Changes in cardiovascular mortality in Chile during the COVID-19 pandemic

Chang, Shin-Tsu; Zitko, Pedro; Passi-Solar, Álvaro; Danaei, Goodarz; Margozzini, Paula

doi:10.1136/heartjnl-2021-320082

Cited by 8 publications

(6 citation statements)

References 30 publications

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“…The length of the data series used for each method was also based on that generally used by researchers using these approaches. Recently published papers on the topic have, in fact, quantified excess deaths by estimating expected mortality in 2020 by using a simple average of the previous years as a reference [7-9] or more sophisticated approaches, including average standardized mortality rates [10,11], the SARIMA [12] and GEE models [13,14], as well as other methodologies [21][22][23][24][25][26]. COVID-19 has affected mortality in different aspects and at different times, thus disentangling this effect from the distortion introduced by the application of different methods can be complex [2].…”

Section: Discussionmentioning

confidence: 99%

Estimating Overall and Cause-Specific Excess Mortality during the COVID-19 Pandemic: Methodological Approaches Compared

Amidei

Fedeli

Gennaro

et al. 2023

IJERPH

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During the COVID-19 pandemic, excess mortality has been reported worldwide, but its magnitude has varied depending on methodological differences that hinder between-study comparability. Our aim was to estimate variability attributable to different methods, focusing on specific causes of death with different pre-pandemic trends. Monthly mortality figures observed in 2020 in the Veneto Region (Italy) were compared with those forecasted using: (1) 2018–2019 monthly average number of deaths; (2) 2015–2019 monthly average age-standardized mortality rates; (3) Seasonal Autoregressive Integrated Moving Average (SARIMA) models; (4) Generalized Estimating Equations (GEE) models. We analyzed deaths due to all-causes, circulatory diseases, cancer, and neurologic/mental disorders. Excess all-cause mortality estimates in 2020 across the four approaches were: +17.2% (2018–2019 average number of deaths), +9.5% (five-year average age-standardized rates), +15.2% (SARIMA), and +15.7% (GEE). For circulatory diseases (strong pre-pandemic decreasing trend), estimates were +7.1%, −4.4%, +8.4%, and +7.2%, respectively. Cancer mortality showed no relevant variations (ranging from −1.6% to −0.1%), except for the simple comparison of age-standardized mortality rates (−5.5%). The neurologic/mental disorders (with a pre-pandemic growing trend) estimated excess corresponded to +4.0%/+5.1% based on the first two approaches, while no major change could be detected based on the SARIMA and GEE models (−1.3%/+0.3%). The magnitude of excess mortality varied largely based on the methods applied to forecast mortality figures. The comparison with average age-standardized mortality rates in the previous five years diverged from the other approaches due to the lack of control over pre-existing trends. Differences across other methods were more limited, with GEE models probably representing the most versatile option.

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Section: Discussionmentioning

confidence: 99%

Estimating Overall and Cause-Specific Excess Mortality during the COVID-19 Pandemic: Methodological Approaches Compared

Amidei

Fedeli

Gennaro

et al. 2023

IJERPH

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“…Third, we know that in Chile, there was a sharp reduction in the supply of non-COVID related health care services. For example, [28] documents a 40% drop in new cases entering cardiovascular programs in the public health-care system as well as an increase in deaths from cardiovascular diseases [29]. This reduced supply appears to have affected more the older population.…”

Section: Plos Onementioning

confidence: 99%

The Impacts of COVID-19 Restrictions on Quality Adjusted Life Years (QALY): Heterogeneous effects and post-pandemic recovery

