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COVID-19 Pandemic: Global Impact and Potential Implications for Cardiovascular Disease in Canada
Leigh C P Botly1, Michelle Martin-Rhee1, Adrienne Kasiban1
1Heart and Stroke Foundation of Canada, Toronto, Ontario, Canada.
Insights
Higher COVID-19 case fatality rates (CFRs) are linked to increased cardiovascular disease (CVD) prevalence and older populations. This study highlights potential strain on Canadian health care resources due to COVID-19.
Area of Science:
- Public Health
- Epidemiology
- Health Services Research
Background:
- Cardiovascular disease (CVD), advanced age, and health care resource availability are known factors influencing COVID-19 case fatality rates (CFRs).
- The specific impact of COVID-19 CFRs on global CVD populations and potential consequences for health care access in Canada remain unclear.
- This study investigates factors affecting COVID-19 CFRs and estimates indirect effects on Canadian health care resources.
Purpose of the Study:
- To analyze the correlation between COVID-19 CFRs and population-level CVD prevalence, proportion of elderly individuals, and health care service availability.
- To estimate the potential indirect impact of COVID-19 on health care resource utilization in Canada, specifically focusing on surgical procedures.
- To explore the relationship between these factors and inform public health strategies.
Main Methods:
- Country-level epidemiological data were analyzed for correlations between COVID-19 CFRs and key demographic and health system indicators.
- The Universal Health Coverage index was used to assess health service availability.
- Estimates of postponed cardiovascular surgeries in Ontario were calculated to gauge indirect health care implications.
Main Results:
- Significant positive correlations were observed between COVID-19 CFRs and the prevalence of CVD (ρ=0.40, P=0.001), the proportion of the population aged 65+ (ρ=0.43, P=0.0005), and the Universal Health Coverage index (ρ=0.27, P=0.03).
- A 1% increase in the elderly population or CVD prevalence was associated with a 9% and 19% rise in COVID-19 CFRs, respectively.
- An estimated 1252 coronary artery bypass grafting, percutaneous coronary intervention, and valve surgeries may be postponed monthly in Ontario due to public health measures.
Conclusions:
- Higher COVID-19 case fatality rates are associated with greater prevalence of cardiovascular disease in a population.
- The findings suggest a significant potential strain on health care resources in Canada as a consequence of the COVID-19 pandemic.
- These results underscore the importance of considering population health status and health system capacity in pandemic response.
Background:
The literature indicates that cardiovascular disease (CVD; including stroke), older age, and availability of health care resources affect COVID-19 case fatality rates (CFRs). The cumulative effect of COVID-19 CFRs in global CVD populations and the extrapolated effect on access to health care services in the CVD population in Canada are not fully known. In this study we explored the relationships of factors that might affect COVID-19 CFRs and estimated the potential indirect effects of COVID-19 on Canadian health care resources.
Methods:
Country-level epidemiological data were analyzed to study the correlation, main effect, and interaction between COVID-19 CFRs and: (1) the proportion of the population with CVD; (2) the proportion of the population 65 years of age or older; and (3) the availability of essential health services as defined by the World Health Organization Universal Health Coverage index. For indirect implications on health care resources, estimates of the volume of postponed coronary artery bypass grafting, percutaneous coronary intervention, and valve surgeries in Ontario were calculated.
Results:
Positive correlations were found between COVID-19 CFRs and: (1) the proportion of the population with CVD (ρ = 0.40; P = 0.001); (2) the proportion of the population 65 years of age or older (ρ = 0.43; P = 0.0005); and (3) Universal Health Coverage index (ρ = 0.27; P = 0.03). For every 1% increase in the proportion of the population 65 years of age or older or proportion of the population with CVD, the COVID-19 CFR was 9% and 19% higher, respectively. Approximately 1252 procedures would be postponed monthly in Ontario because of current public health measures.
Conclusions:
Countries with more prevalent CVD reported higher COVID-19 CFRs. Strain on health care resources is likely in Canada.
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