Study Identifies Thousands of Deaths Caused by Heart Disease and Stroke During the COVID-19 Pandemic

reviewed by Emily Henderson, Bachelor of Science29 September 2020

A major new study has identified 2,085 excess deaths in England and Wales due to heart disease and stroke during the peak of the COVID-19 pandemic. On average, that’s 17 deaths a day for four months that probably could have been prevented.

Excess deaths is the number of deaths above what is normally expected, and the figure refers to the period between March 2 and June 30, 2020.

Scientists believe that the excess deaths were caused by people who did not seek emergency hospital treatment for a heart attack or other acute cardiovascular disease that required urgent medical attention, either because they were afraid of contracting COVID-19 or were not referred for receipt. treatment.

During the same period, there was a sharp increase in the proportion of people who died at home or in a nursing home from acute cardiovascular disease.

It is entirely plausible that several deaths could have been prevented if people had rushed to the hospital when they started having a heart attack or stroke. The sad irony is that previous research we have conducted has shown that heart attack services nationwide remained fully operational and continued to provide high-quality care during the peak of the pandemic. “

Chris Gale, Professor, Cardiovascular Medicine, University of Leeds

The findings, based on an analysis of the information contained in the death certificates, have been published in the journal Heart.

The research was conducted by a team of medical and data scientists, led by academics from the University of Leeds. The other contributors were from Keele University, NHS Digital, the Office for National Statistics, Barts Health NHS Trust, and University College London. This is the third major study by academics investigating how the peak of the COVID-19 pandemic affected emergency cardiovascular services.

Dr. Jianhua Wu, associate professor at Leeds School of Medicine, led the latest study. He said: “This study is the first to give a detailed and comprehensive picture of what was happening to people who were seriously ill with cardiovascular disease in England and Wales.” It reveals a large number of excess deaths. The findings will help the government and the NHS develop messages that ensure that people who are very ill seek help. “

Measuring excess deaths

The analysis examined the information that is collected when a death certificate is issued. List the cause of death and where the person died. To provide baseline data, the study looked at cardiovascular deaths from January 1, 2014, to June 30, 2020.

In the four months from March 2, 2020, when the first COVID-19 death was recorded in the UK, to June 30, there were 28,969 cardiovascular deaths. That was compared to the average number of deaths observed during the same period during each of the previous six years. It was eight percent higher, revealing 2,085 excess deaths.

The excess cardiovascular deaths began to emerge in late March 2020 and peaked in early April; this was when the government was promoting their ‘Stay Home, Protect the NHS, Save Lives’ messages. That may have resulted in fewer people being prepared to go to the hospital when they were getting sick, either because they were concerned about becoming infected with COVID-19 or because they were concerned about overwhelming the NHS.

Previous studies by the researchers, published in The lancet Y European Heart Journal – Quality of care and clinical outcomes, have revealed that the number of people arriving at the hospital with a heart attack dropped dramatically, with some units seeing just over half the expected number of cases.

Changes in where people died

This latest analysis has revealed a change in where people died. There were proportionally fewer deaths in the hospital compared to baseline data: 53.4 percent versus 63 percent. Proportionally, more deaths occurred at home: 30.9 percent versus 23.5 percent, and in nursing homes: 15.7 percent versus 13.5 percent.

Excess deaths occurred disproportionately in the home, 35 percent more than would be expected, and in nursing homes, a 32 percent increase. In the paper, the scientists noted: “This ‘death shift’ most likely means that the public did not seek help or was not referred to hospital during the pandemic …”

Cause of death

For people in nursing homes and hospices, the most common cause of death was stroke and heart failure. For those who died at home, it was a heart attack or heart failure. Pulmonary embolism and cardiogenic shock, in which the heart cannot supply enough blood to the body, were the most common causes of death for those who died in hospital.

Professor Gale said: “Our study has revealed that people who died at home were more likely to have had a heart attack. This further supports the speculation that many people were staying away from the hospital despite being very ill with a disease. Acute cardiovascular disease. The reality of an untreated heart attack is that it will cause complications, leading to death, heart failure, or life-threatening heart rhythms. “

“The messages that were sent out at the time of the shutdown were important. The NHS needed protection from a potential increase in COVID-19 cases. But some people may have taken the message to mean that the NHS would not be able to cope if there were a medical emergency, or that hospitals were a place where they would contract the contagion. “

“As the NHS prepares for any future wave of COVID-19, it needs to ensure that people clearly understand that hospitals are open and have processes in place to minimize the risks of patients becoming infected with COVID-19.”