Contributo para o estudo das plantas vasculares endémicas da Ilha das Flores (Açores).

IV Expedição Científica do Departamento de Biologia – Flores 1989.Conforme mostra MALATO-BELIZ (1988), o número de taxa vasculares endémicos nas ilhas dos Açores varia entre um máximo de 62 taxa (ilha de S. Miguel) e um mínimo de 11 taxa endémicos na ilha Graciosa. A pequena ilha das Flores com 51 taxa endémicos ultrapassa claramente neste particular as ilhas Graciosa (11), S. Maria (35) e Corvo (37) e quase iguala em número de espécies endémicas ilhas bastante maiores como a Terceira (55) e o Faial (55). Não admira pois que em termos da relação "nº taxa endémicos/unidade de superfície (Km2)" a ilha das Flores com 0,357 end./Km2, apenas seja ultrapassada por S. Maria (0,360 end./ Km2) e pelo Corvo (2,126 end./Km2), 0 valor médio para o arquipélago situa-se apenas nos 0,184 end./Km2. A explicação para esta relativa riqueza em espécies endémicas da ilha das Flores fica sem dúvida a dever-se à grande diversidade de biótopos que ela possui e à existência de algumas manchas vegetais menos alteradas pelo homem

Infectious laryngotracheitis virus: detection and molecular characterization, isolation, differential diagnosis and epidemiology of an outbreak in commercial layer flocks in Bastos region, São Paulo State

O presente trabalho descreve o desenvolvimento de uma técnica de nested-PCR para a detecção de ADN do vírus da laringotraqueíte infecciosa (VLTI) utilizando primers que amplificam uma região do gene que codifica a glicoproteína E viral. A técnica padronizada amplificou amostras isoladas e de campo, mostrando alta sensibilidade e especificidade tomando o isolamento em ovos embrionados SPF como técnica de referência. O seqüenciamento de uma amostra positiva por nested-PCR confirmou a identidade do produto amplificado. Foram submetidas a nested-PCR padronizada amostras de traquéia, pulmão e conjuntiva de 51 granjas de poedeiras comerciais procedentes da região de Bastos, Estado de São Paulo, que apresentou um surto caracterizado por sinais respiratórios, queda na produção de ovos e aumento da mortalidade. Vinte e três granjas foram positivas a nested-PCR e vinte e duas amostras foram isoladas. Considerando os resultados das duas técnicas, vinte e quatro granjas resultaram positivas. Não foram detectados os vírus das doenças de Newcastle, pneumovirose aviaria, nem Mycoplasma gallisepticum. O vírus da bronquite infecciosa das galinhas foi detectado em uma granja, e Mycoplasma synoviae em oito. A alta freqüência de ocorrência do VLTI, a alta concordância entre o quadro clínico observado e detecção do VLTI e o resultados do diagnóstico diferencial demonstram que o VLTI foi o agente etiológico causador de um surto de doença respiratória observado na região de Bastos, Estado de São Paulo.The present work describes the development of a nested-PCR technique for the detection of Infectious laryngotracheitis virus (ILTV) DNA using primers to amplify a region that encodes the glycoprotein E. The standardized technique amplified isolated and from clinical strains, offering high sensitivity and specificity, using the isolation in SPF chicken embryos such as reference test. The identity of the amplified product of the nested-PCR was confirmed by DNA sequencing. Trachea, lung and conjunctiva samples from fifty-one commercial layer farms from Bastos region, São Paulo State, which showed an outbreak characterized by respiratory signs, decreased egg production and increased mortality, were tested by the standardized nested-PCR. Twenty-three farms were positive by nested-PCR and samples of twenty-two farms were isolated. Twenty-four farms were positives when the results of both techniques were considered. Newcastle disease virus, Avian Pneumovirus and Mycoplasma gallisepticum were not detected. Infectious bronchitis virus was detected in one farm and Mycoplasma synoviae was detected in eight farms. The high frequency of occurrence of ILTV, the high agreement between clinical signs observed and ILTV detection and the results of differential diagnosis demonstrate that ILTV was the etiological agent of an outbreak respiratory disease observed in Bastos region, São Paulo State

Molecular epidemiology of Infectious laryngotracheitis vírus isolated from an outbreak in commercial layer flocks in São Paulo State

