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Hudson, Lawrence N. ; Newbold, Tim ; Contu, Sara ; Hill, Samantha L. L. ; Lysenko, Igor ; Palma, Adriana de ; Phillips, Helen R. P. ; Senior, Rebecca A. ; Bennett, Dominic J. ; Booth, Hollie ; Choimes, Argyrios ; Correia, David L. P. ; Day, Julie ; Echeverria-Londono, Susy ; Garon, Morgan ; Harrison, Michelle L. K. ; Ingram, Daniel J. ; Jung, Martin ; Kemp, Victoria ; Kirkpatrick, Lucinda ; Martin, Callum D. ; Pan, Yuan ; White, Hannah J. ; Aben, Job ; Abrahamczyk, Stefan ; Adum, Gilbert B. ; Aguilar-Barquero, Virginia ; Aizen, Marcelo ; Ancrenaz, Marc ; Arbelaez-Cortes, Enrique ; Armbrecht, Inge ; Azhar, Badrul ; Azpiroz, Adrián B. ; Baeten, Lander ; Báldi, András ; Banks, John E. ; Barlow, Jos ; Batáry, Péter ; Bates, Adam J. ; Bayne, Erin M. ; Beja, Pedro ; Berg, Åke ; Berry, Nicholas J. ; Bicknell, Jake E. ; Bihn, Jochen H. ; Böhning-Gaese, Katrin ; Boekhout, Teun ; Boutin, Celine ; Bouyer, Jeremy ; Brearley, Francis Q. ; Brito, Isabel ; Brunet, Jörg ; Buczkowski, Grzegorz ; Buscardo, Erika ; Cabra-Garcia, Jimmy ; Calvino-Cancela, Maria ; Cameron, Sydney A. ; Cancello, Eliana M. ; Carrijo, Tiago F. ; Carvalho, Anelena L. ; Castro, Helena ; Castro-Luna, Alejandro Antonio ; Cerda, Rolando ; Cerezo, Alexis ; Chauvat, Matthieu ; Clarke, Frank M. ; Cleary, Daniel F. R. ; Connop, Stuart P. ; D'Aniello, Biagio ; Silva, Pedro Giovani da ; Darvill, Ben ; Dauber, Jens ; Dejean, Alain ; Diekötter, Tim ; Dominguez-Haydar, Yamileth ; Dormann, Carsten F. ; Dumont, Bertrand ; Dures, Simon G. ; Dynesius, Mats ; Edenius, Lars ; Elek, Zoltan ; Entling, Martin H. ; Farwig, Nina ; Fayle, Tom M. ; Felicioli, Antonio ; Felton, Annika M. ; Ficetola, Gentile Francesco ; Filgueiras, Bruno K. C. ; Fonte, Steve J. ; Fraser, Lauchlan H. ; Fukuda, Daisuke ; Furlani, Dario ; Ganzhorn, Jörg U. ; Garden, Jenni G. ; Gheler-Costa, Carla ; Giordani, Paolo ; Giordano, Simonetta ; Gottschalk, Marco S. ; Goulson, Dave ; Gove, Aaron D. ; Grogan, James ; Hanley, Mick E. ; Hanson, Thor ; Hashim, Nor R. ; Hawes, Joseph E. ; Hébert, Christian ; Helden, Alvin J. ; Henden, John-André ; Hernández, Lionel ; Herzog, Felix ; Higuera-Diaz, Diego ; Hilje, Branko ; Horgan, Finbarr G. ; Horvath, Roland ; Hylander, Kristoffer ; Horvath, Roland ; Isaacs-Cubides, Paola ; Ishitani, Mashiro ; Jacobs, Carmen T. ; Jaramillo, Victor J. ; Jauker, Birgit ; Jonsell, Matts ; Jung, Thomas S. ; Kapoor, Vena ; Kati, Vassiliki ; Katovai, Eric ; Kessler, Michael ; Knop, Eva ; Kolb, Annette ; Körösi, Àdám ; Lachat, Thibault ; Lantschner, Victoria ; Le Féon, Violette ; LeBuhn, Gretchen ; Légaré, Jean-Philippe ; Letcher, Susan G. ; Littlewood, Nick A. ; López-Quintero, Carlos A. ; Louhaichi, Mounir ; Lövei, Gabor L. ; Lucas-Borja, Manuel Esteban ; Luja, Victor H. ; Maeto, Kaoru ; Magura, Tibor ; Mallari, Neil Aldrin D. ; Marin-Spiotta, Erika ; Marshall, Edward Jon P. ; Martínez, Eliana ; Mayfield, Margaret M. ; Mikusinski, Gregorz ; Milder, Jeffery C. ; Miller, James R. ; Morales, Carolina L. ; Muriithi-Muchane, Mary Nyawira ; Muchane, Muchai ; Naidoo, Robin ; Nakamura, Akihiro ; Naoe, Shoji ; Nates-Parra, Guiomar ; Navarerete Gutierrez, Dario A. ; Neuschulz, Eike Lena ; Noreika, Norbertas ; Norfolk, Olivia ; Noriega, Jorge Ari ; Nöske, Nicole M. ; O'Dea, Niall ; Oduro, William ; Ofori-Boateng, Caleb ; Oke, Chris O. ; Osgathorpe, Lynne M. ; Paritsis, Juan ; Parrah, Alejandro ; Pelegrin, Nicolás ; Peres, Carlos A. ; Persson, Anna S. ; Petanidou, Theodora ; Phalan, Ben ; Philips, T. Keith ; Poveda, Katja ; Power, Eileen F. ; Presley, Steven J. ; Proença, Vânia ; Quaranta, Marino ; Quintero, Carolina ; Redpath-Downing, Nicola A. ; Reid, J. Leighton ; Reis, Yana T. ; Ribeiro, Danilo B. ; Richardson, Barbara A. ; Richardson, Michael J. ; Robles, Carolina A. ; Römbke, Jörg ; Romero-Duque, Luz Piedad ; Rosselli, Loreta ; Rossiter, Stephen J. ; Roulston, T'ai H. ; Rousseau, Laurent ; Sadler, Jonathan P. ; Sáfián, Szbolcs ; Saldaña-Vásquez, Romeo A. ; Samnegård, Ulrika ; Schüepp, Christof ; Schweiger, Oliver ; Sedlock, Jodi L. ; Shahabuddin, Ghazala ; Sheil, Douglas ; Silva, Fernando A. B. ; Slade, Eleanor ; Smith-Pardo, Allan H. ; Sodhi, Navjot S. ; Somarriba, Eduardo J. ; Sosa, Ramón A. ; Stout, Jane C. ; Struebig, Matthew J. ; Sung, Yik-Hei ; Threlfall, Caragh G. ; Tonietto, Rebecca ; Tóthmérész, Béla ; Tscharntke, Teja ; Turner, Edgar C. ; Tylianakis, Jason M. ; Vanbergen, Adam J. ; Vassilev, Kiril ; Verboven, Hans A. F. ; Vergara, Carlos H. ; Vergara, Pablo M. ; Verhulst, Jort ; Walker, Tony R. ; Wang, Yanping ; Watling, James I. ; Wells, Konstans ; Williams, Christopher D. ; Willig, Michael R. ; Woinarski, John Casimir Zichy ; Wolf, Jan H. D. ; Woodcock, Ben A. ; Yu, Douglas W. ; Zailsev, Andreys ; Collen, Ben ; Ewers, Rob M. ; Mace, Georgina M. ; Purves, Drew W. ; Scharlemann, Jörn P. W. ; Pervis, Andy
Biodiversity continues to decline in the face of increasing anthropogenic pressures such as habitat destruction, exploitation, pollution and introduction of alien species. Existing global databases of species’ threat status or population time series are dominated by charismatic species. The collation of datasets with broad taxonomic and biogeographic extents, and that support computation of a range of biodiversity indicators, is necessary to enable better understanding of historical declines and to project – and avert – future declines. We describe and assess a new database of more than 1.6 million samples from 78 countries representing over 28,000 species, collated from existing spatial comparisons of local-scale biodiversity exposed to different intensities and types of anthropogenic pressures, from terrestrial sites around the world. The database contains measurements taken in 208 (of 814) ecoregions, 13 (of 14) biomes, 25 (of 35) biodiversity hotspots and 16 (of 17) megadiverse countries. The database contains more than 1% of the total number of all species described, and more than 1% of the described species within many taxonomic groups – including flowering plants, gymnosperms, birds, mammals, reptiles, amphibians, beetles, lepidopterans and hymenopterans. The dataset, which is still being added to, is therefore already considerably larger and more representative than those used by previous quantitative models of biodiversity trends and responses. The database is being assembled as part of the PREDICTS project (Projecting Responses of Ecological Diversity In Changing Terrestrial Systems – www.predicts.org.uk). We make site-level summary data available alongside this article. The full database will be publicly available in 2015.
