• Manickam Ponnaiah, Tarun Bhatnagar, Rizwan Suliankachi Abdulkader, Rajalakshmi Elumalai, Janani Surya, Kathiresan Jeyashree, Muthusamy Santhosh Kumar, Ranjithkumar Govindaraju, ThangarajJeromie Wesley VivianJWVDivision of Epidemiology and Biostatistics, ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India., Hari Krishan Aggarwal, Suresh Balan, Tridip Dutta Baruah, Ayan Basu, Yogita Bavaskar, Ajeet Singh Bhadoria, Ashish Bhalla, Pankaj Bhardwaj, Rachana Bhat, Jaya Chakravarty, Gina Maryann Chandy, Bal Kishan Gupta, Rakesh Kakkar, Ali Hasan Faiz Karnam, Sushila Kataria, Janakkumar Khambholja, Dewesh Kumar, Nithin Kumar, Monaliza Lyngdoh, M Selva Meena, Kedar Mehta, M P Sheethal, Subhasis Mukherjee, Anuj Mundra, Arun Murugan, Seetharaman Narayanan, Balamurugan Nathan, Jutika Ojah, Pushpa Patil, Sunita Pawar, A Charles Pon Ruban, R Vadivelu, Rishabh Kumar Rana, S Nagendra Boopathy, S Priya, Saroj Kumar Sahoo, Arti Shah, Mohammad Shameem, Karthikeyan Shanmugam, Sachin K Shivnitwar, Abhishek Singhai, Saurabh Srivastava, Sudheera Sulgante, Arunansu Talukdar, Alka Verma, Rajaat Vohra, Rabbanie Tariq Wani, Bhargavi Bathula, Gayathri Kumari, Divya Saravana Kumar, Aishwariya Narasimhan, N C Krupa, Thirumaran Senguttuvan, Parvathi Surendran, Dharsikaa Tamilmani, Alka Turuk, Gunjan Kumar, Aparna Murkherjee, Rakesh Aggarwal, Manoj Vasant Murhekar, and Sudden Adult Deaths Study Group.
• Division of Online Courses, Chennai, Tamil Nadu, India.
• Indian J Med Res. 2023 Oct 1; 158 (4): 351362351-362.

Background ObjectivesIn view of anecdotal reports of sudden unexplained deaths in India's apparently healthy young adults, linking to coronavirus disease 2019 (COVID-19) infection or vaccination, we determined the factors associated with such deaths in individuals aged 18-45 years through a multicentric matched case-control study.MethodsThis study was conducted through participation of 47 tertiary care hospitals across India. Cases were apparently healthy individuals aged 18-45 years without any known co-morbidity, who suddenly (<24 h of hospitalization or seen apparently healthy 24 h before death) died of unexplained causes during 1 st October 2021-31 st March 2023. Four controls were included per case matched for age, gender and neighborhood. We interviewed/perused records to collect data on COVID-19 vaccination/infection and post-COVID-19 conditions, family history of sudden death, smoking, recreational drug use, alcohol frequency and binge drinking and vigorous-intensity physical activity two days before death/interviews. We developed regression models considering COVID-19 vaccination ≤42 days before outcome, any vaccine received anytime and vaccine doses to compute an adjusted matched odds ratio (aOR) with 95 per cent confidence interval (CI).ResultsSeven hundred twenty nine cases and 2916 controls were included in the analysis. Receipt of at least one dose of COVID-19 vaccine lowered the odds [aOR (95% CI)] for unexplained sudden death [0.58 (0.37, 0.92)], whereas past COVID-19 hospitalization [3.8 (1.36, 10.61)], family history of sudden death [2.53 (1.52, 4.21)], binge drinking 48 h before death/interview [5.29 (2.57, 10.89)], use of recreational drug/substance [2.92 (1.1, 7.71)] and performing vigorous-intensity physical activity 48 h before death/interview [3.7 (1.36, 10.05)] were positively associated. Two doses lowered the odds of unexplained sudden death [0.51 (0.28, 0.91)], whereas single dose did not.Interpretation ConclusionsCOVID-19 vaccination did not increase the risk of unexplained sudden death among young adults in India. Past COVID-19 hospitalization, family history of sudden death and certain lifestyle behaviors increased the likelihood of unexplained sudden death.Copyright © 2023 Copyright: © 2023 Indian Journal of Medical Research.

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