Este estudo teve como objetivo detectar e caracterizar molecularmente isolados de campo do vírus da laringotraqueíte infecciosa (VLTI) detectados de aves comerciais com e sem sintomatologia da doença de diferentes regiões do Estado de São Paulo. O estudo incluiu amostras coletadas durante e após o primeiro surto epidêmico da laringotraqueíte infecciosa (LTI) no Brasil, região de Bastos, e de outras localidades durante o período de 2002-2008. A caracterização molecular foi realizada através da técnica de polimorfismo do comprimento de fragmentos de restrição (RFLP) de produtos da reação em cadeia pela polimerase (PCR) dos genes da glicoproteína E, G, proteína quinase (TK) e da proteína reguladora da transcrição (ICP4), assim como pela análise de seqüências dos genes TK e ICP4. Para seqüenciamento do gene ICP4 foram desenvolvidas duas reações de PCR que amplificam dois diferentes fragmentos do gene ICP4. As técnicas de PCR-RFLP e seqüenciamento de DNA mostraram resultados idênticos, diferenciando os isolados de campo das cepas vacinais de origem de cultivo celular (TCO) e de embrião de galinha (CEO). Os resultados mostraram que o surto clínico na região de Bastos foi causado por uma cepa não vacinal e de alta virulência (cepa Bastos), embora também tenha sido possível detectar dois isolados relacionados à cepa CEO circulando durante o surto. Verificou-se que a cepa causadora do surto severo na região de Bastos continua circulando na região apesar do uso de vacinas atenuadas. Além disso, foram isoladas amostras relacionadas às cepas CEO e à cepa Bastos apartir de granjas comerciais de poedeiras localizadas fora da região de Bastos e que estão envolvidas em quadros clínicos da doença. Este estudo mostra (1): a persistência do vírus selvagem de campo na região de Bastos (cepa Bastos) apesar das medidas de controle e do uso de vacinas atenuadas, (2): a disseminação da cepa Bastos e das cepas vacinais CEO para outras regiões, e (3): a eficacia da estratégia padronizada neste estudo para a caracterização e diferenciação de isolados de campo e de cepas vacinais.The objective of this study was the molecular detection and characterization of field isolates of infectious laryngotracheitis virus (ILTV) detected from commercial chickens with and without clinical signs of the disease from regions of the São Paulo state. The study included samples collected during and after of the first epidemic infectious laryngotracheitis (ILT) outbreak in Brazil, Bastos region, and from other regions during 2002-2008. The molecular characterization was developed by restriction fragment length polymorphic analysis (RFLP) of polymerase chain reaction (PCR) products of glycoprotein E, G, thymidine kinase (TK) and regulatory protein of transcription (ICP4) gene, and by sequence analysis of TK and ICP4 gene. For ICP4 gene sequencing, two PCR assays have been developed for amplification of two different fragments of ICP4 gene. The PCR-RFLP and DNA sequencing techniques showed identical results, they could differentiate the field isolates from vaccine strains, tissue culture origin (TCO) and chicken embryo origin (CEO). The results showed that the severe outbreak in Bastos region was caused by a non-vaccine and virulent strain (Bastos strain); however it was possible to detect two isolates closely related to the CEO vaccine strain circulating during the outbreak. This study showed that the strain, which it caused the severe outbreak in Bastos region continue circulating in these region despite of the use of attenuate vaccines. In addition, the present research showed that isolates related to CEO and Bastos strains are circulating in commercial layer flocks located outside the Bastos region, and were involving in clinical cases of the disease. This study shows (1) the persistence of the wild field strain in Bastos region (Bastos strain) despite of the control measures and the use of attenuate vaccines, (2) the dissemination of the Bastos and CEO strains to other regions, and (3) the efficacy of the strategy standardized in this study to characterization and differentiation of field isolates and vaccine strain

Infectious laryngotracheitis virus: detection and molecular characterization, isolation, differential diagnosis and epidemiology of an outbreak in commercial layer flocks in Bastos region, São Paulo State

