RT Journal Article
SR Electronic
T1 Excess of cardiovascular deaths during the COVID-19 pandemic in Brazilian capital cities
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 1898
OP 1905
DO 10.1136/heartjnl-2020-317663
VO 106
IS 24
A1 Luisa Campos Caldeira Brant
A1 Bruno Ramos Nascimento
A1 Renato Azeredo Teixeira
A1 Marcelo Antônio Cartaxo Queiroga Lopes
A1 Deborah Carvalho Malta
A1 Glaucia Maria Moraes Oliveira
A1 Antonio Luiz Pinho Ribeiro
YR 2020
UL http://heart.bmj.com/content/106/24/1898.abstract
AB Introduction During the COVID-19 pandemic, excess mortality has been reported, while hospitalisations for acute cardiovascular events reduced. Brazil is the second country with more deaths due to COVID-19. We aimed to evaluate excess cardiovascular mortality during COVID-19 pandemic in 6 Brazilian capital cities.Methods Using the Civil Registry public database, we evaluated total and cardiovascular excess deaths, further stratified in specified cardiovascular deaths (acute coronary syndromes and stroke) and unspecified cardiovascular deaths in the 6 Brazilian cities with greater number of COVID-19 deaths (São Paulo, Rio de Janeiro, Fortaleza, Recife, Belém, Manaus). We compared observed with expected deaths from epidemiological weeks 12–22 of 2020. We also compared the number of hospital and home deaths during the period.Results There were 65 449 deaths and 17 877 COVID-19 deaths in the studied period and cities for 2020. Cardiovascular mortality increased in most cities, with greater magnitude in the Northern capitals. However, while there was a reduction in specified cardiovascular deaths in the most cities, the Northern capitals showed an increase of these events. For unspecified cardiovascular deaths, there was a marked increase in all cities, which strongly correlated to the rise in home deaths (r=0.86, p=0.01).Conclusion Excess cardiovascular mortality was greater in the less developed cities, possibly associated with healthcare collapse. Specified cardiovascular deaths decreased in the most developed cities, in parallel with an increase in unspecified cardiovascular and home deaths, presumably as a result of misdiagnosis. Conversely, specified cardiovascular deaths increased in cities with a healthcare collapse.