Mortality Related to Different Circulatory Diseases Before, During and After the COVID-19 Pandemic

Area of Science:

• Public Health
• Epidemiology
• Cardiovascular Disease Research

Background:

• The COVID-19 pandemic significantly increased cardiovascular mortality globally.
• Early pandemic data from Italy showed excess deaths from ischemic heart disease (IHD), cerebrovascular disease (CVD), hypertensive diseases (HD), and atrial fibrillation (AF).
• Uncertainty remained regarding whether these mortality rates returned to pre-pandemic levels.

Purpose of the Study:

• To assess if cardiovascular disease mortality in the Veneto Region, Italy, returned to pre-pandemic levels by 2023.
• To analyze trends in mortality for IHD, CVD, HD, and AF.
• To evaluate the long-term impact of the pandemic on circulatory disease mortality.

Main Methods:

• Analysis of mortality data (≥40 years) in the Veneto Region using multiple causes of death (MCOD) from death certificates.
• Calculation of age-standardized monthly mortality rates for IHD, CVD, HD, and AF.
• Forecasting 2023 mortality using Seasonal ARIMA and Lee-Carter models, with scenarios excluding (2008-2019) and including (2008-2022) the pandemic period.

Main Results:

• A mortality peak for all circulatory diseases was observed in 2020, with hypertensive diseases (HD) peaking at +29%.
• Despite decreasing rates in 2021-2022, mortality remained significantly above pre-pandemic levels.
• By 2023, observed mortality rates aligned with pre-pandemic forecasts (2008-2019 baseline) and were lower than pandemic-inclusive forecasts (2008-2022), indicating a return to pre-pandemic patterns.

Conclusions:

• Mortality from major circulatory diseases in the Veneto Region largely reverted to pre-pandemic trends by 2023.
• The study suggests limited long-term excess mortality from these conditions post-pandemic.
• Highlights the utility of multiple causes of death data and time-series modeling for tracking population health recovery.