O presente trabalho descreve o desenvolvimento de uma técnica de nested-PCR para a detecção de ADN do vírus da laringotraqueíte infecciosa (VLTI) utilizando primers que amplificam uma região do gene que codifica a glicoproteína E viral. A técnica padronizada amplificou amostras isoladas e de campo, mostrando alta sensibilidade e especificidade tomando o isolamento em ovos embrionados SPF como técnica de referência. O seqüenciamento de uma amostra positiva por nested-PCR confirmou a identidade do produto amplificado. Foram submetidas a nested-PCR padronizada amostras de traquéia, pulmão e conjuntiva de 51 granjas de poedeiras comerciais procedentes da região de Bastos, Estado de São Paulo, que apresentou um surto caracterizado por sinais respiratórios, queda na produção de ovos e aumento da mortalidade. Vinte e três granjas foram positivas a nested-PCR e vinte e duas amostras foram isoladas. Considerando os resultados das duas técnicas, vinte e quatro granjas resultaram positivas. Não foram detectados os vírus das doenças de Newcastle, pneumovirose aviaria, nem Mycoplasma gallisepticum. O vírus da bronquite infecciosa das galinhas foi detectado em uma granja, e Mycoplasma synoviae em oito. A alta freqüência de ocorrência do VLTI, a alta concordância entre o quadro clínico observado e detecção do VLTI e o resultados do diagnóstico diferencial demonstram que o VLTI foi o agente etiológico causador de um surto de doença respiratória observado na região de Bastos, Estado de São Paulo.The present work describes the development of a nested-PCR technique for the detection of Infectious laryngotracheitis virus (ILTV) DNA using primers to amplify a region that encodes the glycoprotein E. The standardized technique amplified isolated and from clinical strains, offering high sensitivity and specificity, using the isolation in SPF chicken embryos such as reference test. The identity of the amplified product of the nested-PCR was confirmed by DNA sequencing. Trachea, lung and conjunctiva samples from fifty-one commercial layer farms from Bastos region, São Paulo State, which showed an outbreak characterized by respiratory signs, decreased egg production and increased mortality, were tested by the standardized nested-PCR. Twenty-three farms were positive by nested-PCR and samples of twenty-two farms were isolated. Twenty-four farms were positives when the results of both techniques were considered. Newcastle disease virus, Avian Pneumovirus and Mycoplasma gallisepticum were not detected. Infectious bronchitis virus was detected in one farm and Mycoplasma synoviae was detected in eight farms. The high frequency of occurrence of ILTV, the high agreement between clinical signs observed and ILTV detection and the results of differential diagnosis demonstrate that ILTV was the etiological agent of an outbreak respiratory disease observed in Bastos region, São Paulo State

Molecular epidemiology of Infectious laryngotracheitis vírus isolated from an outbreak in commercial layer flocks in São Paulo State

Este estudo teve como objetivo detectar e caracterizar molecularmente isolados de campo do vírus da laringotraqueíte infecciosa (VLTI) detectados de aves comerciais com e sem sintomatologia da doença de diferentes regiões do Estado de São Paulo. O estudo incluiu amostras coletadas durante e após o primeiro surto epidêmico da laringotraqueíte infecciosa (LTI) no Brasil, região de Bastos, e de outras localidades durante o período de 2002-2008. A caracterização molecular foi realizada através da técnica de polimorfismo do comprimento de fragmentos de restrição (RFLP) de produtos da reação em cadeia pela polimerase (PCR) dos genes da glicoproteína E, G, proteína quinase (TK) e da proteína reguladora da transcrição (ICP4), assim como pela análise de seqüências dos genes TK e ICP4. Para seqüenciamento do gene ICP4 foram desenvolvidas duas reações de PCR que amplificam dois diferentes fragmentos do gene ICP4. As técnicas de PCR-RFLP e seqüenciamento de DNA mostraram resultados idênticos, diferenciando os isolados de campo das cepas vacinais de origem de cultivo celular (TCO) e de embrião de galinha (CEO). Os resultados mostraram que o surto clínico na região de Bastos foi causado por uma cepa não vacinal e de alta virulência (cepa Bastos), embora também tenha sido possível detectar dois isolados relacionados à cepa CEO circulando durante o surto. Verificou-se que a cepa causadora do surto severo na região de Bastos continua circulando na região apesar do uso de vacinas atenuadas. Além disso, foram isoladas amostras relacionadas às cepas CEO e à cepa Bastos apartir de granjas comerciais de poedeiras localizadas fora da região de Bastos e que estão envolvidas em quadros clínicos da doença. Este estudo mostra (1): a persistência do vírus selvagem de campo na região de Bastos (cepa Bastos) apesar das medidas de controle e do uso de vacinas atenuadas, (2): a disseminação da cepa Bastos e das cepas vacinais CEO para outras regiões, e (3): a eficacia da estratégia padronizada neste estudo para a caracterização e diferenciação de isolados de campo e de cepas vacinais.The objective of this study was the molecular detection and characterization of field isolates of infectious laryngotracheitis virus (ILTV) detected from commercial chickens with and without clinical signs of the disease from regions of the São Paulo state. The study included samples collected during and after of the first epidemic infectious laryngotracheitis (ILT) outbreak in Brazil, Bastos region, and from other regions during 2002-2008. The molecular characterization was developed by restriction fragment length polymorphic analysis (RFLP) of polymerase chain reaction (PCR) products of glycoprotein E, G, thymidine kinase (TK) and regulatory protein of transcription (ICP4) gene, and by sequence analysis of TK and ICP4 gene. For ICP4 gene sequencing, two PCR assays have been developed for amplification of two different fragments of ICP4 gene. The PCR-RFLP and DNA sequencing techniques showed identical results, they could differentiate the field isolates from vaccine strains, tissue culture origin (TCO) and chicken embryo origin (CEO). The results showed that the severe outbreak in Bastos region was caused by a non-vaccine and virulent strain (Bastos strain); however it was possible to detect two isolates closely related to the CEO vaccine strain circulating during the outbreak. This study showed that the strain, which it caused the severe outbreak in Bastos region continue circulating in these region despite of the use of attenuate vaccines. In addition, the present research showed that isolates related to CEO and Bastos strains are circulating in commercial layer flocks located outside the Bastos region, and were involving in clinical cases of the disease. This study shows (1) the persistence of the wild field strain in Bastos region (Bastos strain) despite of the control measures and the use of attenuate vaccines, (2) the dissemination of the Bastos and CEO strains to other regions, and (3) the efficacy of the strategy standardized in this study to characterization and differentiation of field isolates and vaccine strain

