; Behnoush, Amir Hossein; Beiranvand, Maryam; Bejarano Ramirez, Diana Fernanda; Belgaumi, Uzma Iqbal; Bell, Michelle L; Bello, Aminu K; Bello, Muhammad Bashir; Bello, Olorunjuwon Omolaja; Belo, Luis; Beloukas, Apostolos; Bendak, Salaheddine; Bennett, Derrick A; Bensenor, Isabela M; Benzian, Habib; Berezvai, Zombor; Berman, Adam E; Bermudez, Amiel Nazer C; Bettencourt, Paulo J G; Beyene, Habtamu B; Beyene, Kebede A; Bhagat, Devidas S; Bhagavathula, Akshaya Srikanth; Bhala, Neeraj; Bhalla, Ashish; Bhandari, Dinesh; Bhardwaj, Nikha; Bhardwaj, Pankaj; Bhardwaj, Prarthna V; Bhargava, Ashish; Bhaskar, Sonu; Bhat, Vivek; Bhatti, Gurjit Kaur; Bhatti, Jasvinder Singh; Bhatti, Manpreet S; Bhatti, Rajbir; Bhutta, Zulfiqar A; Bikbov, Boris; Binmadi, Nada; Bintoro, Bagas Suryo; Biondi, Antonio; Bisignano, Catherine; Bisulli, Francesca; Biswas, Atanu; Biswas, Raaj Kishore; Bitaraf, Saeid; Bjørge, Tone; Bleyer, Archie; Boampong, Mary Sefa; Bodolica, Virginia; Bodunrin, Aadam Olalekan; Bolarinwa, Obasanjo Afolabi; Bonakdar Hashemi, Milad; Bonny, Aime; Bora, Kaustubh; Bora Basara, Berrak; Borodo, Safiya Bala; Borschmann, Rohan; Botero Carvajal, Alejandro; Bouaoud, Souad; Boudalia, Sofiane; Boyko, Edward J; Bragazzi, Nicola Luigi; Braithwaite, Dejana; Brenner, Hermann; Britton, Gabrielle; Browne, Annie J; Brunoni, Andre R; Bulamu, Norma B; Bulto, Lemma N; Buonsenso, Danilo; Burkart, Katrin; Burns, Richard A; Burugina Nagaraja, Sharath; Busse, Reinhard; Bustanji, Yasser; Butt, Zahid A; Caetano dos Santos, Florentino Luciano; Cai, Tianji; Calina, Daniela; Cámera, Luis Alberto; Campos, Luciana Aparecida; Campos-Nonato, Ismael R; Cao, Chao; Cardenas, Carlos Alberto; Cárdenas, Rosario; Carr, Sinclair; Carreras, Giulia; Carrero, Juan J; Carugno, Andrea; Carvalho, Felix; Carvalho, Márcia; Castaldelli-Maia, Joao Mauricio; Castañeda-Orjuela, Carlos A; Castelpietra, Giulio; Catalá-López, Ferrán; Catapano, Alberico L; Cattaruzza, Maria Sofia; Caye, Arthur; Cederroth, Christopher R; Cembranel, Francieli; Cenderadewi, Muthia; Cercy, Kelly M; Cerin, Ester; Cevik, Muge; Chacón-Uscamaita, Pamela R Uscamaita; Chahine, Yaacoub; Chakraborty, Chiranjib; Chan, Jeffrey Shi Kai; Chang, Chin-Kuo; Charalampous, Periklis; Charan, Jaykaran; Chattu, Vijay Kumar; Chatzimavridou-Grigoriadou, Victoria; Chavula, Malizgani Paul; Cheema, Huzaifa Ahmad; Chen, An-Tian; Chen, Haowei; Chen, Lingxiao; Chen, Meng Xuan; Chen, Simiao; Cherbuin, Nicolas; Chew, Derek S; Chi, Gerald; Chirinos-Caceres, Jesus Lorenzo; Chitheer, Abdulaal; Cho, So Mi Jemma; Cho, William C S; Chong, Bryan; Chopra, Hitesh; Choudhary, Rahul; Chowdhury, Rajiv; Chu, Dinh-Toi; Chukwu, Isaac Sunday; Chung, Eric; Chung, Eunice; Chung, Sheng-Chia; Cini, Karly I; Clark, Cain C T; Coberly, Kaleb; Columbus, Alyssa; Comfort, Haley; Conde, Joao; Conti, Sara; Cortesi, Paolo Angelo; Costa, Vera