Adams, Joseph R. ; Aggarwal, Madan Mohan ; Ahammed, Zubayer ; Amonett, J. ; Anderson, B.D. ; Arkhipkin, D. ; Averichev, Georgy S. ; Badyal, S.K. ; Bai, Yu ; Balewski, J. ; Barannikova, O. ; Barnby, L.S. ; Baudot, J. ; Bekele, S. ; Belaga, V.V. ; Bellingeri-Laurikainen, A. ; Bellwied, Rene ; Berger, J. ; Bezverkhny, B.I. ; Bharadwaj, S. ; Bhasin, A. ; Bhati, A.K. ; Bhatia, V.S. ; Bichsel, H. ; Bielcik, J. ; Bielcikova, Jana ; Billmeier, A. ; Bland, L.C. ; Blyth, C.O. ; Blyth, S.-L. ; Bonner, B.E. ; Botje, M. ; Boucham, A. ; Bouchet, J. ; Brandin, A.V. ; Bravar, A. ; Bystersky, M. ; Cadman, R.V. ; Cai, X.Z. ; Caines, Helen Louise ; Calderón de la Barca Sánchez, Manuel ; Castillo Castellanos, Javier Ernesto ; Catu, O. ; Cebra, D. ; Chajecki, Z. ; Chaloupka, Petr ; Chattopadhyay, S. ; Chen, H.F. ; Chen, J.H. ; Chen, Y. ; Cheng, J. ; Cherney, M. ; Chikanian, A. ; Choi, H.A. ; Christie, William ; Coffin, J.P. ; Cormier, T.M. ; Cosentino, M.R. ; Cramer, J.G. ; Crawford, Henry J. ; Das, D. ; Das, S. ; Daugherity, M. ; de Moura, M.M. ; Dedovich, T.G. ; DePhillips, M. ; Derevschikov, A.A. ; Didenko, L. ; Dietel, Thomas ; Dogra, S.M. ; Dong, W.J. ; Dong, X. ; Draper, J.E. ; Du, F. ; Dubey, A.K. ; Dunin, V.B. ; Dunlop, James C. ; Dutta Mazumdar, M.R. ; Eckardt, V. ; Edwards, W.R. ; Efimov, L.G. ; Emelianov, V. ; Engelage, Jon M. ; Eppley, Geary Wareham ; Erazmus, B. ; Estienne, M. ; Fachini, P. ; Faivre, J. ; Fatemi, Renee H. ; Fedorisin, J. ; Filimonov, K. ; Filip, P. ; Finch, Evan ; Fine, V. ; Fisyak, Yuri V. ; Fornazier, K.S.F. ; Fu, J. ; Gagliardi, Carl A. ; Gaillard, L. ; Gans, J. ; Ganti, M.S. ; Geurts, Frank ; Ghazikhanian, V. ; Ghosh, P. ; Gonzalez, Johan Enmanuel ; Gos, H. ; Grachov, O. ; Grebenyuk, O. ; Grosnick, David P. ; Guertin, S.M. ; Guo, Y. ; Gupta, Anik ; Gupta, N. ; Gutierrez, T.D. ; Hallman, T.J. ; Hamed, Ahmed M. ; Hardtke, D. ; Harris, John W. ; Heinz, M. ; Henry, T.W. ; Hepplemann, S. ; Hippolyte, Boris ; Hirsch, A. ; Hjort, E. ; Hoffmann, Gerald W. ; Horner, M.J. ; Huang, H.Z. ; Huang, S.L. ; Hughes, E.W. ; Humanic, Thomas J. ; Igo, G. ; Ishihara, A. ; Jacobs, P. ; Jacobs, W.W. ; Jedynak, M. ; Jiang, H. ; Jones, Peter Graham ; Judd, Eleanor G. ; Kabana, Sonia ; Kang, K. ; Kaplan, M. ; Keane, Declan ; Kechechyan, A. ; Khodyrev, V.Yu. ; Kim, B.C. ; Kiryluk, J. ; Kisiel, A. ; Kislov, E.M. ; Klay, J. ; Klein, S.R. ; Koetke, D.D. ; Kollegger, Thorsten ; Kopytine, M. ; Kotchenda, L. ; Kowalik, K.L. ; Kramer, M. ; Kravtsov, P. ; Kravtsov, V.I. ; Krueger, Keith William ; Kuhn, C. ; Kulikov, A.I. ; Kumar, A. ; Kutuev, R.Kh. ; Kuznetsov, A.A. ; Lamont, Matthew A. C. ; Landgraf, J.M. ; Lange, S. ; Laue, F. ; Lauret, Jerome ; Lebedev, A. ; Lednicky, R. ; Lee, C.-H. ; Lehocka, S. ; LeVine, M.J. ; Li, C. ; Li, Q. ; Li, Y. ; Lin, G. ; Lindenbaum, S.J. ; Lisa, Michael A. ; Liu, F. ; Liu, H. ; Liu, J. ; Liu, L. ; Liu, Q.J. ; Liu, Z. ; Ljubicic, Tonko A. ; Llope, W.J. ; Long, H. ; Longacre, Ronald S. ; Lopez-Noriega, M. ; Love, W.A. ; Lu, Y. ; Ludlam, Thomas ; Lynn, D. ; Ma, G.L. ; Ma, J.G. ; Ma, Y.G. ; Magestro, D. ; Mahajan, Sanjay ; Mahapatra, Durga Prasad ; Majka, R. ; Mangotra, L.K. ; Manweiler, R. ; Margetis, Spyridon ; Markert, Christina ; Martin, L. ; Marx, J.N. ; Matis, Howard S. ; Matulenko, Yu.A. ; McClain, C.J. ; McShane, T.S. ; Meissner, F. ; Melnick, Yu. ; Meschanin, A. ; Miller, M.L. ; Minaev, N.G. ; Mironov, C. ; Mischke, A. ; Mishra, D.K. ; Mitchell, J. ; Mohanty, Bedangadas ; Molnar, L. ; Moore, C.F. ; Morozov, D.A. ; Munhoz, M.G. ; Nandi, B.K. ; Nayak, S.K. ; Nayak, T.K. ; Nelson, J.M. ; Netrakanti, P.K. ; Nikitin, V.A. ; Nogach, L.V. ; Nurushev, S.B. ; Odyniec, G. ; Ogawa, A. ; Okorokov, Vitaly A. ; Oldenburg, M. ; Olson, D. ; Pal, S.K. ; Panebratsev, Y. ; Panitkin, S.Y. ; Pavlinov, A.I. ; Pawlak, T. ; Peitzmann, T. ; Perevoztchikov, V. ; Perkins, C. ; Peryt, W. ; Petrov, V.A. ; Phatak, S.C. ; Picha, R. ; Planinic, M. ; Pluta, J. ; Porile, N. ; Porter, J. ; Poskanzer, A.M. ; Potekhin, M. ; Potrebenikova, E. ; Potukuchi, B.V.K.S. ; Prindle, D. ; Pruneau, C. ; Putschke, Jörn H. ; Rakness, G. ; Raniwala, R. ; Raniwala, S. ; Ravel, O. ; Ray, Robert L. ; Razin, S.V. ; Reichhold, D. ; Reid, Jeffrey G. ; Reinnarth, J. ; Renault, G. ; Retiere, F. ; Ridiger, A. ; Ritter, H.G. ; Roberts, J.B. ; Rogachevskiy, O.V. ; Romero, J.L. ; Rose, A. ; Roy, C. ; Ruan, L. ; Russcher, M.J. ; Sahoo, R. ; Sakrejda, I. ; Salur, Sevil ; Sandweiss, J. ; Sarsour, M. ; Savin, I. ; Sazhin, P.S. ; Schambach, Joachim ; Scharenberg, R.P. ; Schmitz, Norbert ; Schweda, Kai ; Seger, J. ; Seyboth, P. ; Shahaliev, E. ; Shao, M. ; Shao, W. ; Sharma, M. ; Shen, W.Q. ; Shestermanov, K.E. ; Shimanskiy, S.S. ; Sichtermann, E. ; Simon, F. ; Singaraju, R.N. ; Smirnov, Nikolai ; Snellings, Raimond ; Sood, G. ; Sorensen, P. ; Sowinski, J. ; Speltz, J. ; Spinka, Harold. M. ; Srivastava, B. ; Stadnik, A. ; Stanislaus, T.D.S. ; Stock, Reinhard ; Stolpovsky, A. ; Strikhanov, M. ; Stringfellow, B. ; Suaide, Alexandre Alarcon do Passo ; Sugarbaker, E. ; Šumbera, Michal ; Surrow, Bernd ; Swanger, M. ; Symons, T.J.M. ; Szanto de Toledo, A. ; Tai, A. ; Takahashi, Jun ; Tang, A.H. ; Tarnowsky, Terence J. ; Thein, D. ; Thomas, James H. ; Timmins, Anthony Robert ; Timoshenko, S. ; Tokarev, M. ; Trainor, T.A. ; Trentalange, Stephen ; Tribble, Robert E. ; Tsai, Oleg D. ; Ulery, J. ; Ullrich, Thomas ; Underwood, D.G. ; Van Buren, Gene ; van der Kolk, N. ; van Leeuwen, M. ; Vander Molen, A.M. ; Varma, R. ; Vasilevski, I.M. ; Vasiliev, A.N. ; Vernet, R. ; Vigdor, S.E. ; Viyogi, Y.P. ; Vokal, S. ; Voloshin, Sergei ; Waggoner, W.T. ; Wang, F. ; Wang, G. ; Wang, G. ; Wang, X.L. ; Wang, Y. ; Wang, Y. ; Wang, Z.M. ; Ward, H. ; Watson, J.W. ; Webb, J.C. ; Westfall, Gary D. ; Wetzler, Alexander Albert ; Whitten, Charles A. ; Wieman, Howard ; Wissink, Scott W. ; Witt, Richard ; Wood, J. ; Wu, J. ; Xu, N. ; Xu, Z. ; Xu, Z.Z. ; Yamamoto, E. ; Yepes, P. ; Yoo, I.-K. ; Yurevich, V.I. ; Zborovsky, I. ; Zhang, H. ; Zhang, W.M. ; Zhang, Y. ; Zhang, Z.P. ; Zhong, C. ; Zoulkarneev, R. ; Zoulkarneeva, Y. ; Zubarev, A.N. ; Zuo, J.X.
We present the first measurements of charge-dependent correlations on angular difference variables η1 − η2 (pseudorapidity) and φ1 − φ2 (azimuth) for primary charged hadrons with transverse momentum 0.15 <= pt <= 2 GeV/c and |η| <= 1.3 from Au–Au collisions at √sNN = 130 GeV. We observe correlation structures not predicted by theory but consistent with evolution of hadron emission geometry with increasing centrality from one-dimensional fragmentation of color strings along the beam direction to an at least two-dimensional hadronization geometry along the beam and azimuth directions of a hadron-opaque bulk medium.