Consenso colombiano de expertos sobre recomendaciones informadas en la evidencia para la prevención, diagnóstico y manejo de infección por SARS-CoV-2/COVID-19 en pacientes con Enfermedad Renal Crónica en diálisis

La declaración de pandemia por parte de la Organización Mundial de la Salud (OMS) a causa del virus SARS-CoV-2 es un problema de salud pública sin precedentes para la humanidad con gran impacto en la calidad de vida, morbimortalidad y sostenibilidad para todos los sistemas de salud a nivel global. Las personas con diálisis de mantenimiento se consideran una población de alto riesgo  de infección por SARS CoV2, en virtud de las implicaciones que suponen la  multimorbilidad  y las condiciones asociadas al envejecimiento. La periodicidad de la diálisis, la necesidad de viajar con frecuencia a las unidades de diálisis, el contacto comunitario, la agrupación inevitable de pacientes durante los turnos de diálisis, además del impacto humano, social y económico de la pandemia aumentan aún más el riesgo de transmisión viral. En Colombia se reportan más de 3.000 casos de enfermedad renal en niños y cerca de 40 mil personas en estadio 5 o con requerimiento de terapia remplazo renal, de las cuales, aproximadamente 56% corresponden a adultos mayores de 60 años con dos o más comorbilidades (1). Por lo tanto,  la Asociación Colombiana de Nefrología e Hipertensión Arterial y la Asociación de Nefrología Pediátrica conscientes de la responsabilidad académica y científica y alineados con la propuesta del consenso nacional (2),  generamos a través del Comité de Gestión de Conocimiento una  convocatoria multidisciplinaria de expertos, con el fin de desarrollar mediante un consenso multidisciplinario de expertos,  recomendaciones informadas en evidencia  para la prevención, diagnóstico y manejo de infección por SARS CoV2/COVID-19, generando un estándar colombiano que permita orientar la toma de decisiones clínicas y estratégicas en el cuidado centrado en las personas con enfermedad renal crónica, aportando con rigurosidad y pragmatismo en los aspectos de  impacto en la gestión de la población de alto riesgo, los cuales no están cubiertos en profundidad en las recomendaciones nacionales

Consenso colombiano de expertos sobre recomendaciones informadas en la evidencia para la prevención, el diagnóstico y el manejo de la lesión renal aguda por SARS-CoV-2/COVID-19

