Article Text
PDF
Abstract
Background Inconsistent findings about the impact of the COVID-19 pandemic on cardiovascular disease diagnosis and consultations have been reported internationally. The objective of this study was to analyse the impact of the pandemic period (2020–2021) on the incidence rate of coronary heart disease (CHD) compared with the pre-pandemic period (2012–2019) in Bavaria, Germany.
Methods We used health claims data of around 9 million statutorily insured residents (≥20 years) of Bavaria, Germany. We calculated quarterly age-standardised incidence rates for men and women diagnosed with CHD using the European Standard Population 2013. Interrupted time series regression models were used to analyse possible pandemic effects on the CHD incidence rates.
Results Overall, 797 074 new CHD cases (47% women) were diagnosed from 2012 to 2021. Both pre-pandemic and pandemic incidence rates for women were lower than for men. Regression models showed decreasing incidence rates in the pre-pandemic period in men (−5.2% per year (p.a.), 95% CI: −5.7% to −4.7%) and in women (−6.6% p.a., 95% CI: −7.3% to −6.0%) and seasonal effects (higher in quarter 4 compared with Q1–Q3). During the pandemic period, there was no clear evidence of a level change in the incidence rates both in women and men. However, there are indications of a smaller decline in the incidence during the pandemic compared with the pre-pandemic period, in particular in women (−0.7% p.a., 95% CI: −6.0% to 4.8%) and less prominent in men (−1.7% p.a., 95% CI: −6.0% to 2.8%).
Conclusions An overall decreasing CHD incidence rate was observed in men and women in the past decade but no clear impact of the pandemic was seen. These results show the importance of incidence monitoring beyond the pandemics to maintain chronic disease care.
- COVID-19
- Epidemiology
- Coronary Artery Disease
Data availability statement
Data are available upon reasonable request. The data used for these analyses are available from the Bavarian Association of Statutory Health Insurance Physicians (KVB) upon application but restrictions apply. Data are, however, available from the authors upon reasonable request and with permission of the KVB.
Statistics from Altmetric.com
Data availability statement
Data are available upon reasonable request. The data used for these analyses are available from the Bavarian Association of Statutory Health Insurance Physicians (KVB) upon application but restrictions apply. Data are, however, available from the authors upon reasonable request and with permission of the KVB.
Footnotes
Deceased This manuscript is dedicated to the memory of Ewan Donnachie, who has passed away before the publication of this manuscript.
Contributors SJK, LS and ME designed the study. SJK acquired the funding. ED prepared the data and FS carried out data analysis in consultation with ED, GS, ME and CTL. FS, ED, ME, CTL, GS, AK, KH, MT and SJK interpreted the data. FS wrote the manuscript. All authors read and approved the final version of the manuscript. SJK is the guarantor of this work.
Funding The ChroVID study is funded by the German Research Foundation (DFG) under the project number 458556631 . The study funder was not involved in the study’s design, collection, analysis and interpretation of data or the writing of the report and the funder did not impose any restrictions regarding the publication of the report.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.