Prevalence of cardiovascular diseases in COVID-19 related mortality in the United States
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Published on: September 26, 2018
Rhythm Vasudeva1, Abhiram Challa1, Mahmoud Al Rifai2
1Department of Internal Medicine, University of Kansas School of Medicine, Wichita, KS, USA.
Insights
Cardiovascular diseases like hypertension and diabetes were common in COVID-19 deaths. Trends shifted during the pandemic, with some conditions increasing, especially in older individuals.
Area of Science:
- Public Health
- Epidemiology
- Cardiology
Background:
- COVID-19 has been linked to various cardiovascular disease (CVD) risk factors and outcomes.
- Limited data exists on the prevalence of CVD in US COVID-19 related deaths.
Purpose of the Study:
- To analyze the prevalence and trends of cardiovascular conditions among individuals who died from COVID-19 in the US.
- To examine age-specific patterns of these conditions.
Main Methods:
- Descriptive analysis of a public CDC dataset (Conditions Contributing to COVID-19 Deaths, Provisional 2020-2021).
- Analysis of ICD-10 coded CVDs and risk factors in COVID-19 deaths.
- Mann-Kendall trend analysis before and after vaccine introduction (January 2021).
Main Results:
- Hypertensive diseases (19.6%), diabetes (15.9%), and ischemic heart disease (10.9%) were most prevalent.
- Trends showed a decline in hypertensive diseases but an increase in cardiac arrhythmias, heart failure, and obesity.
- CVD burden varied by age, with obesity and circulatory diseases prominent in younger groups, and other conditions increasing with age.
Conclusions:
- Hypertension, diabetes, and ischemic heart disease were leading cardiovascular conditions in COVID-19 deaths.
- Trends evolved during the pandemic, with notable increases in arrhythmias and heart failure.
- Age significantly influenced the prevalence of specific cardiovascular conditions; data limitations include reliance on death certificates.
Background:
Several cardiovascular disease (CVD) risk factors and sequelae have been associated with COVID-19. Little is known about the distribution of CVD conditions in COVID-19 related deaths in the US population.
Methods:
The public-use dataset by CDC, "Conditions Contributing to COVID-19 Deaths, by State and Age, Provisional 2020-2021", was abstracted as of August 1, 2021. A descriptive analysis was conducted to explore the overall and age-specific prevalence of various CVD and risk factors grouped by pre-specified ICD-10 codes amongst COVID-19 patient deaths. Respective trends over the duration of the pandemic were analyzed using the Mann-Kendall method, including time-periods before and after the introduction of vaccines in January 2021. All time-related analysis was conducted between March 2020 and June 2021.
Results:
A total of 600,241 COVID-19 related deaths were reported between March 2020 and June 2021. Hypertensive diseases were the most prevalent (19.6%), followed by diabetes (15.9%), ischemic heart disease (IHD;10.9%), heart failure (7.7%), cardiac arrhythmias (7.5%), other diseases of the circulatory system (6.6%), cerebrovascular diseases (5%), and obesity (4.1%). While a significant downward trend was noted for hypertensive diseases over the course of the pandemic, cardiac arrhythmias, heart failure (HF), obesity, and other circulatory system diseases demonstrated a significant upward trend. Since the introduction of vaccines, the trends for heart failure and cardiac arrhythmias remained steady while having demonstrated a significant rise in the pre-vaccination time-period. While obesity and other diseases of the circulatory system predominated (>50%) amongst the CVD burden in the younger population (0-24 years and 25-34 years), the percentage occurrence of cardiac arrhythmias, hypertensive diseases, HF, and IHD increased with age.
Conclusion:
Hypertensive diseases, diabetes, and IHD were the most prevalent cardiovascular conditions amongst COVID-19 related deaths. These patterns varied by age. While the trend for hypertensive diseases declined over the course of the pandemic, cardiac arrhythmias, HF, obesity, and other diseases of the circulatory system demonstrated an upward trend. An important limitation is the source of the data being limited to death certificates.
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