Schederecker Florian, Lehner Carolin T, Eberl Marian, Schauberger Gunther, Hansmann Katharina, Donnachie Ewan, Tauscher Martin, König Adriana, Sundmacher Leonie, Klug Stefanie J
TUM School of Medicine and Health, Chair of Epidemiology, Technical University of Munich, Munich, Bavaria, Germany.
Bavarian Association of Statutory Insurance Physicians, Munich, Germany.
Heart. 2024 Dec 23;111(2):69-75. doi: 10.1136/heartjnl-2024-324181.
Inconsistent findings about the impact of the COVID-19 pandemic on cardiovascular disease diagnosis and consultations have been reported internationally. The objective of this study was to analyse the impact of the pandemic period (2020-2021) on the incidence rate of coronary heart disease (CHD) compared with the pre-pandemic period (2012-2019) in Bavaria, Germany.
We used health claims data of around 9 million statutorily insured residents (≥20 years) of Bavaria, Germany. We calculated quarterly age-standardised incidence rates for men and women diagnosed with CHD using the European Standard Population 2013. Interrupted time series regression models were used to analyse possible pandemic effects on the CHD incidence rates.
Overall, 797 074 new CHD cases (47% women) were diagnosed from 2012 to 2021. Both pre-pandemic and pandemic incidence rates for women were lower than for men. Regression models showed decreasing incidence rates in the pre-pandemic period in men (-5.2% per year (p.a.), 95% CI: -5.7% to -4.7%) and in women (-6.6% p.a., 95% CI: -7.3% to -6.0%) and seasonal effects (higher in quarter 4 compared with Q1-Q3). During the pandemic period, there was no clear evidence of a level change in the incidence rates both in women and men. However, there are indications of a smaller decline in the incidence during the pandemic compared with the pre-pandemic period, in particular in women (-0.7% p.a., 95% CI: -6.0% to 4.8%) and less prominent in men (-1.7% p.a., 95% CI: -6.0% to 2.8%).
An overall decreasing CHD incidence rate was observed in men and women in the past decade but no clear impact of the pandemic was seen. These results show the importance of incidence monitoring beyond the pandemics to maintain chronic disease care.
国际上已报道了关于新冠疫情对心血管疾病诊断和会诊影响的不一致研究结果。本研究的目的是分析疫情期间（2020 - 2021年）与德国巴伐利亚州疫情前时期（2012 - 2019年）相比，冠心病（CHD）发病率的影响。
我们使用了德国巴伐利亚州约900万法定参保居民（≥20岁）的健康保险数据。我们采用2013年欧洲标准人口计算了诊断为冠心病的男性和女性的季度年龄标准化发病率。采用中断时间序列回归模型分析疫情对冠心病发病率的可能影响。
总体而言，2012年至2021年共诊断出797074例新发冠心病病例（47%为女性）。疫情前和疫情期间女性的发病率均低于男性。回归模型显示，疫情前男性发病率呈下降趋势（每年下降5.2%，95%置信区间：-5.7%至-4.7%），女性发病率也呈下降趋势（每年下降6.6%，95%置信区间：-7.3%至-6.0%），且存在季节性影响（第4季度高于第1 - 3季度）。在疫情期间，没有明确证据表明男性和女性的发病率出现水平变化。然而，有迹象表明，与疫情前时期相比，疫情期间发病率下降幅度较小，尤其是女性（每年下降0.7%，95%置信区间：-6.0%至4.8%），男性则不太明显（每年下降1.7%，95%置信区间：-6.0%至2.8%）。
在过去十年中，男性和女性的冠心病发病率总体呈下降趋势，但未观察到疫情有明显影响。这些结果表明，在疫情之外进行发病率监测对于维持慢性病护理的重要性。
