Publications by authors named "Fredrik Nyberg"
Initiation of Anticoagulants During the COVID-19 Pandemic in Sweden: An Interrupted Time Series Analysis.
Basic Clin Pharmacol Toxicol
February 2025
The COVID-19 pandemic may have increased anticoagulant initiation due to the thrombogenic nature of the disease or decreased due to the societal impact of the pandemic. We aimed to study the effect of the COVID-19 pandemic on initiation of anticoagulants in Sweden. We conducted a single interrupted time series analysis on the monthly cumulative incidence of nonvitamin K antagonist oral anticoagulants (NOAC), warfarin, or heparins, before and after March 2020, using SCIFI-PEARL dataset.
View Article and Find Full Text PDFDemyelinating diseases including multiple sclerosis are associated with prior infectious exposures, so we assessed whether SARS-CoV-2 infection is associated with subsequent diagnoses of non-multiple sclerosis demyelinating diseases and multiple sclerosis. All residents of Sweden aged 3-100 years were followed between 1 January 2020 and 30 November 2022, excluding those with demyelinating disease prior to 2020, comprising 9 959 818 individuals divided into uninfected and those who were infected were categorized into those with and without hospital admission for the infection as a marker of infection severity. Cox regression assessed the risk of two separate outcomes: hospital diagnosed non-multiple sclerosis demyelinating diseases of the CNS and multiple sclerosis.
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- The study investigates the side effects of COVID-19 vaccinations and infections, focusing on the benefits of self-reporting symptoms through a digital system called Symptoms.
- Researchers aimed to understand how this system can capture patient-reported outcomes, which vary in importance depending on individual needs.
- A total of 731 participants used the Symptoms system to track their health-related quality of life and symptoms, highlighting the relevance of personal experiences in monitoring vaccine side effects.
Objectives: Antihypertensives reduce the risk of myocardial infarction and stroke. Restrictions during the COVID-19 pandemic limited access to healthcare, which may have had a negative impact on drug prescribing. This study aimed to assess the effect of the COVID-19 pandemic on the initiation of antihypertensive drugs.
View Article and Find Full Text PDFDuring the coronavirus disease 2019 (COVID-19) pandemic, Sweden emphasized voluntary guidelines over mandates. We exploited a rapid change and reversal of the Public Health Agency of Sweden's COVID-19 testing guidelines for vaccinated and recently infected individuals as a quasi-experiment to examine sociodemographic differences in the response to changes in pandemic guidelines. We analyzed daily polymerase chain reaction tests from 1 October 2021 to 15 December 2021, for vaccinated or recently infected adults (≥20 years; n = 1 596 321) from three Swedish regions (Stockholm, Örebro, and Dalarna).
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- The study investigates the cardiovascular effects of COVID-19 mRNA vaccination in over 8 million Swedish adults, focusing on risks for myocarditis, pericarditis, dysrhythmias, heart failure, myocardial infarction, and cerebrovascular events.
- Results indicate that while there is a temporary increase in risks for myocarditis and extrasystoles shortly after vaccination, overall cardiovascular risks significantly decrease after full vaccination, particularly after the third dose.
- The findings highlight the importance of vaccination in reducing severe cardiovascular complications associated with COVID-19, validating its protective benefits despite some rare adverse events.
Article Synopsis
- - Individuals with mental illness are at a higher risk for severe COVID-19 outcomes, but studies on their vaccination uptake have shown mixed results.
- - This research analyzed data from multiple cohort studies and Swedish registers to explore the relationship between mental illness and COVID-19 vaccination rates.
- - Findings revealed that while overall vaccine uptake was high in both groups, there was a slight decrease in vaccination rates among unmedicated individuals with mental illness, indicating a need for further investigation into this subgroup.
Article Synopsis
- Acute exacerbations of COPD (AECOPDs) pose a heightened risk for cardiovascular events like myocardial infarction (MI) and pulmonary embolism (PE), although the extent of this risk concerning AECOPD history remains unclear.
- A study involving over 66,000 COPD patients found that both the frequency and severity of AECOPDs are positively correlated with an increased risk of future MI and PE, with greater risks observed for more severe exacerbations.
