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Cardiovascular-related deaths at the beginning of the COVID-19 outbreak : A prospective analysis based on the UK Biobank

Cardiovascular-related deaths at the beginning of the COVID-19 outbreak : A prospective analysis based on the UK Biobank


Title: Cardiovascular-related deaths at the beginning of the COVID-19 outbreak : A prospective analysis based on the UK Biobank
Author: Wang, Junren
Zhu, Jianwei
Yang, Huazhen
Hu, Yao
Sun, Yajing
Ying, Zhiye
Qu, Yuanyuan
Valdimarsdottir, Unnur   orcid.org/0000-0001-5382-946X
Fang, Fang
Song, Huan   orcid.org/0000-0003-3845-8079
Date: 2021-06-04
Language: English
Scope: e046931
Department: Faculty of Medicine
Series: BMJ Open; 11(6)
ISSN: 2044-6055
DOI: https://doi.org/10.1136/bmjopen-2020-046931
Subject: COVID-19; Hjartasjúkdómar; Faraldsfræði; cardiology; COVID-19; epidemiology; health services administration & management; SARS-CoV-2; Prospective Studies; Disease Outbreaks; Biological Specimen Banks; Humans; Risk Factors; England/epidemiology; United Kingdom/epidemiology; Medicine (all); 847776
URI: https://hdl.handle.net/20.500.11815/3101

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Citation:

Wang , J , Zhu , J , Yang , H , Hu , Y , Sun , Y , Ying , Z , Qu , Y , Valdimarsdottir , U , Fang , F & Song , H 2021 , ' Cardiovascular-related deaths at the beginning of the COVID-19 outbreak : A prospective analysis based on the UK Biobank ' , BMJ Open , vol. 11 , no. 6 , e046931 , pp. e046931 . https://doi.org/10.1136/bmjopen-2020-046931

Abstract:

Objective To assess the impact of the COVID-19 outbreak on cardiovascular disease (CVD) related mortality and hospitalisation. Design Community-based prospective cohort study. Setting The UK Biobank. Participants 421 372 UK Biobank participants who were registered in England and alive as of 1 January 2020. Primary and secondary outcome measures The primary outcome of interest was CVD-related death, which was defined as death with CVD as a cause in the death register. We retrieved information on hospitalisations with CVD as the primary diagnosis from the UK Biobank hospital inpatient data. The study period was 1 January 2020 to June 30 2020, and we used the same calendar period of the three preceding years as the reference period. In order to control for seasonal variations and ageing of the study population, standardised mortality/incidence ratios (SMRs/SIRs) with 95% CIs were used to estimate the relative risk of CVD outcomes during the study period, compared with the reference period. Results We observed a distinct increase in CVD-related deaths in March and April 2020, compared with the corresponding months of the three preceding years. The observed number of CVD-related deaths (n=218) was almost double in April, compared with the expected number (n=120) (SMR=1.82, 95% CI 1.58 to 2.07). In addition, we observed a significant decline in CVD-related hospitalisations from March onwards, with the lowest SIR observed in April (0.45, 95% CI 0.41 to 0.49). Conclusions There was a distinct increase in the number of CVD-related deaths in the UK Biobank population at the beginning of the COVID-19 outbreak. The shortage of medical resources for hospital care and stress reactions to the pandemic might have partially contributed to the excess CVD-related mortality, underscoring the need of sufficient healthcare resources and improved instructions to the public about seeking healthcare in a timely way.

Description:

Funding Information: Funding This work is supported by the National Science Foundation of China (No. 81971262 to HS), West China Hospital COVID-19 Epidemic Science and Technology Project (No. HX-2019-nCoV-014 to HS), Sichuan University Emergency Grant (No. 2020scunCoVyingji10002 to HS), EU Horizon2020 Research and Innovation Action Grant (847776 to UV and FF) and NordForsk grant (105668 to UV and FF). Publisher Copyright: ©

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