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Heartbeat: an increase in preventable cardiovascular deaths during the COVID-19 pandemic due to avoidance of medical care
  1. Catherine M Otto
  1. Division of Cardiology, University of Washington, Seattle, WA 98195, USA
  1. Correspondence to Professor Catherine M Otto, Division of Cardiology, University of Washington, Seattle, WA 98195, USA; cmotto{at}

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Patients with cardiovascular disease (CVD) have an increased mortality risk with COVID-19 infection yet several studies have shown fewer hospital-based CVD diagnoses and procedures during the COVID-19 pandemic. In this issue of Heart, Wu and colleagues1 show that despite a decrease in the number of patients presenting with an acute CVD event there was an 8% excess of CVD deaths in England between March and June 2020 (during the COVID-19 pandemic), compared with the previous 6 years (figure 1). About ½ of these deaths occurred outside the hospital with the most frequent causes of CVD death being stroke (35.6%), acute coronary syndrome (24.5%), heart failure (23.4%) pulmonary embolism (9.3%) and cardiac arrest (4.6%). Most of these deaths were not related to a known COVID-19 infection, suggesting they were most likely due to delays in seeking medical care or undiagnosed COVID-19 infection.

Figure 1

Time series of acute cardiovascular (CV) deaths, by place of death. The number of daily CV deaths is presented using a 7-day simple moving average (indicating the mean number of daily CV deaths for that day and the preceding 6 days) from 1 February 2020 up to and including 30 June 2020, adjusted for seasonality. The number of non-COVID-19 excess CV deaths each day from 1 February 2020 were subtracted from the expected daily death estimated …

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