The hidden toll of COVID-19 on people with heart disease
Hospital activity for cardiovascular disease fell by 60 to 100% during the pandemic, and we estimated tens of thousands of excess deaths in England, direct and indirect.
The question
People with cardiovascular disease are at higher risk if they catch COVID-19. But the pandemic may also have harmed them indirectly, by disrupting the care they needed. How big could the combined effect be?
What we did
With a large team led by UCL, we combined three sources: national mortality data for England and Wales, routine data from hospitals in England, Italy and China on referral, diagnosis and treatment, and electronic health records of 3,862,012 people in England. We modelled direct effects through infection under several assumptions about the extra risk.
What we found
Cardiovascular service activity fell by 60 to 100% compared with before the pandemic in eight hospitals. At 10% COVID-19 prevalence, we estimated 31,205 to 62,410 direct excess deaths in England, and 49,932 to 99,865 indirect excess deaths. Mortality data suggested the indirect effects would be delayed rather than immediate.
Why it matters
Many of these deaths were potentially avoidable. The study made the case for keeping cardiovascular care running through the pandemic.