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Cardiovascular Health of the Balearic Islands (Spain) After the COVID-19 Pandemic
Hugo Del Castillo1,2, José M Gámez1,2,3
1Department of Cardiology, University Hospital Son Llatzer, 07198 Palma de Mallorca, Spain.
Insights
The COVID-19 pandemic negatively impacted cardiovascular health, particularly heart failure and hypertension, on the Balearic Islands. Resource reallocation correlated with increased cardiovascular mortality, especially in 2021.
Area of Science:
- Cardiology
- Public Health
- Healthcare Management
Background:
- The COVID-19 pandemic necessitated resource reallocation, significantly impacting routine cardiovascular care.
- The first wave of the pandemic particularly disrupted established cardiovascular healthcare services.
Purpose of the Study:
- To assess the short- and mid-term effects of healthcare resource reallocation on cardiovascular health.
- To analyze variations in cardiovascular admissions and mortality causes on the Balearic Islands between 2019 and 2021.
Main Methods:
- Utilized regional healthcare system data and national/regional statistics from 2019-2021.
- Analyzed changes in admission types and primary causes of cardiovascular mortality.
- Examined correlations between monthly mortality variations and total cardiovascular mortality.
Main Results:
- Cardiovascular mortality increased by 4.8% in 2021 compared to pre-pandemic levels, driven by heart failure (6.4%) and hypertension (26.45%).
- In 2020, myocardial infarction was the primary driver of increased cardiovascular mortality.
- In 2021, chronic conditions (heart failure, hypertension) became the main drivers, showing significant correlations with mortality.
- A correlation between COVID-19 resource allocation and cardiovascular mortality was observed in 2021, though not statistically significant.
Conclusions:
- Mid-term cardiovascular health deteriorated in the Balearic Islands region post-pandemic.
- Hypertension and heart failure emerged as key contributors to the rise in cardiovascular mortality.
- Significant shifts in mortality drivers occurred between 2020 and 2021, highlighting evolving pandemic impacts.
Abstract:
Background/Objectives: The COVID-19 pandemic caused healthcare managers to reallocate resources from other areas in order to handle the outbreak. Cardiovascular usual care was especially affected during the first wave. Methods: We analyzed the short- and mid-term impact of the resource reallocation on cardiovascular health, focusing on the Balearic Islands in Spain. Data from 2019 to 2021 of the regional healthcare system and from the national and regional stats center were collected in order to analyze the variations in type of admissions, main causes of cardiovascular mortality, and the correlation between the monthly variation in those causes of mortality and total cardiovascular mortality. Results: The year 2021 showed worse results in terms of healthcare outcomes compared to the pre-pandemic period, with a population-adjusted cardiovascular mortality increase of 4.8% and heart failure and hypertension being the main drivers (6.4% and 26.45%, respectively). However, this impact was not homogeneous in both pandemic years. In 2020, the main driver for the cardiovascular mortality increase was myocardial infarction (R Pearson = 0.655/p = 0.021). On the other hand, chronic conditions such as heart failure and hypertension led to the increase in cardiovascular mortality in 2021 (R Pearson = 0.671/p = 0.017 and R Pearson = 0.619/p = 0.032, respectively). In-hospital resources for COVID-19 showed a positive correlation to cardiovascular mortality in 2021; however, it did not reach statistical significance (R Pearson = 0.41/p = 0.1). Conclusions: Mid-term cardiovascular health worsened in the Spanish Balearic Island region, with hypertension and heart failure being the main drivers, with important differences in influence between 2020 and 2021. We found a correlation between COVID-19 in-hospital resource allocation and total cardiovascular mortality.
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