Mamas Mamas m.mamas@keele.ac.uk
Place and causes of acute cardiovascular mortality during the COVID-19 pandemic
Mamas
Authors
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.
Acceptance Date | Sep 3, 2020 |
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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 |
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