Dhand R, Okumura K, Nishida S, Dhand A. Rise in deaths from drug overdose and firearm injury during coronavirus disease 2019 pandemic and its impact on organ transplantation. World J Transplant 2025; 15(2): 101986 [DOI: 10.5500/wjt.v15.i2.101986]
Corresponding Author of This Article
Abhay Dhand, MD, Associate Professor, Department of Surgery and Medicine, Westchester Medical Center and New York Medical College, 100 Woods Road, ACP- Transplant Center, Valhalla, NY 10595, United States. abhay.dhand@wmchealth.org
Research Domain of This Article
Transplantation
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Roshan Dhand, Horace Greeley High School, Chappaqua, NY 10514, United States
Kenji Okumura, Seigo Nishida, Department of Surgery, Westchester Medical Center and New York Medical College, Valhalla, NY 10595, United States
Abhay Dhand, Department of Surgery and Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY 10595, United States
Author contributions: Dhand A and Okumura K contributed to conceptualization and design; Dhand R, Okumura K, Nishida, S and Dhand A contributed to material preparation, data acquisition, and analysis; All authors contributed to writing-draft manuscript and writing-revision and approved to submit the final version.
Institutional review board statement: This study was considered exempt by the Institutional Review Board because of secondary use of the de-identified data.
Informed consent statement: Informed consent was not required for this retrospective study using de-identified data from pre-existing databases.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Abhay Dhand, MD, Associate Professor, Department of Surgery and Medicine, Westchester Medical Center and New York Medical College, 100 Woods Road, ACP- Transplant Center, Valhalla, NY 10595, United States. abhay.dhand@wmchealth.org
Received: October 4, 2024 Revised: October 30, 2024 Accepted: November 20, 2024 Published online: June 18, 2025 Processing time: 140 Days and 10.1 Hours
Abstract
BACKGROUND
The coronavirus disease 2019 (COVID-19) pandemic had a profound societal impact in the United States which was associated with a decrease in overall life expectancy and an increase in substance abuse and firearm injury. Our understanding of changes in mortality trends during the pandemic and its effect on organ availability for transplantation is limited.
AIM
To examine the trends of substance abuse and firearm injury fatalities during COVID-19 and a potential correlation with organ transplantation.
METHODS
Crude rates of population-based deaths among adults (18-75 years) from firearm injury and substance abuse from the period of 2014-2021 were obtained from centers of disease control wide-ranging online data for epidemiologic research database. Crude rates of causes of donor (18-75 years) deaths from 2014-2021 were obtained from the united network for organ sharing database.
RESULTS
Average annual percentage change (AAPC) deaths among the United States population were 16.4% from substance abuse and 3.4% from firearm injury. AAPC in cause of death among organ donors was 10.9% from drug intoxication and 2.1% from firearm injury. There was a significant (P < 0.001) and progressive increase in mortality from both causes during the pandemic (2020-2021) and significant correlation (P < 0.001) between population and donor causes of death. COVID-19 exacerbated trends in substance abuse and firearm mortality with a consequent increase in organ donation from donors who died from these two causes.
CONCLUSION
Identifying the socioeconomic and regional disparities associated with increase in deaths from substance abuse and firearms can help guide post-pandemic healthcare policies and mitigate their impact on organ transplantation.
Core Tip: Population based deaths from substance abuse and firearm injury increased during the coronavirus disease 2019 (COVID-19) pandemic in the United States. The progressive increase in the crude rate of firearm injury and substance abuse death seen during the early part of COVID-19 pandemic continues to persist, with a higher impact in Black/African American, American Indian or Alaska Natives, and those in United States south central and rural areas. These morality trends correlate with changes in organ donation resulting in rise in donors who died from drug overdose and firearm injury from 2014-2021, with a significant increase seen during the COVID-19 pandemic.