Atal,

Bedregal,

Carrasco

et al. 2024

PLoS ONE

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Objectives Estimate the effects of non-pharmacological interventions used to prevent the spread of COVID-19 on the quality of life, measured by Quality Adjusted Life Years (QALYs). Methods A survey on 1,506 heads of households from Chile in May of 2022. Respondents were asked basic socioeconomic questions and a version of the EQ-5D-5L questionnaire that was used to calculate the evolution of HRQoLs. Comparisons of means in HRQoLs measures before the pandemic, at the peak of restrictions, and at the moment of the survey were performed. Results The average HRQoL of the population before the pandemic was similar to other countries in the region (0.96). At the peak of restrictions (June 2020–August 2021), the average HRQoL decreased to 0.87 (-9%). At the time of survey (May 2022), the average HQRoL was 0.91 (4%). Assuming the recovery trend continued, pre-pandemic HRQoLs would be reached by January 2024. Altogether, the pandemic would have reduced QALYs by 0.2 in average. The effect is larger and the recovery slower among women. Our estimates imply that the restrictions to manage the pandemic came at a cost of 2.4 months of life years for the average (surviving) person, 1.8 months for men and 3.4 for women. Conclusions Our results suggest that COVID-19 had worse effects on life quality than previously thought. These effects are more significant among women than among men. Efforts to improve life quality and speed up its recovery could have large positive consequences for the population.

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“…In Nepal, worsening health outcomes among older adults with pre-existing conditions have been reported in part due to significant difficulties in obtaining medications during lockdowns [40]. In Chile, important indirect effects on cardiovascular mortality were reported and were found to be inequitably distributed between women and men [41]. In a study across 15 countries, more stringent COVID containment policies were associated with more psychological distress [42].…”

Section: Estimatementioning

confidence: 99%

Associations between the stringency of COVID-19 containment policies and health service disruptions in 10 countries

Reddy

Kapoor

Kubota³

et al. 2023

BMC Health Serv Res

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Background Disruptions in essential health services during the COVID-19 pandemic have been reported in several countries. Yet, patterns in health service disruption according to country responses remain unclear. In this paper, we investigate associations between the stringency of COVID-19 containment policies and disruptions in 31 health services in 10 low- middle- and high-income countries in 2020. Methods Using routine health information systems and administrative data from 10 countries (Chile, Ethiopia, Ghana, Haiti, Lao People’s Democratic Republic, Mexico, Nepal, South Africa, South Korea, and Thailand) we estimated health service disruptions for the period of April to December 2020 by dividing monthly service provision at national levels by the average service provision in the 15 months pre-COVID (January 2019-March 2020). We used the Oxford COVID-19 Government Response Tracker (OxCGRT) index and multi-level linear regression analyses to assess associations between the stringency of restrictions and health service disruptions over nine months. We extended the analysis by examining associations between 11 individual containment or closure policies and health service disruptions. Models were adjusted for COVID caseload, health service category and country GDP and included robust standard errors. Findings Chronic disease care was among the most affected services. Regression analyses revealed that a 10% increase in the mean stringency index was associated with a 3.3 percentage-point (95% CI -3.9, -2.7) reduction in relative service volumes. Among individual policies, curfews, and the presence of a state of emergency, had the largest coefficients and were associated with 14.1 (95% CI -19.6, 8.7) and 10.7 (95% CI -12.7, -8.7) percentage-point lower relative service volumes, respectively. In contrast, number of COVID-19 cases in 2020 was not associated with health service disruptions in any model. Conclusions Although containment policies were crucial in reducing COVID-19 mortality in many contexts, it is important to consider the indirect effects of these restrictions. Strategies to improve the resilience of health systems should be designed to ensure that populations can continue accessing essential health care despite the presence of containment policies during future infectious disease outbreaks.

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Changes in cardiovascular mortality in Chile during the COVID-19 pandemic

Cited by 8 publications

References 30 publications

Estimating Overall and Cause-Specific Excess Mortality during the COVID-19 Pandemic: Methodological Approaches Compared

Estimating Overall and Cause-Specific Excess Mortality during the COVID-19 Pandemic: Methodological Approaches Compared

The Impacts of COVID-19 Restrictions on Quality Adjusted Life Years (QALY): Heterogeneous effects and post-pandemic recovery

Associations between the stringency of COVID-19 containment policies and health service disruptions in 10 countries

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