Coronary artery disease continues to be the leading cause of sudden death among young adults in India, while a significant proportion of cases remain unexplained, underscoring the need for targeted public health strategies and broader use of advanced post-mortem investigations, according to a recent study by a scientific scholar.
But a rigorous, one-year autopsy-based study conducted at AIIMS, New Delhi, has found no scientific evidence linking Covid-19 vaccination with sudden deaths among young adults.
The study clearly showed that such deaths are attributable to underlying cardiovascular and other medical causes.
Dr. Sudheer Arava of AIIMS, Delhi, asserted that evidence-based research must guide public understanding.
The research, based on autopsy data from a forensic mortuary, highlights that sudden death in individuals aged 18-45 years now constitutes a major public health concern, even though such deaths were traditionally considered rare in younger age groups. Of the 2,214 autopsies conducted during the study period, 180 cases met the criteria for sudden death, accounting for 8.1 per cent of all cases.
Notably, 57.2 per cent of these sudden deaths occurred in young adults, compared to 42.8 per cent in those aged 46-65 years.
The incidence of sudden death among young people accounted for 4.7 per cent of all autopsied cases. After excluding cases with advanced autolytic changes, the final analysis included 94 young adults and 68 older individuals. The mean age of sudden death in the younger group was 33.6 years, with a striking male predominance and a male-to-female ratio of 4.5:1.
Researchers found that cardiac causes accounted for nearly two-thirds of sudden deaths in the young, with coronary artery disease emerging as the most common underlying pathology. Non-cardiac causes contributed to about one-third of cases.
The study noted that the pattern of sudden death in young adults differs significantly from that seen in the elderly, with arrhythmogenic disorders, cardiomyopathies and congenital anomalies playing a relatively larger role.
Lifestyle risk factors were prominent across both age groups. More than half of the young individuals who suffered sudden death were smokers, and over 50 per cent consumed alcohol, with a majority being regular users.
While traditional comorbidities such as diabetes and hypertension were less common in the young compared to older individuals, their presence was still documented in a small but significant proportion.
The analysis also revealed that sudden deaths occurred across all seasons, with a slight clustering during autumn and winter months.
Around 40 per cent of deaths took place at night or in the early morning hours, and more than half occurred at home. Sudden loss of consciousness was the most frequently reported symptom preceding death, followed by chest pain, breathlessness and gastrointestinal complaints.
Despite detailed autopsy examinations, the study found that nearly one-third of sudden deaths remained unexplained, categorised as sudden unexplained deaths.
The authors emphasised that incorporating molecular autopsy and post-mortem genetic testing could significantly improve diagnostic accuracy in such cases.
The study further pointed out that many sudden deaths in young individuals are not subjected to autopsy due to administrative hurdles and a lack of awareness, resulting in gaps in national data.
Researchers stressed the need for systematic investigation, better surveillance and preventive strategies to address the growing burden of sudden death among young adults in India. (ANI)