Marisa; Cousin, Ewerton; Cowden, Richard G; Criqui, Michael H; Cruz-Martins, Natália; Culbreth, Garland T; Cullen, Patricia; Cunningham, Matthew; da Silva e Silva, Daniel; Dadana, Sriharsha; Dadras, Omid; Dai, Zhaoli; Dalal, Koustuv; Dalli, Lachlan L; Damiani, Giovanni; D'Amico, Emanuele; Daneshvar, Sara; Darwesh, Aso Mohammad; Das, Jai K; Das, Saswati; Dash, Nihar Ranjan; Dashti, Mohsen; Dávila-Cervantes, Claudio Alberto; Davis Weaver, Nicole; Davletov, Kairat; De Leo, Diego; Debele, Aklilu Tamire; Degenhardt, Louisa; Dehbandi, Reza; Deitesfeld, Lee; Delgado-Enciso, Ivan; Delgado-Ortiz, Laura; Demant, Daniel; Demessa, Berecha Hundessa; Demetriades, Andreas K; Deng, Xinlei; Denova-Gutiérrez, Edgar; Deribe, Kebede; Dervenis, Nikolaos; Des Jarlais, Don C; Desai, Hardik Dineshbhai; Desai, Rupak; Deuba, Keshab; Devanbu, Vinoth Gnana Chellaiyan; Dey, Sourav; Dhali, Arkadeep; Dhama, Kuldeep; Dhimal, Mandira Lamichhane; Dhimal, Meghnath; Dhingra, Sameer; Dias da Silva, Diana; Diaz, Daniel; Dima, Adriana; Ding, Delaney D; Dirac, M Ashworth; Dixit, Abhinav; Dixit, Shilpi Gupta; Do, Thanh Chi; Do, Thao Huynh Phuong; do Prado, Camila Bruneli; Dodangeh, Masoud; Dokova, Klara Georgieva; Dolecek, Christiane; Dorsey, E Ray; dos Santos, Wendel Mombaque; Doshi, Rajkumar; Doshmangir, Leila; Douiri, Abdel; Dowou, Robert Kokou; Driscoll, Tim Robert; Dsouza, Haneil Larson; Dube, John; Dumith, Samuel C; Dunachie, Susanna J; Duncan, Bruce B; Duraes, Andre Rodrigues; Duraisamy, Senbagam; Durojaiye, Oyewole Christopher; Dutta, Sulagna; Dzianach, Paulina Agnieszka; Dziedzic, Arkadiusz Marian; Ebenezer, Oluwakemi; Eboreime, Ejemai; Ebrahimi, Alireza; Echieh, Chidiebere Peter; Ed-Dra, Abdelaziz; Edinur, Hisham Atan; Edvardsson, David; Edvardsson, Kristina; Efendi, Defi; Efendi, Ferry; Eghdami, Shayan; Eikemo, Terje Andreas; Eini, Ebrahim; Ekholuenetale, Michael; Ekpor, Emmanuel; Ekundayo, Temitope Cyrus; El Arab, Rabie Adel; El Morsi, Doaa Abdel Wahab; El Sayed Zaki, Maysaa; El Tantawi, Maha; Elbarazi, Iffat; Elemam, Noha Mousaad; Elgar, Frank J; Elgendy, Islam Y; ElGohary, Ghada Metwally Tawfik; Elhabashy, Hala Rashad; Elhadi, Muhammed; Elmeligy, Omar Abdelsadek Abdou; Elshaer, Mohammed; Elsohaby, Ibrahim; Emami Zeydi, Amir; Emamverdi, Mehdi; Emeto, Theophilus I; Engelbert Bain, Luchuo; Erkhembayar, Ryenchindorj; Eshetie, Tesfahun C; Eskandarieh, Sharareh; Espinosa-Montero, Juan; Estep, Kara; Etaee, Farshid; Eze, Ugochukwu Anthony; Fabin, Natalia; Fadaka, Adewale Oluwaseun; Fagbamigbe, Adeniyi Francis; Fahimi, Saman; Falzone, Luca; Farinha, Carla Sofia e Sá; Faris, MoezAlIslam Ezzat Mahmoud; Farjoud Kouhanjani, Mohsen; Faro, Andre; Farrokhpour, Hossein; Fatehizadeh, Ali; Fattahi, Hamed; Fauk, Nelsensius Klau; Fazeli, Pooria; Feigin, Valery L; Fekadu, Ginenus; Fereshtehnejad, Seyed-Mohammad; Feroze, Abdullah