Siddiqi Rabbia, Farhan Syed H, Shah Syeda A, Mushahid Hasan, Nasir Muhammad M, Moukarbel George V
University of Toledo OH USA.
Dow University of Health Sciences Karachi Pakistan.
J Am Heart Assoc. 2025 May 20;14(10):e038987. doi: 10.1161/JAHA.124.038987. Epub 2025 May 15.
The COVID-19 pandemic saw a rise in cardiovascular death, likely the result of disruptions in health care delivery and the infection itself. We examine mortality trends of heart failure (HF) and acute myocarditis (AM) before and during the pandemic and identify the most affected demographic subgroups.
We queried the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database for deaths from HF and AM before (1999-2019) and during (2020-2021) the COVID-19 pandemic. Age-adjusted mortality rates were calculated and stratified by sex, race and ethnicity, and age category. Trend-level analysis was performed using the Joinpoint Regression Program, which estimates average annual percentage change (AAPC) in age-adjusted mortality rate with corresponding 95% CI. A total of 7 366 944 HF deaths and 33 750 AM deaths occurred during 1999 to 2021. HF and AM mortality rates downtrended before the pandemic (AAPC, -0.63 and -2.42, respectively) but reversed during the pandemic (HF AAPC, 7.91; and AM AAPC, 20.3). Overall, during the pandemic, the age-adjusted mortality rate for both HF and AM was greater for men, non-Hispanic Black people, and adults aged ≥65 years. The sharpest increase was observed among non-Hispanic American Indian people (AAPC, 14.9), Hispanic people (AAPC, 9.63), and young adults (AAPC, 20.9) for HF and among women (AAPC 18.7), non-Hispanic Black people (AAPC, 15.6), and older adults (AAPC, 23.5) for AM.
The prepandemic downward trends of HF and AM mortality rates have reversed since 2020. Subgroups that had the greatest absolute mortality rates from both AM and HF in the pandemic years were men, non-Hispanic Black people, and older adults (aged ≥65 years).
在新冠疫情期间，心血管疾病死亡率有所上升，这可能是医疗服务中断以及感染本身所致。我们研究了疫情之前和期间心力衰竭（HF）和急性心肌炎（AM）的死亡率趋势，并确定了受影响最大的人口亚组。
我们查询了美国疾病控制与预防中心的广泛在线流行病学研究数据库，以获取1999 - 2019年（疫情之前）和2020 - 2021年（疫情期间）因HF和AM导致的死亡数据。计算年龄调整死亡率，并按性别、种族和族裔以及年龄类别进行分层。使用Joinpoint回归程序进行趋势水平分析，该程序估计年龄调整死亡率的平均年度百分比变化（AAPC）及其相应的95%置信区间。1999年至2021年期间，共发生了7366944例HF死亡和33750例AM死亡。在疫情之前，HF和AM死亡率呈下降趋势（AAPC分别为 -0.63和 -2.42），但在疫情期间出现逆转（HF的AAPC为7.91；AM的AAPC为20.3）。总体而言，在疫情期间，HF和AM的年龄调整死亡率在男性、非西班牙裔黑人以及年龄≥65岁的成年人中更高。在HF方面，非西班牙裔美国印第安人（AAPC为14.9）、西班牙裔人（AAPC为9.63）和年轻人（AAPC为20.9）的死亡率增幅最大；在AM方面，女性（AAPC为18.7）、非西班牙裔黑人（AAPC为15.6）和老年人（AAPC为23.5）的死亡率增幅最大。
自2020年以来，疫情前HF和AM死亡率的下降趋势已经逆转。在疫情期间，AM和HF绝对死亡率最高的亚组是男性、非西班牙裔黑人以及老年人（年龄≥65岁）。
