Department of Medicine, University Hospitals, Cleveland, OH; Harrington Heart and Vascular Institute, University Hospitals and School of Medicine, Case Western Reserve University, Cleveland, OH.
Loyola University Medical Center, Maywood, IL.
Mayo Clin Proc. 2022 Dec;97(12):2206-2214. doi: 10.1016/j.mayocp.2022.07.008. Epub 2022 Jul 21.
To investigate the patterns and demographic features of cardiovascular disease (CVD) death and subtypes myocardial infarction (MI), stroke, and heart failure in the pre-COVID-19 era (2018-2019) vs during the COVID-19 pandemic (2020-2021) in the United States.
In this cross-sectional study, we used the US Multiple Cause of Death files for 2018 to 2021 to examine the trend of excess cause-specific deaths using International Classification of Diseases, Tenth Revision codes for CVD (I00 to I99), MI (I21 and I22), stroke (I60 to I69), and heart failure (I42 and I50). Our primary outcome was excess mortality from CVD and its 3 subtypes (MI, stroke, and heart failure) between prepandemic (2018-2019) and pandemic (2020-2021) years. We performed a subgroup analysis on race and month-to-month and year-to-year variation using χ analysis to test statistical significance.
Overall, 3,598,352 CVD deaths were analyzed during the study period. There was a 6.7% excess CVD mortality, 2.5% MI mortality, and 8.5% stroke mortality during the COVID-19 pandemic (2020-2021) compared with the prepandemic era (2018-2019). Black individuals had higher excess CVD mortality (13.8%) than White individuals (5.1%; P<.001). This remained consistent across subtypes of CVD, including MI (9.6% vs 1.0%; P<.001), stroke (14.5% vs 6.9%; P<.001), and heart failure (5.1% vs -1.2%; P<.001).
There has been a significant rise in CVD and subtype-specific mortality during the COVID-19 pandemic that has been persistent despite 2 years since the onset of the pandemic. Excess CVD mortality has disproportionately affected Black compared with White individuals. Further studies targeting and eliminating health care disparities are necessary.
在美国，研究 2018-2019 年新冠大流行前（pre-COVID-19）时期和 2020-2021 年新冠大流行期间（COVID-19）心血管疾病（CVD）死亡和各亚型（心肌梗死[MI]、中风和心力衰竭）的模式和人口统计学特征。
在这项横断面研究中，我们使用美国 2018 年至 2021 年的多病因死亡文件，使用国际疾病分类，第十版（ICD-10）编码 I00 至 I99 对 CVD、I21 和 I22 对 MI、I60 至 I69 对中风和 I42 对心力衰竭进行分析，以检查特定病因死亡率的趋势。我们的主要结局是大流行前（2018-2019 年）和大流行期间（2020-2021 年） CVD 及其 3 个亚型（MI、中风和心力衰竭）的超额死亡率。我们使用 χ 分析进行了种族和逐月及逐年差异的亚组分析，以检验统计学意义。
在研究期间，共分析了 3598352 例 CVD 死亡。与大流行前时期（2018-2019 年）相比，新冠大流行期间（2020-2021 年）CVD 死亡率增加了 6.7%，MI 死亡率增加了 2.5%，中风死亡率增加了 8.5%。黑人个体的 CVD 超额死亡率（13.8%）高于白人个体（5.1%；<.001）。这种情况在 CVD 的各个亚型中均保持一致，包括 MI（9.6%比 1.0%；<.001）、中风（14.5%比 6.9%；<.001）和心力衰竭（5.1%比-1.2%；<.001）。
自新冠大流行开始以来的 2 年里，尽管已经过去了 2 年，但 COVID-19 大流行期间 CVD 和亚型特异性死亡率显著上升。CVD 超额死亡率不成比例地影响了黑人，而不是白人。需要进一步的研究来针对和消除医疗保健差距。