Hamid; Ferrante, Daniela; Ferrara, Pietro; Ferreira, Nuno; Fetensa, Getahun; Filip, Irina; Fischer, Florian; Flavel, Joanne; Flaxman, Abraham D; Flor, Luisa S; Florin, Bobirca Teodor; Folayan, Morenike Oluwatoyin; Foley, Kristen Marie; Fomenkov, Artem Alekseevich; Force, Lisa M; Fornari, Carla; Foroutan, Behzad; Foschi, Matteo; Francis, Kate Louise; Franklin, Richard Charles; Freitas, Alberto; Friedman, Joseph; Friedman, Sara D; Fukumoto, Takeshi; Fuller, John E; Gaal, Peter Andras; Gadanya, Muktar A; Gaihre, Santosh; Gaipov, Abduzhappar; Gakidou, Emmanuela; Galali, Yaseen; Galehdar, Nasrin; Gallus, Silvano; Gan, Quan; Gandhi, Aravind P; Ganesan, Balasankar; Garg, Jalaj; Gau, Shuo-Yan; Gautam, Prem; Gautam, Rupesh K; Gazzelloni, Federica; Gebregergis, Miglas W; Gebrehiwot, Mesfin; Gebremariam, Tesfay Brhane; Gerema, Urge; Getachew, Motuma Erena; Getachew, Tamirat; Gething, Peter W; Ghafourifard, Mansour; Ghahramani, Sulmaz; Ghailan, Khalid Yaser; Ghajar, Alireza; Ghanbarnia, Mohammad Javad; Ghasemi, MohammadReza; Ghasemzadeh, Afsaneh; Ghassemi, Fariba; Ghazy, Ramy Mohamed; Ghimire, Sailaja; Gholamian, Asadollah; Gholamrezanezhad, Ali; Ghorbani Vajargah, Pooyan; Ghozali, Ghozali; Ghozy, Sherief; Ghuge, Arun Digambarrao; Gialluisi, Alessandro; Gibson, Ruth Margaret; Gil, Artyom Urievich; Gill, Paramjit Singh; Gill, Tiffany K; Gillum, Richard F; Ginindza, Themba G; Girmay, Alem; Glasbey, James C; Gnedovskaya, Elena V; Göbölös, Laszlo; Goel, Amit; Goldust, Mohamad; Golechha, Mahaveer; Goleij, Pouya; Golestanfar, Arefeh; Golinelli, Davide; Gona, Philimon N; Goudarzi, Houman; Goudarzian, Amir Hossein; Goyal, Anmol; Greenhalgh, Scott; Grivna, Michal; Guarducci, Giovanni; Gubari, Mohammed Ibrahim Mohialdeen; Gudeta, Mesay Dechasa; Guha, Avirup; Guicciardi, Stefano; Gunawardane, Damitha Asanga; Gunturu, Sasidhar; Guo, Cui; Gupta, Anish Kumar; Gupta, Bhawna; Gupta, Indarchand Ratanlal; Gupta, Rajat Das; Gupta, Sapna; Gupta, Veer Bala; Gupta, Vijai Kumar; Gupta, Vivek Kumar; Gutiérrez, Reyna Alma; Habibzadeh, Farrokh; Habibzadeh, Parham; Hachinski, Vladimir; Haddadi, Mohammad; Haddadi, Rasool; Haep, Nils; Hajj Ali, Adel; Halboub, Esam S; Halim, Sobia Ahsan; Hall, Brian J; Haller, Sebastian; Halwani, Rabih; Hamadeh, Randah R; Hamagharib Abdullah, Kanaan; Hamidi, Samer; Hamiduzzaman, Mohammad; Hammoud, Ahmad; Hanifi, Nasrin; Hankey, Graeme J; Hannan, Md Abdul; Haque, Md Nuruzzaman; Harapan, Harapan; Haro, Josep Maria; Hasaballah, Ahmed I; Hasan, Faizul; Hasan, Ikramul; Hasan, M Tasdik; Hasani, Hamidreza; Hasanian, Mohammad; Hasanpour- Dehkordi, Ali; Hassan, Abbas M; Hassan, Amr; Hassanian-Moghaddam, Hossein; Hassanipour, Soheil; Haubold, Johannes; Havmoeller, Rasmus J; Hay, Simon I; Hbid, Youssef; Hebert, Jeffrey J; Hegazi, Omar E; Heidari, Golnaz; Heidari, Mohammad; Heidari-Foroozan, Mahsa; Heidari-Soureshjani, Reza; Helfer, Bartosz; Herteliu, Claudiu; Hesami, Hamed; Hettiarachchi, Dineshani; Heyi, Demisu