Introduction: Acute kidney injury is a frequent complication in patients with COVID-19 and its occurrence is a potential indicator of multi-organ dysfunction and disease severity. Objective: Develop, through an expert consensus, evidence-based recommendations for the prevention, diagnosis, and management of acute kidney injury in patients with SARS CoV2 / COVID-19 infection. Materials and methods: Based on a rapid systematic review in Embase and Pubmed databases and documents from scientific societies, we made preliminary recommendations and consulted with an expert group through an online tool. Then we defined agreement after at least 70 % consensus approval. Quality evidence was evaluated according to the type of document included. The strength of the recommendations was graded as strong or weak. Results: Fifty clinical experts declared their conflict of interest; the consultation took place between May 24 and 29, 2020. The range of agreement ranged from 75.5 % to 100 %. Recommendations for prevention, diagnosis and management of acute kidney injury in patients with SARS CoV2 infection are presented. Conclusions: Although the good quality information available regarding acute kidney injury in patients with COVID-19 is scarce, the recommendations of clinical experts will guide clinical decision-making and strategies around patients with this complication, guaranteeing care focused on the people, with high quality standards, and the generation of safety, health and wellness policies for multidisciplinary care teams.Introducción: la lesión renal aguda es una complicación frecuente en pacientes con COVID-19 y su aparición es un potencial indicador de disfunción multiorgánica y de gravedad de la enfermedad. Objetivo: desarrollar, mediante un consenso de expertos, recomendaciones para la prevención, el diagnóstico y el manejo de la lesión renal aguda en pacientes con infección por SARS-CoV-2/COVID-19 con base en la evidencia disponible. Materiales y métodos: a partir de una rápida revisión sistemática en las bases de datos EMBASE y PubMed y en los portales de algunas sociedades científicas, se formularon recomendaciones preliminares, las cuales fueron consultadas a un colectivo experto a través de una herramienta en línea. Se definió acuerdo respecto a las recomendaciones cuando se obtuvo aprobación en al menos el 70 %. La calidad de la evidencia se evalúo de acuerdo con el tipo de documento incluido y la fuerza de las recomendaciones se clasificó como fuerte o débil. Resultados: la consulta al colectivo de expertos tuvo lugar entre el 24 y 29 de mayo de 2020. El rango de acuerdo osciló entre 75,5 % y 100 % y 50 expertos clínicos declararon su conflicto de interés. Se lograron establecer recomendaciones para prevenir, diagnosticar y manejar la lesión renal aguda en pacientes con infección por SARS CoV2/COVID-19. Conclusiones: aunque la información disponible de buena calidad respecto a lesión renal aguda en paciente con COVID-19 es escasa, las recomendaciones aquí presentadas permitirán orientar la toma de decisiones clínicas y estratégicas alrededor de pacientes con esta complicación; de igual forma se garantizará un cuidado centrado en las personas y con altos estándares de calidad, y la generación de políticas de seguridad, salud y bienestar para los equipos multidisciplinarios de atención

II Congreso de Educación: UNA nueva mirada en la mediación pedagógica

Memoria incluye las ponencias presentadas en el II Congreso de Educación, celebrado en Sede Chorotega, 2019El acto de educar requiere de escenarios educativos propicios, para la construcción del conocimiento y el desarrollo de valores humanos, donde la emoción y los pensamientos de cada ser humano son fundamentales. Si las emociones y sentimientos provocan cambios estructurales, químicos, energéticos y neuronales esta debe visibilizarse en el aula. La química del aprendizaje debe estar presente en todo momento; de modo que, se deben estimular todas las áreas que conforman el cerebro. Por ello, el educador debe promover ambientes que fomenten distintas vivencias, con el fin de lograr la interacción entre la mente y el cuerpo del aprendiente, así como, la relación de este con el resto de sus iguales. Es el momento, de atender la problemática generalizada de la desmotivación del alumnado, es la hora de reencantar la educación, de nutrir el pensamiento, los sentimientos y la correcta aplicación de los aprendizajes, es la hora de hacer vibrar el alma y los corazones de los aprendientes. En este sentido, las aulas son el lugar perfecto, para la interacción, es ahí en donde el educador tiene la plena conciencia de quién y cómo es cada aprendiente, es en ese recinto, en donde es más fácil comprender a ese ser humano en su totalidad. Esto, le permite ayudarlo a desarrollar mejor sus potencialidades, sus talentos, sus competencias y sus habilidades, para que, como un Ser pleno, durante el proceso educativo, desarrolle actos de amor; además, de valores tales como la solidaridad y la colaboración, acciones que le permiten alcanzar la finalidad de la existencia humana, que es encontrar prolongados estados de bienestar y felicidad.Universidad NacionalUniversidad Naciona

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

BackgroundEstimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period.Methods22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution.FindingsGlobal all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations.InterpretationGlobal adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic