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Objective <p>As&#xa0;non-communicable diseases (NCDs) predicted poor prognosis in COVID-19, in this paper we present two analyses: (1) A comprehensive analysis and overview of clinical practice guidelines (CPGs) for use by patients with NCDs in the Western-Pacific and South-East Asian regions during the COVID-19 pandemic between 2020 and 2023, focussing on economically transitional countries and the four main NCDs that were the leading causes of death in the regions. An analysis of CPGs in developed countries for these four NCDs to identify lessons for the two WHO regions was also undertaken. (2) A retrospective analysis of WHO’s systemic and policy guidance designed to address COVID-19 management in the two WHO regions, identifying lessons learnt from countries that contained the impact of the pandemic from 2019 to early 2021. COVID-19 mitigation and economic policies by some Governments in the two regions were also analysed. COVID-19 impacts on chronic diseases were analysed.</p> Methods <p>We conducted a PRISMA-ScR searching PUBMED, Medline and Google-Scholar from 1966 to 2023. We also retrieved published control initiatives, policy guidelines and country-specific outbreak data from international websites. We systematically collected publicly available national weekly surveillance data on COVID-19 infections and national interventions during 2019–2021 from WHO and Oxford tracking websites.</p> Results <p>The PRISMA ScR found a negative impact on the routine management of individuals with NCDs, and those individuals&#xa0;who contracted SARS-CoV-2 had poorer outcomes during the pandemic. Countries developed CPGs to manage COVID-19 patients with NCD comorbidities, which were expected to have been used routinely when treating these individuals. Countries should aim for well-targeted vaccination coverage and mitigation strategies, with Singapore and Malaysia serving as models for other countries in the region given low death rates in the face of relatively high attack rates. Thailand had a low case fatality rate of 0.33%&#xa0;despite a large population and low vaccination coverage. Its prioritisation plan for ICU beds and stay at home orders may have mitigated contagion and ensured good treatment of severely ill patients, contributing to a lower death rate.</p> Conclusion <p>Although some countries developed CPGs to manage COVID-19 patients with NCD comorbidities, the number of CPGs developed in the Asia-Pacific region to support the management of NCDs more broadly was limited. In future prolonged disruptive events, governments should develop resources that support the development and implementation of CPGs related to NCDs to reduce and manage the impact of future emergencies in the region on the burden of NCDs. Countries with more extensive vaccine coverage and well-organised mitigation strategies had lower mortality rates despite higher COVID-19 attack rates.</p>

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The management of chronic diseases during the SARS-Cov-2 pandemic in WHO Western-Pacific and South-East Asian regions

  • 期刊论文

  • 发表日期：

    2025年8月5日

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  • Angeline Kuek,
  • Kathryn M. Antioch,
  • Priscilla Robinson

摘要

Objective

As non-communicable diseases (NCDs) predicted poor prognosis in COVID-19, in this paper we present two analyses: (1) A comprehensive analysis and overview of clinical practice guidelines (CPGs) for use by patients with NCDs in the Western-Pacific and South-East Asian regions during the COVID-19 pandemic between 2020 and 2023, focussing on economically transitional countries and the four main NCDs that were the leading causes of death in the regions. An analysis of CPGs in developed countries for these four NCDs to identify lessons for the two WHO regions was also undertaken. (2) A retrospective analysis of WHO’s systemic and policy guidance designed to address COVID-19 management in the two WHO regions, identifying lessons learnt from countries that contained the impact of the pandemic from 2019 to early 2021. COVID-19 mitigation and economic policies by some Governments in the two regions were also analysed. COVID-19 impacts on chronic diseases were analysed.

Methods

We conducted a PRISMA-ScR searching PUBMED, Medline and Google-Scholar from 1966 to 2023. We also retrieved published control initiatives, policy guidelines and country-specific outbreak data from international websites. We systematically collected publicly available national weekly surveillance data on COVID-19 infections and national interventions during 2019–2021 from WHO and Oxford tracking websites.

Results

The PRISMA ScR found a negative impact on the routine management of individuals with NCDs, and those individuals who contracted SARS-CoV-2 had poorer outcomes during the pandemic. Countries developed CPGs to manage COVID-19 patients with NCD comorbidities, which were expected to have been used routinely when treating these individuals. Countries should aim for well-targeted vaccination coverage and mitigation strategies, with Singapore and Malaysia serving as models for other countries in the region given low death rates in the face of relatively high attack rates. Thailand had a low case fatality rate of 0.33% despite a large population and low vaccination coverage. Its prioritisation plan for ICU beds and stay at home orders may have mitigated contagion and ensured good treatment of severely ill patients, contributing to a lower death rate.

Conclusion

Although some countries developed CPGs to manage COVID-19 patients with NCD comorbidities, the number of CPGs developed in the Asia-Pacific region to support the management of NCDs more broadly was limited. In future prolonged disruptive events, governments should develop resources that support the development and implementation of CPGs related to NCDs to reduce and manage the impact of future emergencies in the region on the burden of NCDs. Countries with more extensive vaccine coverage and well-organised mitigation strategies had lower mortality rates despite higher COVID-19 attack rates.