Changes in cardiovascular mortality in Chile during the COVID-19 pandemic

The COVID-19 pandemic has impacted regular cardiovascular healthcare access and delivery. Service utilisation has declined, and excess cardiovascular mortality has been reported in several countries. We aim to estimate excess cardiovascular deaths in Chile during 2020.

We collected mortality data from the Chilean Department of Statistics and Health Information and refined them using the maps of Global Burden of Disease Studies in 2017 and 2010. We conducted a time series analysis using quasi-Poisson distribution to predict cardiovascular mortality in 2020 and compared it with observed numbers and calculated attributable fractions (AFs) with 95% uncertainty intervals, as a whole and by sex, age group and type of cardiovascular disease.

During 2015-2020, 173 283 cardiovascular deaths were recorded, with 28 141 deaths in 2020. The observation in 2020 was lower than our projection in the overall data (-4.0% (-5.0% to -2.8%)) and in male (-11.7% (-13% to -10.3%)). However, positive AFs were noted among female (5.0% (3.2% to 6.8%)), people in age group 80-89 years (11.0% (8.6% to 13.5%)) and people who died from hypertensive heart diseases (18.9% (14.7% to 23.5%)).

Less overall cardiovascular deaths were observed in 2020 compared with our projection, possibly associated with competing risks from COVID-19 infection in men. Nonetheless, excess cardiovascular deaths were observed among women, people in the age group 80-89 years and people who died from hypertensive heart diseases suggesting possible negative cardiovascular impacts brought by the pandemic on these vulnerable groups.