Place and causes of acute cardiovascular mortality during the COVID-19 pandemic

Mamas

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.

Citation

Mamas. (2021). Place and causes of acute cardiovascular mortality during the COVID-19 pandemic. Heart, 113-119. https://doi.org/10.1136/heartjnl-2020-317912

• Acceptance Date: Sep 3, 2020
• Publication Date: Jan 1, 2021
• Journal: Heart
• Print ISSN: 1355-6037
• Publisher: BMJ Publishing Group
• Pages: 113-119
• DOI: https://doi.org/10.1136/heartjnl-2020-317912
• Keywords: acute coronary syndromes, stroke
• Publisher URL: http://dx.doi.org/10.1136/heartjnl-2020-317912