Zenbaba; Hezam, Kamal; Hiraike, Yuta; Hoffman, Howard J; Holla, Ramesh; Horita, Nobuyuki; Hossain, Md Belal; Hossain, Md Mahbub; Hossain, Sahadat; Hosseini, Mohammad-Salar; Hosseinzadeh, Hassan; Hosseinzadeh, Mehdi; Hostiuc, Mihaela; Hostiuc, Sorin; Hsairi, Mohamed; Hsieh, Vivian Chia-rong; Hu, Chengxi; Huang, Junjie; Huda, Md Nazmul; Hugo, Fernando N; Hultström, Michael; Hussain, Javid; Hussain, Salman; Hussein, Nawfal R; Huy, Le Duc; Huynh, Hong-Han; Hwang, Bing-Fang; Ibitoye, Segun Emmanuel; Idowu, Oluwatope Olaniyi; Ijo, Desta; Ikuta, Kevin S; Ilaghi, Mehran; Ilesanmi, Olayinka Stephen; Ilic, Irena M; Ilic, Milena D; Immurana, Mustapha; Inbaraj, Leeberk Raja; Iradukunda, Arnaud; Iravanpour, Farideh; Iregbu, Kenneth Chukwuemeka; Islam, Md Rabiul; Islam, Mohammad Mainul; Islam, Sheikh Mohammed Shariful; Islami, Farhad; Ismail, Nahlah Elkudssiah; Isola, Gaetano; Iwagami, Masao; Iwu, Chidozie C D; Iwu-Jaja, Chinwe Juliana; Iyer, Mahalaxmi; J, Linda Merin; Jaafari, Jalil; Jacob, Louis; Jacobsen, Kathryn H; Jadidi-Niaragh, Farhad; Jafarinia, Morteza; Jaggi, Khushleen; Jahankhani, Kasra; Jahanmehr, Nader; Jahrami, Haitham; Jain, Akhil; Jain, Nityanand; Jairoun, Ammar Abdulrahman; Jakovljevic, Mihajlo; Jalilzadeh Yengejeh, Reza; Jamshidi, Elham; Jani, Chinmay T; Janko, Mark M; Jatau, Abubakar Ibrahim; Jayapal, Sathish Kumar; Jayaram, Shubha; Jeganathan, Jayakumar; Jema, Alelign Tasew; Jemere, Digisie Mequanint; Jeong, Wonjeong; Jha, Anil K; Jha, Ravi Prakash; Ji, John S; Jiang, Heng; Jin, Yingzhao; Jin, Yinzi; Johnson, Olatunji; Jomehzadeh, Nabi; Jones, Darwin Phan; Joo, Tamas; Joseph, Abel; Joseph, Nitin; Joshua, Charity Ehimwenma; Jozwiak, Jacek Jerzy; Jürisson, Mikk; Kaambwa, Billingsley; Kabir, Ali; Kabir, Hannaneh; Kabir, Zubair; Kadashetti, Vidya; Kahe, Farima; Kakodkar, Pradnya Vishal; Kalani, Rizwan; Kalankesh, Leila R; Kaliyadan, Feroze; Kalra, Sanjay; Kamath, Ashwin; Kamireddy, Arun; Kanagasabai, Thanigaivelan; Kandel, Himal; Kanmiki, Edmund Wedam; Kanmodi, Kehinde Kazeem; Kantar, Rami S; Kapoor, Neeti; Karajizadeh, Mehrdad; Karami Matin, Behzad; Karanth, Shama D; Karaye, Ibraheem M; Karim, Asima; Karimi, Hanie; Karimi, Salah Eddin; Karimi Behnagh, Arman; Karkhah, Samad; Karna, Ajit K; Kashoo, Faizan Zaffar; Kasraei, Hengameh; Kassaw, Nigussie Assefa; Kassebaum, Nicholas J; Kassel, Molly B; Katamreddy, Adarsh; Katikireddi, Srinivasa Vittal; Katoto, Patrick DMC; Kauppila, Joonas H; Kaur, Navjot; Kaydi, Neda; Kayibanda, Jeanne Françoise; Kayode, Gbenga A; Kazemi, Foad; Kazemian, Sina; Kazeminia, sara; Keikavoosi-Arani, Leila; Keller, Cathleen; Kempen, John H; Kerr, Jessica A; Kesse-Guyot, Emmanuelle; Keykhaei, Mohammad; Khadembashiri, Mohamad Mehdi; Khadembashiri, Mohammad Amin; Khafaie, Morteza Abdullatif; Khajuria, Himanshu; Khalafi, Mohammad; Khalaji, Amirmohammad; Khalid, Nauman; Khalil, Ibrahim