Retrospective analysis of ethnic/racial disparities and excess vascular mortality associated with the COVID-19 pandemic.

Publication date: Oct 01, 2024

The Sars coronavirus 2019 (COVID-19) pandemic has resulted in increased morbidity and mortality; however, there is limited understanding of how excess mortality is distributed among different racial and ethnic subgroups and vascular diseases. We conducted a retrospective, cross-sectional study design using data from the United States (US) Center for Disease Control (CDC) Wide Ranging Online Data for Epidemiologic Research (Wonder) database. The database contains death certificate information for all US residents by cause of death as ascertained by the treating physician. We examined the trends of excess death by vascular disease specific mortality among different racial and ethnicity subgroups. Excess deaths were defined as the difference between observed numbers of deaths in specific time periods and the expected numbers of deaths in the same time periods. We compared mortality rates during the reference period of 2018-2019 (pre-pandemic) with the study period of 2020-2021 (pandemic years). We also compared excess mortality rates among racial and ethnic subgroups (Non-Hispanic white, Non-Hispanic Black, and Hispanic individuals). Vascular disease was categorized by administrative diagnostic codes (ICD10): Vascular disease (I26, I82, I70-73, I74) and its subtypes Arterial thrombosis (I74), venous thromboembolism (I26, I82) and atherosclerotic disease (I70-73). Compared to 2018-2019, there was a 1. 3 % excess mortality associated with vascular disease, a 12. 2 % excess mortality due to arterial thrombosis mortality, and an 8. 0 % excess mortality due to thromboembolism in 2020-2021. Black individuals demonstrated higher excess vascular mortality (6. 9 %) compared to white individuals (-0. 3 %) P < .001, higher excess venous thromboembolism mortality (14. 1 % vs 5. 1 % P = 0. 002) and higher atherosclerosis mortality (2. 1 % vs -2. 6 % P = 0. 002). Hispanics compared to white individuals had higher excess vascular mortality (5. 1 % vs -0. 3 % P = 0. 03) and excess venous thromboembolism mortality (24. 2 % vs 5. 1 % P < 0. 001). The COVID-19 pandemic has led to a significant and persistent increase in vascular mortality. Excess mortality has disproportionately affected Black and Hispanic individuals compared to white individuals, highlighting the need for further studies to address and eliminate these health care disparities.

Concepts Keywords
Atherosclerosis Aged
Coronavirus COVID-19
Hispanics COVID-19
Probl Cross-Sectional Studies
Disparities
Embolism
Epidemiology
Ethnicity
Female
Health Status Disparities
Humans
Male
Middle Aged
Racial Groups
Retrospective Studies
SARS-CoV-2
Thrombosis
United States
Vascular Diseases

Semantics

Type Source Name
disease MESH COVID-19 pandemic
disease MESH morbidity
disease MESH vascular diseases
disease VO study design
disease MESH death
disease MESH cause of death
disease VO time
disease MESH venous thromboembolism
disease MESH thromboembolism
disease MESH atherosclerosis
disease MESH Embolism
disease MESH arterial occlusive disease
disease MESH Thrombosis

Original Article

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