Excess all-cause mortality during COVID-19 outbreak: potential role of untreated cardiovascular disease

Saglietto, Andrea; D’Ascenzo, Fabrizio; Frati, Giacomo; Anselmino, Matteo; Versaci, Francesco; Biondi‐Zoccai, Giuseppe; Ferrari, Gaetano Maria De

doi:10.23736/s2724-5683.20.05349-9

Cited by 6 publications

(1 citation statement)

References 22 publications

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“…There were 30 peer-reviewed publications (96.8%) (10, 27-49, 51-56) and 1 pre-print (3.2%) (10). There were 30 (96.8%) cohort observational studies (10,(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(48)(49)(50)(51)(52)(53)(54)(55)(56), and 1 (3.2%) case-control (47) observational study with no randomized control trials. Research ethics board (REB) approval and consent were obtained in 6 (19.4%) studies (29, 36, 37, 45, 50, 53), 14 (45.2%) studies (10, 32, 35, 38-44, 47-49, 54) stated formal ethics approval was not required or the study was exempted while 11 (35.2%) studies (27,28,30,33,34,46, 51, 52, 54-56) did not report REB approval or were not applicable (stated as none with no explanation).…”

Section: Study Characteristicsmentioning

confidence: 99%

Coronavirus disease 2019 (COVID-19) excess mortality outcomes associated with pandemic effects study (COPES): A systematic review and meta-analysis

Dhanoa

Cheema

et al. 2022

Front. Med.

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Background and aimWith the Coronavirus Disease 2019 (COVID-19) pandemic continuing to impact healthcare systems around the world, healthcare providers are attempting to balance resources devoted to COVID-19 patients while minimizing excess mortality overall (both COVID-19 and non-COVID-19 patients). To this end, we conducted a systematic review (SR) to describe the effect of the COVID-19 pandemic on all-cause excess mortality (COVID-19 and non-COVID-19) during the pandemic timeframe compared to non-pandemic times.MethodsWe searched EMBASE, Cochrane Database of SRs, MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Cochrane Controlled Trials Register (CENTRAL), from inception (1948) to December 31, 2020. We used a two-stage review process to screen/extract data. We assessed risk of bias using Newcastle-Ottawa Scale (NOS). We used Critical Appraisal and Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology.ResultsOf 11,581 citations, 194 studies met eligibility. Of these studies, 31 had mortality comparisons (n = 433,196,345 participants). Compared to pre-pandemic times, during the COVID-19 pandemic, our meta-analysis demonstrated that COVID-19 mortality had an increased risk difference (RD) of 0.06% (95% CI: 0.06–0.06% p < 0.00001). All-cause mortality also increased [relative risk (RR): 1.53, 95% confidence interval (CI): 1.38–1.70, p < 0.00001] alongside non-COVID-19 mortality (RR: 1.18, 1.07–1.30, p < 0.00001). There was “very low” certainty of evidence through GRADE assessment for all outcomes studied, demonstrating the evidence as uncertain.InterpretationThe COVID-19 pandemic may have caused significant increases in all-cause excess mortality, greater than those accounted for by increases due to COVID-19 mortality alone, although the evidence is uncertain.Systematic review registration[https://www.crd.york.ac.uk/prospero/#recordDetails], identifier [CRD42020201256].

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Section: Study Characteristicsmentioning

confidence: 99%

Coronavirus disease 2019 (COVID-19) excess mortality outcomes associated with pandemic effects study (COPES): A systematic review and meta-analysis

Dhanoa

Cheema

et al. 2022

Front. Med.

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Intensive cardiac care unit admission trends during the COVID-19 outbreak in Italy: a multi-center study

et al. 2021

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A significant decline in the admission to intensive cardiac care unit (ICCU) has been noted in Italy during the COVID-19 outbreak. Previous studies have provided data on clinical features and outcome of these patients, but information is still incomplete. In this multicenter study conducted in six ICCUs, we enrolled consecutive adult patients admitted to ICCU in three specific time intervals: from February 8 to March 9, 2020 [before national lockdown (pre-LD)], from March 10 to April 9, 2020 [during the first period of national lockdown (in-LD)] and from May 18 to June 17, 2020 [soon after the end of all containment measures (after-LD)]. Compared to pre-LD, in-LD was associated with a significant drop in the admission to ICCU for all causes (− 35%) and acute coronary syndrome (ACS; − 49%), with a rebound soon after-LD. The in-LD reduction was greater for women (− 49%) and NSTEMI (− 61%) compared to men (− 28%) and STEMI (− 33%). Length-of-stay, and in-hospital mortality did not show any significant change from to pre-LD to in-LD in the whole population as well as in the ACS group. This study confirms a notable reduction in the admissions to ICCUs from pre-LD to in-LD followed by an increment in the admission rates after-LD. These data strongly suggest that people, particularly women and patients with NSTEMI, are reluctant to seek medical care during lockdown, possibly due to the fear of viral infection. Such a phenomenon, however, was not associated with a rise in mortality among patients who get hospitalization.

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Interplay between COVID-19, pollution, and weather features on changes in the incidence of acute coronary syndromes in early 2020

Versaci

Gaspardone

Danesi

et al. 2021

International Journal of Cardiology

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Excess all-cause mortality during COVID-19 outbreak: potential role of untreated cardiovascular disease

Abstract: The final version may contain major or minor changes.Subscription: Information about subscribing to Minerva Medica journals is online at: http://www.minervamedica.it/en/how-to-order-journals.php Reprints and permissions: For information about reprints and permissions send an email to:

Cited by 6 publications

References 22 publications

Coronavirus disease 2019 (COVID-19) excess mortality outcomes associated with pandemic effects study (COPES): A systematic review and meta-analysis

Coronavirus disease 2019 (COVID-19) excess mortality outcomes associated with pandemic effects study (COPES): A systematic review and meta-analysis

Intensive cardiac care unit admission trends during the COVID-19 outbreak in Italy: a multi-center study

Interplay between COVID-19, pollution, and weather features on changes in the incidence of acute coronary syndromes in early 2020

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