- The increased risk is more pronounced within the first year following an AECOPD episode and tends to diminish over time, suggesting a timeline in which the risk factors impact the patients’ health.
Article Synopsis
- - The study analyzed the relationship between alcohol consumption and metabolic syndrome (MetS) using data from 3,051 adults in the Swedish INTERGENE cohort, identifying different definitions of MetS (ATP III, IDF, JIS) and their varying prevalence rates.
- - Results indicated that medium to high alcohol consumption was linked to lower odds of MetS, while abstainers showed no significant differences; prevalence estimates for MetS ranged from 13.9% to 25.3%, with men generally being more affected than women.
- - The findings suggest that the impact of alcohol on MetS varies depending on the definition used, specifically that those meeting the strictest MetS criteria (ATP III) might actually benefit from
Article Synopsis
- Assessing COVID-19 risk in asthma patients is complex because the impact of risk factors varies significantly among different age groups, which can lead to misleading insights if studied together.
- The study examined 201,140 asthma patients from the Swedish National Airway Register, analyzing COVID-19 outcomes like infection rates, hospitalization, and mortality from January 2020 to February 2021, with specific attention to age-related factors.
- Results showed distinct differences in risk factors for COVID-19 hospitalizations and deaths across age groups, highlighting the importance of asthma control, lung function, and other health conditions, with serious outcomes primarily occurring in patients aged 40 and older.
Article Synopsis
- The study investigates how different types of physical activity (leisure, work, transport, and household) relate to stroke incidence and outcomes like death or dependency on daily activities after a stroke, using long-term data from a Swedish cohort.
- Data from 3,614 individuals, tracked over a median of 20 years, showed that higher levels of leisure time physical activity significantly lowered the risk of stroke and improved post-stroke outcomes.
- Specifically, both intermediate and high leisure time physical activities reduced stroke incidence, and certain transport activity levels also showed protective effects against stroke.
Article Synopsis
- Norway and Sweden's different early pandemic responses affected how mental health care was managed during COVID-19, highlighting variations in medication usage and hospitalization rates.
- Analyses of national registries revealed immediate reductions in medication prescriptions and hospitalizations in Norway, while Sweden saw differing trends, particularly in outpatient visits.
- The study concluded that the early policy responses to the pandemic likely influenced the mental health care dynamics in both countries.
Article Synopsis
- A prospective cohort study was conducted in Swedish ICUs from March 2020 to December 2022 to analyze survival trends and predictors of death among critically ill COVID-19 patients.
- Of the 8,975 patients studied, 32.6% died, with survival rates worse during the Omicron variant period.
- Key factors influencing survival included age (older patients had higher risk), gender (men were at higher risk), and certain health conditions, while those with booster vaccines, foreign-born status, and steroid use showed improved survival rates.
Article Synopsis
- Patients with a history of oral glucocorticoid (GC) treatment before contracting COVID-19 show higher mortality rates compared to those who did not receive GCs.
- * A study in Sweden involving over 1.2 million COVID-19 patients found that GC users had significant increases in deaths from various causes, including pulmonary embolism and sepsis.
- * The researchers concluded that prior GC exposure is linked to greater overall mortality in COVID-19 patients, particularly among those with high GC usage.
Article Synopsis
- The paper addresses the issue of outcome under-ascertainment in epidemiologic research, which complicates the identification and reporting of cases.
- It introduces a new framework that combines capture-recapture methods with propensity score weighting to better estimate exposure effects and adjust for confounding factors.
- The authors demonstrate this method's effectiveness using a study on healthcare workers and COVID-19 testing in Sweden, highlighting the significant impact of accounting for under-ascertainment on research outcomes.
Article Synopsis
- Solid organ transplant recipients (SOTRs) faced significantly higher COVID-19-related health risks, including increased hospitalization rates (47.3% for SOTRs vs. 19% for the general population) and ICU care needs (8% for SOTRs).
- A cohort study in Sweden analyzed data from over 10 million individuals, finding SOTRs had higher risks of severe outcomes, including a case fatality rate of 7.7%, compared to lower rates in general populations.
- The study also noted that SOTRs were vaccinated earlier than others, with lung transplant recipients experiencing the worst outcomes, especially in late 2021.