Levine, John E. ; Grupp, Stephan ; Pulsipher, Michael A. ; Dietz, Andrew C. ; Rives, Susana ; Myers, G. Douglas ; August, Keith J. ; Verneris, Michael R. ; Büchner, Jochen ; Laetsch, Theodore W. ; Bittencourt, Henrique ; Baruchel, Andre ; Boyer, Michael W. ; De Moerloose, Barbara ; Qayed, Muna ; Davies, Stella M. ; Phillips, Christine L. ; Driscoll, Timothy A. ; Bader, Peter ; Schlis, Krysta ; Wood, Patricia A ; Mody, Rajen ; Yi, Lan ; Leung, Mimi ; Eldjerou, Lamis K. ; June, Carl H. ; Maude, Shannon L
Background: Tisagenlecleucel, an anti-CD19 chimeric antigen receptor T cell therapy, has demonstrated efficacy in children and young adults with relapsed/refractory B cell acute lymphoblastic leukemia (B-ALL) in two multicenter phase 2 trials (ClinicalTrials.gov, NCT02435849 (ELIANA) and NCT02228096 (ENSIGN)), leading to commercialization of tisagenlecleucel for the treatment of patients up to age 25 years with B-ALL that is refractory or in second or greater relapse.
Methods: A pooled analysis of 137 patients from these trials (ELIANA: n=79; ENSIGN: n=58) was performed to provide a comprehensive safety profile for tisagenlecleucel.
Results: Grade 3/4 tisagenlecleucel-related adverse events (AEs) were reported in 77% of patients. Specific AEs of interest that occurred ≤8 weeks postinfusion included cytokine-release syndrome (CRS; 79% (grade 4: 22%)), infections (42%; grade 3/4: 19%), prolonged (not resolved by day 28) cytopenias (40%; grade 3/4: 34%), neurologic events (36%; grade 3: 10%; no grade 4 events), and tumor lysis syndrome (4%; all grade 3). Treatment for CRS included tocilizumab (40%) and corticosteroids (23%). The frequency of neurologic events increased with CRS severity (p<0.001). Median time to resolution of grade 3/4 cytopenias to grade ≤2 was 2.0 (95% CI 1.87 to 2.23) months for neutropenia, 2.4 (95% CI 1.97 to 3.68) months for lymphopenia, 2.0 (95% CI 1.87 to 2.27) months for leukopenia, 1.9 (95% CI 1.74 to 2.10) months for thrombocytopenia, and 1.0 (95% CI 0.95 to 1.87) month for anemia. All patients who achieved complete remission (CR)/CR with incomplete hematologic recovery experienced B cell aplasia; however, as nearly all responders also received immunoglobulin replacement, few grade 3/4 infections occurred >1 year postinfusion.
Conclusions: This pooled analysis provides a detailed safety profile for tisagenlecleucel during the course of clinical trials, and AE management guidance, with a longer follow-up duration compared with previous reports.
