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Impact of the COVID-19 pandemic on cardiovascular mortality and catherization activity during the lockdown in central
Holger M Nef1,2, Albrecht Elsässer3, Helge Möllmann4
1Department of Cardiology, Justus Liebig University Giessen, University Hospital Giessen, Medical Clinic I, Klinikstrasse 33, 35392, Giessen, Germany. holger.nef@innere.med.uni-giessen.de.
Insights
During the COVID-19 lockdown, central Germany saw a significant rise in cardiovascular deaths despite a non-significant increase in overall mortality. Cardiac catheterization procedures also decreased, highlighting potential impacts on cardiovascular care during the pandemic.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Hospital admissions for cardiac care decreased during the COVID-19 pandemic.
- The impact of pandemic-related lockdowns on cardiovascular mortality remains unclear.
- Central Germany experienced a lockdown period impacting healthcare services.
Purpose of the Study:
- To evaluate the effect of the COVID-19 lockdown in central Germany on overall and cardiovascular mortality.
- To assess changes in catheterization activities during the same period.
- To understand the broader implications of pandemic restrictions on cardiovascular health.
Main Methods:
- Data on deaths and causes of death were collected from 22 public health authorities in central Germany.
- Hospitalization data for chronic coronary syndrome (CCS), acute coronary syndrome (ACS), and out-of-hospital cardiac arrest (OHCA) were analyzed.
- Cardiac catheterization rates were compared between the lockdown period (March 23-April 26, 2020) and the same period in 2019.
Main Results:
- A significant increase in cardiovascular mortality (7.6%) and cardiac mortality (11.8%) was observed during the lockdown compared to 2019.
- All-cause mortality showed a non-significant increase of 2.6%.
- Cardiac catheterization procedures notably decreased during the lockdown period.
Conclusions:
- The COVID-19 lockdown in central Germany was associated with a significant rise in cardiovascular mortality.
- Reduced catheterization activities coincided with increased cardiovascular deaths.
- Further research is needed to elucidate the mechanisms behind these findings and inform future pandemic responses regarding cardiovascular care.
Aims:
During the COVID-19 pandemic, hospital admissions for cardiac care have declined. However, effects on mortality are unclear. Thus, we sought to evaluate the impact of the lockdown period in central Germany on overall and cardiovascular deaths. Simultaneously we looked at catheterization activities in the same region.
Methods And Results:
Data from 22 of 24 public health-authorities in central Germany were aggregated during the pandemic related lockdown period and compared to the same time period in 2019. Information on the total number of deaths and causes of death, including cardiovascular mortality, were collected. Additionally, we compared rates of hospitalization (n = 5178) for chronic coronary syndrome (CCS), acute coronary syndrome (ACS), and out of hospital cardiac arrest (OHCA) in 26 hospitals in this area. Data on 5,984 deaths occurring between March 23, 2020 and April 26, 2020 were evaluated. In comparison to the reference non-pandemic period in 2019 (deaths: n = 5832), there was a non-significant increase in all-cause mortality of 2.6% [incidence rate ratio (IRR) 1.03, 95% confidence interval (CI) 0.99-1.06; p = 0.16]. Cardiovascular and cardiac mortality increased significantly by 7.6% (IRR 1.08, 95%-CI 1.01-1.14; p = 0.02) and by 11.8% (IRR 1.12, 95%-CI 1.05-1.19; p < 0.001), respectively. During the same period, our data revealed a drop in cardiac catherization procedures.
Conclusion:
During the COVID-19-related lockdown a significant increase in cardiovascular mortality was observed in central Germany, whereas catherization activities were reduced. The mechanisms underlying both of these observations should be investigated further in order to better understand the effects of a pandemic-related lockdown and social-distancing restrictions on cardiovascular care and mortality.
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