Excess cardiovascular mortality during the first year of the COVID-19 pandemic

Abstract

Introduction. Excess mortality is an objective indicator that allows assessing the impact of the pandemic on public health and identifying the features of the epidemiological process. We analyzed data on mortality associated with cardiovascular diseases (CVD) during the first year of the COVID-19 pandemic in 16 cities of the Russian Federation. The aim was to quantify excess mortality associated with CVD during the first year of the COVID-19 pandemic. Materials and methods. We used aggregated daily data on mortality from CVD during the first year of the COVID-19 pandemic (2020) and three to ten years preceding the start of the pandemic in 16 cities of the Russian Fede ration. For each city, time series of mortality data were generated with a time interval of 1 month, taking into account long-term and seasonal trends. To calculate expected mortality rate for every month of 2020, which would have been observed in the absence of the COVID-19 pandemic, adaptive mo dels were used: exponential smoothing and autoregression and integrated moving average, allowing to take into account the trend, seasonality and cyclicality of the series and are presented in the form of expected mortality from CVD for each month of 2020 with 95% confidence intervals. Excess mortality during the first year of the pandemic is the cumulative number of excess deaths from CVD from April 1 to December 31, 2020. Results. A high level of excess mortality was identified in each of the cities studied. The average excess mortality rate from cardiovascular diseases was 17.7%. The cities where the highest values were recorded are Lipetsk (36.9%), Norilsk (34.9%), Omsk (32.6%). The lowest levels were noted in Irkutsk (6.1%), Petropavlovsk-Kamchatskiy (8.3%) and Arkhangelsk (10.0%). In Norilsk, Omsk, Magadan, Severodvinsk, Arkhangelsk, excess mortality from cardiovascular diseases among women was higher than among men. In Krasnoyarsk, and Yakutsk, the mortality rate among men, on the contrary, exceeded the rates among women. Conclusion. The COVID-19 pandemic had a significant impact on excess cardiovascular mortality, due to the peculiarities of the organization of the work of healthcare institutions, the introduction of strict restrictive measures, and a negative psycho-emotional background among the population of the Russian Federation. Taken together, these aspects may have caused changes in providing medical care, delayed visits of citizens to medical organizations, delayed diagnosis and, as a consequence, an increase in mortality from somatic diseases including CVD.