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Excess deaths in people with cardiovascular diseases during the COVID-19 pandemic.
Banerjee, Amitava; Chen, Suliang; Pasea, Laura; Lai, Alvina G; Katsoulis, Michail; Denaxas, Spiros; Nafilyan, Vahe; Williams, Bryan; Wong, Wai Keong; Bakhai, Ameet; Khunti, Kamlesh; Pillay, Deenan; Noursadeghi, Mahdad; Wu, Honghan; Pareek, Nilesh; Bromage, Daniel; McDonagh, Theresa A; Byrne, Jonathan; Teo, James T H; Shah, Ajay M; Humberstone, Ben; Tang, Liang V; Shah, Anoop S V; Rubboli, Andrea; Guo, Yutao; Hu, Yu; Sudlow, Cathie L M; Lip, Gregory Y H; Hemingway, Harry.
  • Banerjee A; Institute of Health Informatics, University College London, 222 Euston Road, London, UK, NW1 1DA.
  • Chen S; Health Data Research UK, Gibbs Building, 215 Euston Road, London, UK, NW1 2BE.
  • Pasea L; Department of Cardiology, Barts Health NHS Trust, Royal London Hospital, Whitechapel Road, London, UK, E1 1BB.
  • Lai AG; University College London Hospitals NHS Trust, 235 Euston Road, London, UK, NW1 2BU.
  • Katsoulis M; Institute of Health Informatics, University College London, 222 Euston Road, London, UK, NW1 1DA.
  • Denaxas S; Health Data Research UK, Gibbs Building, 215 Euston Road, London, UK, NW1 2BE.
  • Nafilyan V; Institute of Health Informatics, University College London, 222 Euston Road, London, UK, NW1 1DA.
  • Williams B; Health Data Research UK, Gibbs Building, 215 Euston Road, London, UK, NW1 2BE.
  • Wong WK; Institute of Health Informatics, University College London, 222 Euston Road, London, UK, NW1 1DA.
  • Bakhai A; Health Data Research UK, Gibbs Building, 215 Euston Road, London, UK, NW1 2BE.
  • Khunti K; Institute of Health Informatics, University College London, 222 Euston Road, London, UK, NW1 1DA.
  • Pillay D; Health Data Research UK, Gibbs Building, 215 Euston Road, London, UK, NW1 2BE.
  • Noursadeghi M; Institute of Health Informatics, University College London, 222 Euston Road, London, UK, NW1 1DA.
  • Wu H; Health Data Research UK, Gibbs Building, 215 Euston Road, London, UK, NW1 2BE.
  • Pareek N; Office for National Statistics. 1 Drummond Gate, Pimlico, London, UK, SW1V 2QQ.
  • Bromage D; University College London Hospitals NHS Trust, 235 Euston Road, London, UK, NW1 2BU.
  • McDonagh TA; Institute of Cardiovascular Science, University College London, London, UK, WC1E 6BT.
  • Byrne J; University College London Hospitals NIHR Biomedical Research Centre, Maple House, 1st Floor, 149 Tottenham Court Road, London, UK, W1T 7DN.
  • Teo JTH; Institute of Health Informatics, University College London, 222 Euston Road, London, UK, NW1 1DA.
  • Shah AM; University College London Hospitals NHS Trust, 235 Euston Road, London, UK, NW1 2BU.
  • Humberstone B; Department of Cardiology, Royal Free Hospital, Pond Street, London, UK, NW3 2QG.
  • Tang LV; Diabetes Research Centre, University of Leicester, Leicester General Hospital, Gwendolen Rd, Leicester, UK, LE5 4PW.
  • Shah ASV; Division of Infection and Immunity, UCL Cruciform Building, University College London, Gower Street, London, UK, WC1E 6BT.
  • Rubboli A; University College London Hospitals NHS Trust, 235 Euston Road, London, UK, NW1 2BU.
  • Guo Y; Division of Infection and Immunity, UCL Cruciform Building, University College London, Gower Street, London, UK, WC1E 6BT.
  • Hu Y; Institute of Health Informatics, University College London, 222 Euston Road, London, UK, NW1 1DA.
  • Sudlow CLM; Health Data Research UK, Gibbs Building, 215 Euston Road, London, UK, NW1 2BE.
  • Lip GYH; School of Computer and Software, Najing University of Information Science and Technology, Ningliu Road, Nanjing, Jiangsu Province, P.R.C. 210044, China.
  • Hemingway H; Kings College Hospital NHS Foundation Trust, Denmark Hill, Brixton, London, UK, SE5 9RS.
Eur J Prev Cardiol ; 28(14): 1599-1609, 2021 12 20.
Article in English | MEDLINE | ID: covidwho-1091243
Preprint
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ABSTRACT

AIMS:

Cardiovascular diseases (CVDs) increase mortality risk from coronavirus infection (COVID-19). There are also concerns that the pandemic has affected supply and demand of acute cardiovascular care. We estimated excess mortality in specific CVDs, both 'direct', through infection, and 'indirect', through changes in healthcare. METHODS AND

RESULTS:

We used (i) national mortality data for England and Wales to investigate trends in non-COVID-19 and CVD excess deaths; (ii) routine data from hospitals in England (n = 2), Italy (n = 1), and China (n = 5) to assess indirect pandemic effects on referral, diagnosis, and treatment services for CVD; and (iii) population-based electronic health records from 3 862 012 individuals in England to investigate pre- and post-COVID-19 mortality for people with incident and prevalent CVD. We incorporated pre-COVID-19 risk (by age, sex, and comorbidities), estimated population COVID-19 prevalence, and estimated relative risk (RR) of mortality in those with CVD and COVID-19 compared with CVD and non-infected (RR 1.2, 1.5, 2.0, and 3.0).Mortality data suggest indirect effects on CVD will be delayed rather than contemporaneous (peak RR 1.14). CVD service activity decreased by 60-100% compared with pre-pandemic levels in eight hospitals across China, Italy, and England. In China, activity remained below pre-COVID-19 levels for 2-3 months even after easing lockdown and is still reduced in Italy and England. For total CVD (incident and prevalent), at 10% COVID-19 prevalence, we estimated direct impact of 31 205 and 62 410 excess deaths in England (RR 1.5 and 2.0, respectively), and indirect effect of 49 932 to 99 865 deaths.

CONCLUSION:

Supply and demand for CVD services have dramatically reduced across countries with potential for substantial, but avoidable, excess mortality during and after the pandemic.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cardiovascular Diseases / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Eur J Prev Cardiol Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cardiovascular Diseases / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Eur J Prev Cardiol Year: 2021 Document Type: Article