Article Synopsis
- - The COVID-19 pandemic has negatively impacted the mental health of children and adolescents, leading to changes in medication use in Norway, Sweden, and Italy, particularly in terms of psychotropic medications.
- - A study analyzing drug prescriptions and dispensings from January 2018 to December 2021 revealed varied impacts on different medications, with notable trends for ADHD, antidepressants, and anxiolytics increasing among adolescents in Norway and Sweden after March 2020.
- - While some medications like insulin showed minor changes, asthma medications experienced a dip in dispensing initially, followed by an overall increasing trend, especially among younger age groups across all studied countries.
Article Synopsis
- The study aimed to create a disease risk score to predict hospitalization and mortality due to COVID-19 in Sweden, and validate this score in Norway.
- It analyzed data from national health registries and focused on individuals with confirmed SARS-CoV-2 infections, comparing hospitalized patients to controls and considering various health factors.
- The findings indicated the risk scores had moderate predictability for hospitalization and mortality, with better performance in the validation cohort from Norway, particularly regarding mortality prediction.
Article Synopsis
- The study focuses on the importance of creating accurate phenotype definitions for reliable safety research, comparing different definitions to see how they affect background incidence rates of adverse events.
- Using data from 16 sources, the researchers analyzed 13 adverse events and discovered significant variations in incidence rates based on how phenotypes were defined, particularly with different modifications like inpatient settings.
- The results indicated that requiring an inpatient setting significantly increased the incidence rates, showing the need to carefully evaluate definitions before using them for background rate assessments in a global context.
Article Synopsis
- - The study aimed to evaluate how effective primary Covid-19 vaccination is at preventing post-Covid-19 condition (PCC) in adults in Sweden, using a large cohort of over 589,000 individuals who were infected from December 2020 to February 2022.
- - Results showed that vaccinated individuals had a significantly lower incidence of PCC, with only 0.4% diagnosed compared to 1.4% in unvaccinated individuals; overall, being vaccinated reduced the risk of PCC by 58%.
- - Effectiveness varied by the number of vaccine doses: one dose showed 21% effectiveness, two doses demonstrated 59%, and three or more doses had 73% effectiveness against developing PCC. *
Article Synopsis
- * Results showed that women, older individuals, and those with lower income or immigrant backgrounds were more likely to take sick leave, with the oldest age group showing the highest rates.
- * A key finding is that while sick leave was influenced by sociodemographic factors in the general population, these factors were less pronounced or even reversed among hospitalized patients.
Article Synopsis
- * While the infection rates of COVID-19 were similar between the two groups, AI patients had significantly higher rates of hospitalization (2.1% vs. 0.8%), intensive care admissions (0.3% vs. 0.1%), and deaths (0.8% vs. 0.2%).
- * The study concluded that AI patients face over twice the risk of severe COVID-19 outcomes, highlighting the need for prioritized vaccinations and targeted treatments for these individuals.
Article Synopsis
- The study assessed the incidence and effects of COVID-19 on patients with chronic respiratory failure (CRF) receiving long-term oxygen therapy (LTOT) in Sweden over different time periods.
- Findings showed that CRF patients had a higher cumulative incidence of COVID-19 compared to the general population during the early pandemic but lower incidence in later periods.
- Additionally, CRF patients faced a significantly higher risk of severe or critical COVID-19 in all periods studied, with COVID-19 linked to increased one-year mortality, particularly in the pre-alpha and alpha phases.
Regular Inhaled Corticosteroids Use May Protect Against Severe COVID-19 Outcome in COPD.
Int J Chron Obstruct Pulmon Dis
August 2023
Article Synopsis
- A study investigated the effects of inhaled corticosteroids (ICS) on COVID-19 outcomes in patients with Chronic Obstructive Pulmonary Disease (COPD) using a Swedish population database during 2020.
- Regular ICS exposure showed only minor increases in the onset of COVID-19, hospitalization, and death in both the general population and COPD subpopulation, with some exceptions in ICU admissions.
- In hospitalized COPD patients, ICS therapy significantly reduced the risk of progressing to ICU admission and death, suggesting that continuing ICS treatment is safe and beneficial for these patients.