Cardiovascular mortality during the COVID-19 pandemics in a large Brazilian city : a comprehensive analysis.
Introduction: The impact of COVID-19 pandemics on cardiovascular diseases (CVD) may be caused by health system reorganization and/or collapse, or from changes in the behaviour of individuals. In Brazil, municipalities were empowered to define regulatory measures, potentially resulting in diverse eff...
| Autores: | ; ; ; ; ; ; ; ; |
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| Tipo de documento: | Artículo |
| Estado: | Published version |
| Fecha de publicación: | 2022 |
| País: | Brasil |
| Institución: | UFOP |
| Repositorio: | Repositório Institucional da UFOP |
| Lenguaje: | Inglés |
| OAI Identifier: | oai:repositorio.ufop.br:123456789/16799 |
| Acceso en línea: | http://www.repositorio.ufop.br/jspui/handle/123456789/16799 https://doi.org/10.5334/gh.1101 |
| Nivel de acceso: | Acceso abierto |
| Palabra clave: | Cardiovascular diseases Hospitalization Social vulnerability |
| Sumario: | Introduction: The impact of COVID-19 pandemics on cardiovascular diseases (CVD) may be caused by health system reorganization and/or collapse, or from changes in the behaviour of individuals. In Brazil, municipalities were empowered to define regulatory measures, potentially resulting in diverse effects on CVD morbimortality. Objective: To analyse the impact of COVID-19 pandemics on CVD outcomes in Belo Horizonte (BH), the sixth greater capital city in Brazil, including: mortality, mortality at home, hospitalizations, intensive care unit utilization, and in-hospital mortality; and the differential effect according to sex, age range, social vulnerability, and pandemic’s phase. Methods: Ecological study analysing data from the Mortality and Hospital Information System of BH residents aged ≥30 years. CVD was defined as in Chapter IX from ICD- 10. Social vulnerability was classified by a composite socioeconomic index as high, medium and low. The observed age-standardized rates for epidemiological weeks 10–48, 2020, were compared to the expected rates (mean of 2015–2019). Risk ratios (RiR) were analysed and 95% confidence intervals were calculated for all estimates. Population projected to 2020 for BH and its census tracts were used to calculate rates. Results: We found no changes in CVD mortality rates (RiR 1.01, 95%CI 0.96–1.06). However, CVD deaths occurred more at homes (RiR 1.32, 95%CI 1.20–1.46) than in hospitals (RiR 0.89, 95%CI 0.79–0.99), as a result of a substantial decline in hospitalization rates, even though proportional in-hospital deaths increased. The rise in home deaths was greater in older adults and in had an increasing gradient in those more socially vulnerable (RiR 1.45); for high (RiR 1.45), medium (RiR 1.32) and low vulnerability (RiR 1.21). Conclusion: The greater occurrence of CVD deaths at home, in parallel with lower hospitalization rates, suggests that CVD care was disrupted during the COVID-19 pandemics, which more adversely affected older and more socially vulnerable individuals, exacerbating health inequities in BH. |
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