Impact of COVID-19 Pandemic on Cardiovascular Health

Roth GA, Vaduganathan M, Mensah GA.
Impact of the COVID-19 Pandemic on Cardiovascular Health in 2020: JACC State-of-the-Art Review. J Am Coll Cardiol 2022;80:631-640.

The following are key points to remember from this state-of-the-art review on coronavirus disease 2019 (COVID-19) and cardiovascular health:

  1. The impact of COVID-19 on the burden of cardiovascular diseases (CVDs) during the early pandemic remains unclear.
  2. Evidence suggests that COVID-19 has become one of the leading causes of global mortality, with a disproportionate impact on persons with CVD.
  3. Studies of health facility admissions for CVD found significant decreases during the pandemic but studies of hospital mortality for CVD were more variable. Decreases in health care delivery were observed in many countries in 2020 because of lockdown policies and health systems shifting to create capacity for COVID-19 patients.
  4. Studies of population-level CVD mortality differed across countries, with most showing decreases, although some revealed increases in deaths. Of note, Ecuador, Mexico, Russia, and the United States reported increases in deaths attributed to COVID-19.
  5. In some countries where large increases in CVD deaths were reported in vital registration systems, misclassification of COVID-19 as CVD may have occurred.
  6. Taken together, studies suggest heterogeneous effects of the COVID-19 pandemic on CVD without large increases in CVD mortality in 2020 for a number of countries.
  7. Clinical and population science research is needed to examine the ways in which the pandemic may have affected CVD burden.
  8. The Global Burden of Disease (GBD) study offers one opportunity for better understanding of how CVD may have changed because of the COVID-19 pandemic. This is an ongoing multinational effort to produce a consistent and comparable assessment of disease burden for all countries in the world.
  9. There is a great need for basic, clinical, and population science research as well as health services research and implementation science to provide a deeper understanding of the direct and indirect effects of SARS-CoV-2 infection and COVID-19 on changes in CVD burden.
  10. At the population science level, a major lesson learned during the COVID-19 pandemic is that countries with sophisticated data linkage capabilities for almost the entire population, such as England, where substantial linkages of electronic health records and vital registration data exist, were able to rapidly produce evidence to answer key population health questions.

Clinical Topics: Prevention

Keywords: Cardiovascular Diseases, COVID-19, Electronic Health Records, Global Burden of Disease, Hospital Mortality, Implementation Science, Myocardial Ischemia, Pandemics, Population Health, Primary Prevention, SARS-CoV-2

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