A; Khamesipour, Faham; Khan, Asaduzzaman; Khan, Gulfaraz; Khan, Ikramullah; Khan, Imteyaz A; Khan, Maseer; Khan, Moien AB; Khan, Taimoor; Khan suheb, Mahammed Ziauddin; Khanmohammadi, Shaghayegh; Khatab, Khaled; Khatami, Fatemeh; Khavandegar, Armin; Khayat Kashani, Hamid Reza; Kheirallah, Khalid A; Khidri, Feriha Fatima; Khodadoust, Elaheh; Khormali, Moein; Khosrowjerdi, Mahmood; Khubchandani, Jagdish; Khusun, Helda; Kifle, Zemene Demelash; Kim, Grace; Kim, Jihee; Kimokoti, Ruth W; Kinzel, Kasey E; Kiross, Girmay Tsegay; Kisa, Adnan; Kisa, Sezer; Kiss, Juniper Boroka; Kivimäki, Mika; Klu, Desmond; Knudsen, Ann Kristin Skrindo; Kolahi, Ali-Asghar; Kompani, Farzad; Koren, Gerbrand; Kosen, Soewarta; Kostev, Karel; Kotnis, Ashwin Laxmikant; Koul, Parvaiz A; Koulmane Laxminarayana, Sindhura Lakshmi; Koyanagi, Ai; Kravchenko, Michael A; Krishan, Kewal; Krishna, Hare; Krishnamoorthy, Vijay; Krishnamoorthy, Yuvaraj; Krohn, Kris J; Kuate Defo, Barthelemy; Kubeisy, Connor M; Kucuk Bicer, Burcu; Kuddus, Md Abdul; Kuddus, Mohammed; Kuitunen, Ilari; Kujan, Omar; Kulimbet, Mukhtar; Kulkarni, Vishnutheertha; Kumar, Ashish; Kumar, Harish; Kumar, Nithin; Kumar, Rahul; Kumar, Shiv; Kumari, Madhulata; Kurmanova, Almagul; Kurmi, Om P; Kusnali, Asep; Kusuma, Dian; Kutluk, Tezer; Kuttikkattu, Ambily; Kyei, Evans F; Kyriopoulos, Ilias; La Vecchia, Carlo; Ladan, Muhammad Awwal; Laflamme, Lucie; Lahariya, Chandrakant; Lahmar, Abdelilah; Lai, Daphne Teck Ching; Laksono, Tri; Lal, Dharmesh Kumar; Lalloo, Ratilal; Lallukka, Tea; Lám, Judit; Lamnisos, Demetris; Lan, Tuo; Lanfranchi, Francesco; Langguth, Berthold; Lansingh, Van Charles; Laplante-Lévesque, Ariane; Larijani, Bagher; Larsson, Anders O; 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Mueller, Ulrich Otto; Mughal, Faraz; Mukherjee, Sumoni; Mukoro, George Duke; Mulita, Admir; Mulita, Francesk; Muniyandi, Malaisamy; Munjal, Kavita; Musaigwa, Fungai; Musallam, Khaled M; Mustafa, Ghulam; Muthu, Sathish; Muthupandian, Saravanan; Myung, Woojae; Nabhan, Ashraf F; Nafukho, Fredrick Muyia; Nagarajan, Ahamarshan Jayaraman; Naghavi, Mohsen; Naghavi, Pirouz; Naik, Ganesh R; Naik, Gurudatta; Naimzada, Mukhammad David; Nair, Sanjeev; Nair, Tapas Sadasivan; Najmuldeen, Hastyar Hama Rashid; Naldi, Luigi; Nangia, Vinay; Nargus, Shumaila; Nascimento, Bruno Ramos; Nascimento, Gustavo G; Naser, Abdallah Y; Nasiri, Mohammad Javad; Natto, Zuhair S; Nauman, Javaid; Naveed, Muhammad; Nayak, Biswa Prakash; Nayak, Vinod C; Nayyar, Ashish Kumar; Nazri-Panjaki, Athare; Negash, Hadush; Negero, Amayu Kumesa; Negoi, Ionut; Negoi, Ruxandra Irina; Negru, Serban Mircea; Nejadghaderi, Seyed Aria; Nejjari, Chakib; Nematollahi, Mohammad Hadi; Nena, Evangelia; Nepal, Samata; Nesbit, Olivia D; Newton, Charles Richard James; 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