1. Place and causes of acute cardiovascular mortality during the COVID-19 pandemic.
- Author
-
Wu J, Mamas MA, Mohamed MO, Kwok CS, Roebuck C, Humberstone B, Denwood T, Luescher T, de Belder MA, Deanfield JE, and Gale CP
- Subjects
- Adult, Aged, Aged, 80 and over, Causality, England epidemiology, Female, Hospitalization statistics & numerical data, Humans, Male, Middle Aged, Outcome and Process Assessment, Health Care, Residence Characteristics statistics & numerical data, Retrospective Studies, SARS-CoV-2 isolation & purification, Acute Coronary Syndrome etiology, Acute Coronary Syndrome mortality, COVID-19 diagnosis, COVID-19 epidemiology, Cause of Death, Mortality trends, Stroke etiology, Stroke mortality
- Abstract
Objective: To describe the place and causes of acute cardiovascular death during the COVID-19 pandemic., Methods: Retrospective cohort of adult (age ≥18 years) acute cardiovascular deaths (n=5 87 225) in England and Wales, from 1 January 2014 to 30 June 2020. The exposure was the COVID-19 pandemic (from onset of the first COVID-19 death in England, 2 March 2020). The main outcome was acute cardiovascular events directly contributing to death., Results: After 2 March 2020, there were 28 969 acute cardiovascular deaths of which 5.1% related to COVID-19, and an excess acute cardiovascular mortality of 2085 (+8%). Deaths in the community accounted for nearly half of all deaths during this period. Death at home had the greatest excess acute cardiovascular deaths (2279, +35%), followed by deaths at care homes and hospices (1095, +32%) and in hospital (50, +0%). The most frequent cause of acute cardiovascular death during this period was stroke (10 318, 35.6%), followed by acute coronary syndrome (ACS) (7 098, 24.5%), heart failure (6 770, 23.4%), pulmonary embolism (2 689, 9.3%) and cardiac arrest (1 328, 4.6%). The greatest cause of excess cardiovascular death in care homes and hospices was stroke (715, +39%), compared with ACS (768, +41%) at home and cardiogenic shock (55, +15%) in hospital., Conclusions and Relevance: The COVID-19 pandemic has resulted in an inflation in acute cardiovascular deaths, nearly half of which occurred in the community and most did not relate to COVID-19 infection suggesting there were delays to seeking help or likely the result of undiagnosed COVID-19., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2021
- Full Text
- View/download PDF