Examining Disparities and Excess Cardiovascular Mortality Before and During the COVID-19 Pandemic

Janus, Scott E.; Makhlouf, Mohamed H.E.; Chahine, Nicole; Motairek, Issam; Al‐Kindi, Sadeer G.

doi:10.1016/j.mayocp.2022.07.008

Cited by 20 publications

(10 citation statements)

References 21 publications

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“…Our findings revealed higher mortality from diseases of the circulatory system in the non-Hispanic African American/Black population than other racial and ethnic groups for residents 35 to 84 years of age (Figure 1 ). This pattern has been seen nationally, with evidence that disparities in cardiovascular disease mortality were exacerbated during the COVID-19 pandemic [ 25 ], including a greater increase in cardiovascular mortality among the African American/Black population during the pandemic years compared to other race groups [ 25 - 26 ].…”

Section: Discussionmentioning

confidence: 98%

Life Expectancy and Causes of Premature Death by Subgroup for Community-Based Action in Marin County, California, 2017-2021

Soriano,

Prebil,

Hannah

et al. 2023

Cureus

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Introduction: Marin is a medium-sized county in California’s San Francisco Bay Area. Despite its historically higher-than-average life expectancy and socioeconomic level, known economic and health disparities by race, ethnicity, and geography became more visible during the COVID-19 pandemic. Methods: We calculated life expectancy, measured years of potential life lost (YPLLs), and described premature mortality for the five years of 2017-2021 by race, ethnicity, census tract, and resource level (as measured by Healthy Places Index [HPI]) to provide data on inequities to guide community-centered action to reduce premature mortality. Results: Life expectancy for the county was 85.2 years. The non-Hispanic African American/Black population experienced the lowest life expectancy of 77.1 years, 11.6 years lower than the non-Hispanic Asian population which had the highest life expectancy (88.7 years). There was a 14.9-year difference in life expectancy between the census tracts with the lowest (77.1 years) and highest (92.0 years) estimates. We found a moderate, positive association between census tract resource level (HPI) and life expectancy (r=0.58, p<0.01). The leading causes of premature death were cancer, diseases of the circulatory system, and accidental overdoses, with variation by subgroup. Conclusion: These data highlight health disparities that persist in Marin County and can inform data-driven public health strategies to narrow gaps in longevity between communities.

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Section: Discussionmentioning

confidence: 98%

Life Expectancy and Causes of Premature Death by Subgroup for Community-Based Action in Marin County, California, 2017-2021

Soriano,

Prebil,

Hannah

et al. 2023

Cureus

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“…In the early months of the pandemic, studies showed a significant increase in deaths from CVD compared to the same period in 2019 ( 14 ). Subsequently, other studies comparing cardiovascular mortality rates before and after the pandemic found significant increase in mortality and excess deaths despite 2 years since the onset of the pandemic ( 6 ). A recent study demonstrated elevated cardiovascular deaths persisted until early 2022 by characterizing trends in excess CVD deaths ( 15 ).…”

Section: Discussionmentioning

confidence: 98%

“…Ultimately, we chose to include data on cardiovascular disease-related deaths between January 1, 2010, and December 31, 2023, among adults aged no less than 25 years. As for the retrieval of causes of death, we opted International Statistical Classiﬁcation of Diseases, Tenth Revision (ICD-10) codes to identify the cause of death by CVD(I00-I99,diseases of the circulatory system) ( 6 ). Meanwhile, the corresponding ICD-10 code for COVID-19 was recognized as U07.1 which was classified under the codes for emergency use.…”

Section: Methodsmentioning

confidence: 99%

Impact of the COVID-19 pandemic on cardiovascular mortality and contrast analysis within subgroups

Song,

Guo,

et al. 2024

Front. Cardiovasc. Med.