Pirkis, Jane ; Gunnell, David ; Shin, Sangsoo ; Del Pozo-Banos, Marcos ; Arya, Vikas ; Analuisa Aguilar, Pablo ; Appleby, Louis ; Yasir Arafat, S. M. ; Arensman, Ella ; Ayuso-Mateos, Jose Luis ; Pal Singh Balhara, Yatan ; Bantjes, Jason ; Baran, Anna ; Behera, Chittaranjan ; Bertolote, Jose ; Borges, Guilherme ; Bray, Michael ; Brečić, Petrana ; Caine, Eric ; Calati, Raffaella ; Carli, Vladimir ; Castelpietra, Giulio ; Fong Chan, Lai ; Chang, Shu-Sen ; Colchester, David ; Coss-Guzmán, Maria ; Crompton, David ; Ćurković, Marko ; Dandona, Rakhi ; De Jaegere, Eva ; De Leo, Diego ; Deisenhammer, Eberhard A. ; Dwyer, Jeremy ; Erlangsen, Annette ; Faust, Jeremy S. ; Fornaro, Michele ; Fortune, Sarah ; Garrett, Andrew ; Gentile, Guendalina ; Gerstner, Rebekka ; Gilissen, Renske ; Gould, Madelyn ; Kumar Gupta, Sudhir ; Hawton, Keith ; Holz, Franziska ; Kamenshchikov, Iurii ; Kapur, Navneet ; Kasal, Alexandr ; Khan, Murad ; Kirtley, Olivia J. ; Knipe, Duleeka ; Kõlves, Kairi ; Kölzer, Sarah C. ; Krivda, Hryhorii ; Leske, Stuart ; Madeddu, Fabio ; Marshall, Andrew ; Memon, Anjum ; Mittendorfer-Rutz, Ellenor ; Nestadt, Paul ; Neznanov, Nikolay ; Niederkrotenthaler, Thomas ; Nielsen, Emma ; Nordentoft, Merete ; Oberlerchner, Herwig ; O’Connor, Rory C. ; Papsdorf, Rainer ; Partonen, Timo ; Phillips, Michael R. ; Platt, Steve ; Portzky, Gwendolyn ; Psota, Georg ; Qin, Ping ; Radeloff, Daniel ; Reif, Andreas ; Reif-Leonhard, Christine ; Rezaeian, Mohsen ; Román-Vázquez, Nayda ; Roskar, Saska ; Rozanov, Vsevolod ; Sara, Grant ; Scavacini, Karen ; Schneider, Barbara ; Semenova, Natalia ; Sinyor, Mark ; Tambuzzi, Stefano ; Townsend, Ellen ; Ueda, Michiko ; Wasserman, Danuta ; Webb, Roger T. ; Winkler, Petr ; Yip, Paul S. F. ; Zalsman, Gil ; Zoja, Riccardo ; John, Ann ; Spittal, Matthew J.
Background: Predicted increases in suicide were not generally observed in the early months of the COVID-19 pandemic. However, the picture may be changing and patterns might vary across demographic groups. We aimed to provide a timely, granular picture of the pandemic's impact on suicides globally.
Methods: We identified suicide data from official public-sector sources for countries/areas-within-countries, searching websites and academic literature and contacting data custodians and authors as necessary. We sent our first data request on 22nd June 2021 and stopped collecting data on 31st October 2021. We used interrupted time series (ITS) analyses to model the association between the pandemic's emergence and total suicides and suicides by sex-, age- and sex-by-age in each country/area-within-country. We compared the observed and expected numbers of suicides in the pandemic's first nine and first 10-15 months and used meta-regression to explore sources of variation.
Findings: We sourced data from 33 countries (24 high-income, six upper-middle-income, three lower-middle-income; 25 with whole-country data, 12 with data for area(s)-within-the-country, four with both). There was no evidence of greater-than-expected numbers of suicides in the majority of countries/areas-within-countries in any analysis; more commonly, there was evidence of lower-than-expected numbers. Certain sex, age and sex-by-age groups stood out as potentially concerning, but these were not consistent across countries/areas-within-countries. In the meta-regression, different patterns were not explained by countries’ COVID-19 mortality rate, stringency of public health response, economic support level, or presence of a national suicide prevention strategy. Nor were they explained by countries’ income level, although the meta-regression only included data from high-income and upper-middle-income countries, and there were suggestions from the ITS analyses that lower-middle-income countries fared less well.
Interpretation: Although there are some countries/areas-within-countries where overall suicide numbers and numbers for certain sex- and age-based groups are greater-than-expected, these countries/areas-within-countries are in the minority. Any upward movement in suicide numbers in any place or group is concerning, and we need to remain alert to and respond to changes as the pandemic and its mental health and economic consequences continue.
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