tetano
Editor, Senior Moderator
Thromb Res
. 2022 Feb 20;212:44-50.
doi: 10.1016/j.thromres.2022.02.008. Online ahead of print.
Deaths related to pulmonary embolism and cardiovascular events before and during the 2020 COVID-19 pandemic: An epidemiological analysis of data from an Italian high-risk area
Davide Voci[SUP] 1 [/SUP], Ugo Fedeli[SUP] 2 [/SUP], Ioannis T Farmakis[SUP] 3 [/SUP], Lukas Hobohm[SUP] 4 [/SUP], Karsten Keller[SUP] 4 [/SUP], Luca Valerio[SUP] 3 [/SUP], Elena Schievano[SUP] 2 [/SUP], Claudio Barbiellini Amidei[SUP] 5 [/SUP], Stavros V Konstantinides[SUP] 6 [/SUP], Nils Kucher[SUP] 1 [/SUP], Stefano Barco[SUP] 7 [/SUP]
Affiliations
Abstract
Background: Pulmonary embolism is a known complication of coronavirus disease 2019 (COVID-19). Epidemiological population data focusing on pulmonary embolism-related mortality is limited.
Methods: Veneto is a region in Northern Italy counting 4,879,133 inhabitants in 2020. All ICD-10 codes from death certificates (1st January 2018 to 31st December 2020) were examined. Comparisons were made between 2020 (COVID-19 outbreak) and the average of the two-year period 2018-2019. All-cause, COVID-19-related and the following cardiovascular deaths have been studied: pulmonary embolism, hypertensive disease, ischemic heart disease, atrial fibrillation/flutter, and cerebrovascular diseases.
Results: In 2020, a total of 56,412 deaths were recorded, corresponding to a 16% (n = 7806) increase compared to the period 2018-2019. The relative percentage increase during the so-called first and second waves was 19% and 44%, respectively. Of 7806 excess deaths, COVID-19 codes were reported in 90% of death certificates. The percentage increase in pulmonary embolism-related deaths was 27% (95%CI 19-35%), 1018 deaths during the year 2020, compared to 804 mean annual deaths in the period 2018-2019. This was more evident among men, who experience an absolute increase of 147 deaths (+45%), than in women (+67 deaths; +14%). The increase was primarily driven by deaths recorded during the second wave (+91% in October-December). An excess of deaths, particularly among men and during the second wave, was also observed for other cardiovascular diseases, notably hypertensive disease, atrial fibrillation, cerebrovascular disease, and ischemic heart disease.
Conclusions: We observed a considerable increase of all-cause mortality during the year 2020. This was mainly driven by COVID-19 and its complications. The relative increase in the number of pulmonary embolism-related deaths was more prominent during the second wave, suggesting a possible underdiagnosis during the first wave.
. 2022 Feb 20;212:44-50.
doi: 10.1016/j.thromres.2022.02.008. Online ahead of print.
Deaths related to pulmonary embolism and cardiovascular events before and during the 2020 COVID-19 pandemic: An epidemiological analysis of data from an Italian high-risk area
Davide Voci[SUP] 1 [/SUP], Ugo Fedeli[SUP] 2 [/SUP], Ioannis T Farmakis[SUP] 3 [/SUP], Lukas Hobohm[SUP] 4 [/SUP], Karsten Keller[SUP] 4 [/SUP], Luca Valerio[SUP] 3 [/SUP], Elena Schievano[SUP] 2 [/SUP], Claudio Barbiellini Amidei[SUP] 5 [/SUP], Stavros V Konstantinides[SUP] 6 [/SUP], Nils Kucher[SUP] 1 [/SUP], Stefano Barco[SUP] 7 [/SUP]
Affiliations
- PMID: 35219931
- DOI: 10.1016/j.thromres.2022.02.008
Abstract
Background: Pulmonary embolism is a known complication of coronavirus disease 2019 (COVID-19). Epidemiological population data focusing on pulmonary embolism-related mortality is limited.
Methods: Veneto is a region in Northern Italy counting 4,879,133 inhabitants in 2020. All ICD-10 codes from death certificates (1st January 2018 to 31st December 2020) were examined. Comparisons were made between 2020 (COVID-19 outbreak) and the average of the two-year period 2018-2019. All-cause, COVID-19-related and the following cardiovascular deaths have been studied: pulmonary embolism, hypertensive disease, ischemic heart disease, atrial fibrillation/flutter, and cerebrovascular diseases.
Results: In 2020, a total of 56,412 deaths were recorded, corresponding to a 16% (n = 7806) increase compared to the period 2018-2019. The relative percentage increase during the so-called first and second waves was 19% and 44%, respectively. Of 7806 excess deaths, COVID-19 codes were reported in 90% of death certificates. The percentage increase in pulmonary embolism-related deaths was 27% (95%CI 19-35%), 1018 deaths during the year 2020, compared to 804 mean annual deaths in the period 2018-2019. This was more evident among men, who experience an absolute increase of 147 deaths (+45%), than in women (+67 deaths; +14%). The increase was primarily driven by deaths recorded during the second wave (+91% in October-December). An excess of deaths, particularly among men and during the second wave, was also observed for other cardiovascular diseases, notably hypertensive disease, atrial fibrillation, cerebrovascular disease, and ischemic heart disease.
Conclusions: We observed a considerable increase of all-cause mortality during the year 2020. This was mainly driven by COVID-19 and its complications. The relative increase in the number of pulmonary embolism-related deaths was more prominent during the second wave, suggesting a possible underdiagnosis during the first wave.