Cardiovascular Deaths During the COVID-19 Pandemic in the United States,Journal of the American College of Cardiology

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Cardiovascular Deaths During the COVID-19 Pandemic in the United States
Journal of the American College of Cardiology ( IF 21.7 ) Pub Date : 2021-01-01 , DOI: 10.1016/j.jacc.2020.10.055
Rishi K Wadhera ₁ , Changyu Shen ₁ , Suhas Gondi ₁ , Siyan Chen ₁ , Dhruv S Kazi ₁ , Robert W Yeh ₁

Affiliation

Background Although the direct toll of COVID-19 in the United States has been substantial, concerns have also arisen about the indirect effects of the pandemic. Hospitalizations for acute cardiovascular conditions have declined, raising concern that patients may be avoiding hospitals because of fear of contracting severe acute respiratory syndrome- coronavirus-2 (SARS-CoV-2). Other factors, including strain on health care systems, may also have had an indirect toll. Objectives This investigation aimed to evaluate whether population-level deaths due to cardiovascular causes increased during the COVID-19 pandemic. Methods The authors conducted an observational cohort study using data from the National Center for Health Statistics to evaluate the rate of deaths due to cardiovascular causes after the onset of the pandemic in the United States, from March 18, 2020, to June 2, 2020, relative to the period immediately preceding the pandemic (January 1, 2020 to March 17, 2020). Changes in deaths were compared with the same periods in the previous year. Results There were 397,042 cardiovascular deaths from January 1, 2020, to June 2, 2020. Deaths caused by ischemic heart disease increased nationally after the onset of the pandemic in 2020, compared with changes over the same period in 2019 (ratio of the relative change in deaths per 100,000 in 2020 vs. 2019: 1.11, 95% confidence interval: 1.04 to 1.18). An increase was also observed for deaths caused by hypertensive disease (1.17, 95% confidence interval: 1.09 to 1.26), but not for heart failure, cerebrovascular disease, or other diseases of the circulatory system. New York City experienced a large relative increase in deaths caused by ischemic heart disease (2.39, 95% confidence interval: 1.39 to 4.09) and hypertensive diseases (2.64, 95% confidence interval: 1.52 to 4.56) during the pandemic. More modest increases in deaths caused by these conditions occurred in the remainder of New York State, New Jersey, Michigan, and Illinois but not in Massachusetts or Louisiana. Conclusions There was an increase in deaths caused by ischemic heart disease and hypertensive diseases in some regions of the United States during the initial phase of the COVID-19 pandemic. These findings suggest that the pandemic may have had an indirect toll on patients with cardiovascular disease.

中文翻译：

美国 COVID-19 大流行期间的心血管死亡人数

背景尽管 COVID-19 在美国造成的直接死亡人数相当可观，但人们也开始担心这一流行病的间接影响。因急性心血管疾病住院的人数有所下降，这引发了人们的担忧，即患者可能因为担心感染严重急性呼吸系统综合症-冠状病毒-2 (SARS-CoV-2)而避免去医院。其他因素，包括医疗保健系统的压力，也可能造成间接损失。目的本调查旨在评估在 COVID-19 大流行期间，因心血管原因导致的人口死亡是否有所增加。方法作者利用国家卫生统计中心的数据进行了一项观察性队列研究，以评估美国大流行爆发后2020年3月18日至2020年6月2日期间因心血管原因导致的死亡率。相对于大流行之前的时期（2020年1月1日至2020年3月17日）。死亡人数变化与上年同期相比。结果 2020年1月1日至2020年6月2日，心血管疾病死亡人数为397,042人。2020年疫情爆发后，全国范围内缺血性心脏病死亡人数较2019年同期有所上升（相对变化率2020 年与 2019 年每 10 万人的死亡人数：1.11，95% 置信区间：1.04 至 1.18）。高血压疾病导致的死亡人数也有所增加（1.17，95%置信区间：1.09至1.26），但心力衰竭、脑血管疾病或其他循环系统疾病则没有增加。纽约市因缺血性心脏病导致的死亡人数相对大幅增加（2.39，95% 置信区间：1.39 至 4。09）和大流行期间的高血压疾病（2.64，95%置信区间：1.52至4.56）。纽约州、新泽西州、密歇根州和伊利诺伊州其他地区因这些情况造成的死亡人数增幅较小，但马萨诸塞州和路易斯安那州则不然。结论在 COVID-19 大流行初期，美国部分地区因缺血性心脏病和高血压疾病导致的死亡人数有所增加。这些发现表明，大流行可能对心血管疾病患者造成了间接损失。

更新日期：2021-01-01

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