{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:38:23Z","timestamp":1777937903381,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2023,12,28]],"date-time":"2023-12-28T00:00:00Z","timestamp":1703721600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Scand J Public Health"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title>Aims:<\/jats:title>\n                    <jats:p>Since its outbreak in 2020, the COVID-19 pandemic has directly caused the premature death of millions. However, indirect consequences, such as social restrictions, have affected a far greater number. We explored the association between the spread of COVID-19 and end-of-life circumstances in the infected and non-infected population in Sweden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this descriptive, population-based, observational study, we primarily used data from the Swedish National Registry of Palliative Care, which covers about 60% of all deaths in Sweden. We explored the association between the spread of COVID-19 and place of death, people present at death and end-of-life symptoms using regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The study included 190,291 individuals who died in any region of Sweden from 1 January 2019 to 30 June 2022, of which 10,646 were COVID-19 cases. Correlated to the temporal and geographical spread of COVID-19, there was a greater proportion of individuals dying without the presence of their next-of-kin, and consequently more people dying alone, both in those with and without COVID-19. There was a similar pattern of a greater proportion of deaths taking place in nursing homes and in the individual\u2019s own home. However, we did not find substantial associations to reported symptoms, such as anxiety or confusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This study shows the profound effects of the COVID-19 pandemic on end-of-life circumstances in both the infected and non-infected population in Sweden. As we prepare for future pandemics, there is a need to develop strategies to minimise the impact on non-infected individuals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/14034948231216197","type":"journal-article","created":{"date-parts":[[2023,12,28]],"date-time":"2023-12-28T07:48:00Z","timestamp":1703749680000},"page":"290-298","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations between the spread of COVID-19 and end-of-life circumstances in the non-infected population of Sweden"],"prefix":"10.1177","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7114-2757","authenticated-orcid":false,"given":"Stefan","family":"Sennf\u00e4lt","sequence":"first","affiliation":[{"name":"Department of Neurology, Karolinska University Hospital, Sweden"},{"name":"Department of Clinical Neuroscience, Karolinska Institutet, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4183-7598","authenticated-orcid":false,"given":"Christel","family":"Hedman","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Lund University, Sweden"},{"name":"Institute for Palliative Care, Lund University and Region Sk\u00e5ne, Sweden"},{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet, Sweden"},{"name":"R&D Department, Stockholms Sjukhem Foundation, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl Johan","family":"F\u00fcrst","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Lund University, Sweden"},{"name":"Institute for Palliative Care, Lund University and Region Sk\u00e5ne, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,12,28]]},"reference":[{"key":"bibr1-14034948231216197","volume":"399","author":"COVID-19 Excess Mortality Collaborators","year":"2022","journal-title":"Lancet"},{"key":"bibr2-14034948231216197","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.8524"},{"key":"bibr3-14034948231216197","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-021-11111-1"},{"key":"bibr4-14034948231216197","doi-asserted-by":"publisher","DOI":"10.1177\/0269216320920780"},{"key":"bibr5-14034948231216197","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2021.01.138"},{"key":"bibr6-14034948231216197","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2020.07.020"},{"key":"bibr7-14034948231216197","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnsa.2021.100031"},{"key":"bibr8-14034948231216197","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckab065"},{"key":"bibr9-14034948231216197","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-045343"},{"key":"bibr10-14034948231216197","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2021.104000"},{"key":"bibr11-14034948231216197","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2022.154050"},{"key":"bibr12-14034948231216197","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30460-8"},{"key":"bibr13-14034948231216197","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnaa194"},{"key":"bibr14-14034948231216197","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-048503"},{"key":"bibr15-14034948231216197","doi-asserted-by":"publisher","DOI":"10.1111\/apa.15582"},{"key":"bibr16-14034948231216197","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa864"},{"key":"bibr17-14034948231216197","first-page":"1","volume":"14","author":"Anell A","year":"2012","journal-title":"Health Syst Transit"},{"key":"bibr18-14034948231216197","unstructured":"Swedish Registry of Palliative Care. 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