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BackgroundAn increase in deaths has been perceived during the pandemic, which cannot be explained only by COVID-19. The actual number of deaths far exceeds the recorded data on deaths directly related to SARS-CoV-2 infection. Data from early and short-lived pandemic studies show a dramatic shift in cardiovascular mortality. Grounded in the post-pandemic era, macroscopic big data on cardiovascular mortality during the pandemic need to be further reviewed and studied, which is crucial for cardiovascular disease prevention and control.MethodsWe retrieved and collected data associated with cardiovascular disease mortality from the National Vital Statistic System from the Center for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) platform based on the ICD-10 codes. We applied regression analysis to characterize overall cardiovascular disease mortality trends from 2010 to 2023 and built a time series model to predict mortality for 2020–2023 based on mortality data from 2010 to 2019 in order to affirm the existence of the excess deaths by evaluating observed vs. predicted mortality. We also conducted subgroup analyses by sex, age and race/ethnicity for the purpose of obtaining more specific sociodemographic information.ResultsAll-cause age-standardised mortality rates (ASMRs) for CVD dramatically increased between 2019 and 2021[annual percentage change (APC) 11.27%, p < 0.01], and then decreased in the following 2021–2023(APC: −7.0%, p < 0.01). Subgroup analyses found that the ASMR change was most pronounced in Alaska Indians/Native American people (APC: 16.5% in 2019–2021, −12.5% in 2021–2023, both p < 0.01), Hispanics (APC: 12.1% in 2019–2021, −12.2% in 2021–2023, both p < 0.05) and non-Hispanic Black people (APC:11.8% in 2019–2021, −10.3% in 2021–2023, both p < 0.01)whether during the increasing or declining phase. Similarly, the ASMR change was particularly dramatic for the 25–44 age group (APC:19.8% in 2019–2021, −15.4% in 2021–2023, both p < 0.01) and males (APC: 11.5% in 2019–2021, −7.6% in 2021–2023, both p < 0.01). By the end of 2023, the proportion of COVID-related excess death remained high among the elderly (22.4%), males (42.8%) and Alaska Indians/Native American people(39.7%). In addition, we did not find the presence of excess deaths in the young (25–44) and middle-aged cohort (45–64) in 2023, while excess deaths remained persistent in the elderly.ConclusionsAll-cause ASMRs for CVD increased notably during the initial two years of the COVID-19 pandemic and then witnessed a decline in 2021–2023. The cohorts (the young, males and minorities) with the steepest rise in mortality decreased at the fastest rate instead. Previous initiatives to promote cardiovascular health were effective, but further research on cardiovascular healthcare for the elderly and racial disparities should be attached to priority considering the presence of sociodemographic differences in CVD death.

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“…While it was well understood that significant disparities existed in the delivery of cardiovascular care to certain racial, ethnic, and socioeconomic groups prior the pandemic, clear trends emerged early and persisted showing disproportionate cardiovascular morbidity and mortality during the pandemic, particularly among communities of color and historically marginalized groups. 175 , 176 The higher prevalence of both cardiovascular disease, as well as cardiovascular disease risk factors, in nonwhite populations has been well characterized. This, however, does not sufficiently explain why certain nonwhite populations (specifically Black, Hispanic, and Asians), experienced a 20% increase in cardiovascular death, while White individuals experienced only a 2% increase.…”

Section: Disparities In Cardiovascular Care During the Pandemicmentioning

confidence: 99%

Interaction of COVID-19 With Common Cardiovascular Disorders

Boulos

Freeman

Henry

et al. 2023

Circulation Research

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The onset and widespread dissemination of the severe acute respiratory syndrome coronavirus-2 in late 2019 impacted the world in a way not seen since the 1918 H1N1 pandemic, colloquially known as the Spanish Flu. Much like the Spanish Flu, which was observed to disproportionately impact young adults, it became clear in the early days of the coronavirus disease 2019 (COVID-19) pandemic that certain groups appeared to be at higher risk for severe illness once infected. One such group that immediately came to the forefront and garnered international attention was patients with preexisting cardiovascular disease. Here, we examine the available literature describing the interaction of COVID-19 with a myriad of cardiovascular conditions and diseases, paying particular attention to patients diagnosed with arrythmias, heart failure, and coronary artery disease. We further discuss the association of acute COVID-19 with de novo cardiovascular disease, including myocardial infarction due to coronary thrombosis, myocarditis, and new onset arrhythmias. We will evaluate various biochemical theories to explain these findings, including possible mechanisms of direct myocardial injury caused by the severe acute respiratory syndrome coronavirus-2 virus at the cellular level. Finally, we will discuss the strategies employed by numerous groups and governing bodies within the cardiovascular disease community to address the unprecedented challenges posed to the care of our most vulnerable patients, including heart transplant recipients, end-stage heart failure patients, and patients suffering from acute coronary syndromes, during the early days and height of the COVID-19 pandemic.

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Examining Disparities and Excess Cardiovascular Mortality Before and During the COVID-19 Pandemic

Cited by 20 publications

References 21 publications

Life Expectancy and Causes of Premature Death by Subgroup for Community-Based Action in Marin County, California, 2017-2021

Life Expectancy and Causes of Premature Death by Subgroup for Community-Based Action in Marin County, California, 2017-2021

Impact of the COVID-19 pandemic on cardiovascular mortality and contrast analysis within subgroups

Interaction of COVID-19 With Common Cardiovascular Disorders

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