Cardiovascular mortality during the COVID-19 pandemics in a large Brazilian city : a comprehensive analysis.
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Date
2022
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Abstract
Introduction: The impact of COVID-19 pandemics on cardiovascular diseases (CVD)
may be caused by health system reorganization and/or collapse, or from changes
in the behaviour of individuals. In Brazil, municipalities were empowered to define
regulatory measures, potentially resulting in diverse effects on CVD morbimortality.
Objective: To analyse the impact of COVID-19 pandemics on CVD outcomes in Belo
Horizonte (BH), the sixth greater capital city in Brazil, including: mortality, mortality at
home, hospitalizations, intensive care unit utilization, and in-hospital mortality; and the
differential effect according to sex, age range, social vulnerability, and pandemic’s phase.
Methods: Ecological study analysing data from the Mortality and Hospital Information
System of BH residents aged ≥30 years. CVD was defined as in Chapter IX from ICD-
10. Social vulnerability was classified by a composite socioeconomic index as high,
medium and low. The observed age-standardized rates for epidemiological weeks
10–48, 2020, were compared to the expected rates (mean of 2015–2019). Risk ratios
(RiR) were analysed and 95% confidence intervals were calculated for all estimates.
Population projected to 2020 for BH and its census tracts were used to calculate rates.
Results: We found no changes in CVD mortality rates (RiR 1.01, 95%CI 0.96–1.06). However,
CVD deaths occurred more at homes (RiR 1.32, 95%CI 1.20–1.46) than in hospitals (RiR
0.89, 95%CI 0.79–0.99), as a result of a substantial decline in hospitalization rates, even
though proportional in-hospital deaths increased. The rise in home deaths was greater
in older adults and in had an increasing gradient in those more socially vulnerable (RiR
1.45); for high (RiR 1.45), medium (RiR 1.32) and low vulnerability (RiR 1.21).
Conclusion: The greater occurrence of CVD deaths at home, in parallel with lower
hospitalization rates, suggests that CVD care was disrupted during the COVID-19
pandemics, which more adversely affected older and more socially vulnerable
individuals, exacerbating health inequities in BH.
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Keywords
Cardiovascular diseases, Hospitalization, Social vulnerability
Citation
BRANT, L. C. C. et al. Cardiovascular mortality during the COVID-19 pandemics in a large brazilian city: a comprehensive analysis. Global Heart, v. 17, n. 1, artigo e11, 2022. Disponível em: <https://globalheartjournal.com/article/10.5334/gh.1101/>. Acesso em: 11 out. 2022.