Medical Journal News

New England Journal of Medicine, Volume 392, Issue 11, Page 1120-1120, March 13/20, 2025.

New England Journal of Medicine, Volume 392, Issue 11, March 13/20, 2025.

New England Journal of Medicine, Volume 392, Issue 11, Page 1121-1132, March 13/20, 2025.

New England Journal of Medicine, Volume 392, Issue 11, Page 1111-1119, March 13/20, 2025.

New England Journal of Medicine, Volume 392, Issue 13, April 3, 2025.

In 2020, WHO published guidance on the use of multiple micronutrient supplements (MMS) for pregnant women, which usually provide up to 15 vitamins and minerals in tablet or capsule form.1 In the 2020 update to the 2016 guidance,2 WHO issued a context-specific recommendation: “Antenatal multiple micronutrient supplements that include iron and folic acid are recommended in the context of rigorous research.”2 The evidence that informed this recommendation indicated that, compared with standard of care (iron and folic acid [IFA] supplementation), MMS reduced the prevalence of low birthweight but had little to no impact on other maternal and neonatal outcomes.

When compared with a licensed, quadrivalent meningococcal conjugate vaccine, and given alongside other routine vaccines, a single dose of NmCV-5 was safe and elicited a non-inferior immune response in infants aged 9 months and young children aged 15 months.

Since the introduction of the MenA conjugate vaccine in the African meningitis belt through mass vaccination campaigns and its inclusion in the Essential Program on Immunization (EPI), cases of serogroup A meningococcal meningitis have disappeared. This success has provided hope of eliminating serogroup A meningococcal disease and certainly epidemics in the African meningitis belt. The novel MenACWYX conjugate vaccine (NmCV-5), which contains four additional polysaccharides, is now expected to do the same for the remaining epidemic-causing serogroups in the region.

by Sara Ahmadi-Abhari, Piotr Bandosz, Martin J. Shipley, Joni V. Lindbohm, Abbas Dehghan, Paul Elliott, Mika Kivimaki

Background

The direct and indirect impacts of the COVID-19 pandemic on life expectancy (LE) and years of life lost with and without disability remain unclear. Accounting for pre-pandemic trends in morbidity and mortality, we assessed these impacts in 18 European countries, for the years 2020–2022.

Methods and Findings

We used multi-state Markov modeling based on several data sources to track transitions of the population aged 35 or older between eight health states from disease-free, combinations of cardiovascular disease, cognitive impairment, dementia, and disability, through to death. We quantified separately numbers and rates of deaths attributable to COVID-19 from those related to mortality from other causes during 2020–2022, and estimated the proportion of loss of life expectancy and years of life with and without disability that could have been avoided if the pandemic had not occurred. Estimates were disaggregated by COVID-19 versus non-COVID causes of deaths, calendar year, age, sex, disability status, and country. We generated the 95% uncertainty intervals (UIs) using Monte Carlo simulations with 500 iterations. Among the 289 million adult population in the 18 countries, person-years of life lost (PYLL) in millions were 4.7 (95% UI 3.4–6.0) in 2020, 7.1 (95% UI 6.6–7.9) in 2021, and 5.0 (95% UI 4.1–6.2) in 2022, totaling 16.8 (95% UI 12.0–21.8) million. PYLL per capita varied considerably between the 18 countries ranging between 20 and 109 per 1,000 population. About 60% of the total PYLL occurred among persons aged over 80, and 30% in those aged 65–80. If the pandemic were avoided, over half (9.8 million (95% UI 4.7–15.1)) of the 16.8 million PYLL were estimated to have been lived without disability. Of the total PYLL, 11.6–13.2 million were due to registered COVID-19 deaths and 3.6–5.3 million due to non-COVID mortality. Despite a decrease in PYLL attributable to COVID-19 after 2021, PYLL associated with other causes of death continued to increase from 2020 to 2022 in most countries. Lower income countries had higher PYLL per capita as well as a greater proportion of disability-free PYLL during 2020–2022. Similar patterns were observed for life expectancy. In 2021, LE at age 35 (LE-35) declined by up to 2.8 (95% UI 2.3–3.3) years, with over two-thirds being disability-free. With the exception of Sweden, LE-35 in the studied countries did not recover to 2019 levels by 2022.

Conclusions

The considerable loss of life without disability and the rise in premature mortality not directly linked to COVID-19 deaths during 2020–2022 suggest a potential broader, longer-term and partially indirect impact of the pandemic, possibly resulting from disruptions in healthcare delivery and services for non-COVID conditions and unintended consequences of COVID-19 containment measures. These findings highlight a need for better pandemic preparedness in Europe, ideally, as part of a more comprehensive global public health agenda.

Diagnosis and management of patients with suspected acute brain infections improved following introduction of a simple intervention package across a diverse range of hospitals on three continents. The intervention is now being implemented in other settings as part of the WHO Meningitis Roadmap and encephalitis control initiatives.

New England Journal of Medicine, Volume 392, Issue 11, March 13/20, 2025.

New England Journal of Medicine, Volume 392, Issue 11, Page 1046-1049, March 13/20, 2025.

New England Journal of Medicine, Volume 392, Issue 11, Page 1044-1046, March 13/20, 2025.

Referred to as “cause for national shame” by the Health Secretary, Wes Streeting, maternity services in the UK have been the focus of repeated national scandals, with shocking reports of gross negligence and avoidable deaths in units across the UK. The largest maternity review in National Health Service (NHS) history, involving more than 2000 families, is now underway at Nottingham University Hospitals Trust. The government has promised the biggest reimagining of the NHS since its inception with the 10-year Health Plan, due this spring—in doing so, the government must deliver on long overdue pledges to improve maternity services.

The treatment landscape for first-line oncogene driver-negative metastatic non-small-cell lung cancer (NSCLC) has remained largely unchanged in recent years. Since the 2016 approval of the anti-PD-1 immune checkpoint inhibitor (ICI) pembrolizumab for front-line treatment of patients with metastatic NSCLC with PD-L1 expression of 50% or greater,1 numerous ICI monotherapies and combination regimens have followed. With an abundance of treatment options already available in the first-line setting, the HARMONi-2 trial—the results of which are presented by Anwen Xiong and colleagues in The Lancet2—raises critical questions: does ivonescimab, a novel bispecific antibody targeting VEGF and PD-L1, offer meaningful clinical advantages over existing PD-1 or PD-L1 inhibitors? And is there a compelling need for another therapeutic option in this space?

Germany's likely new Chancellor inherits a series of plans for health reform and must deal with an ageing population and underinvestment in infrastructure. Ferry Biedermann reports.

More than 300 cases have been reported, which experts have linked to infection with Campylobacter jejuni. Samaan Lateef reports from Mumbai.

The government is investing in a new single-dose vaccine as São Paulo state declares a state of emergency. Lise Alves reports.

Founded 5 years ago, the Institute of HIV Research and Innovation works with communities to answer the research questions that matter most to them. Sima Barmania reports from Bangkok.