PT  - JOURNAL ARTICLE
AU  - Junren Wang
AU  - Jianwei Zhu
AU  - Huazhen Yang
AU  - Yao Hu
AU  - Yajing Sun
AU  - Zhiye Ying
AU  - Yuanyuan Qu
AU  - Unnur Valdimarsdottir
AU  - Fang Fang
AU  - Huan Song
TI  - Cardiovascular-related deaths at the beginning of the COVID-19 outbreak: a prospective analysis based on the UK Biobank
AID  - 10.1136/bmjopen-2020-046931
DP  - 2021 Jun 01
TA  - BMJ Open
PG  - e046931
VI  - 11
IP  - 6
4099  - http://bmjopen.bmj.com/content/11/6/e046931.short
4100  - http://bmjopen.bmj.com/content/11/6/e046931.full
SO  - BMJ Open2021 Jun 01; 11
AB  - Objective To assess the impact of the COVID-19 outbreak on cardiovascular disease (CVD) related mortality and hospitalisation.Design Community-based prospective cohort study.Setting The UK Biobank.Participants 421 372 UK Biobank participants who were registered in England and alive as of 1 January 2020.Primary and secondary outcome measures The primary outcome of interest was CVD-related death, which was defined as death with CVD as a cause in the death register. We retrieved information on hospitalisations with CVD as the primary diagnosis from the UK Biobank hospital inpatient data. The study period was 1 January 2020 to June 30 2020, and we used the same calendar period of the three preceding years as the reference period. In order to control for seasonal variations and ageing of the study population, standardised mortality/incidence ratios (SMRs/SIRs) with 95% CIs were used to estimate the relative risk of CVD outcomes during the study period, compared with the reference period.Results We observed a distinct increase in CVD-related deaths in March and April 2020, compared with the corresponding months of the three preceding years. The observed number of CVD-related deaths (n=218) was almost double in April, compared with the expected number (n=120) (SMR=1.82, 95% CI 1.58 to 2.07). In addition, we observed a significant decline in CVD-related hospitalisations from March onwards, with the lowest SIR observed in April (0.45, 95% CI 0.41 to 0.49).Conclusions There was a distinct increase in the number of CVD-related deaths in the UK Biobank population at the beginning of the COVID-19 outbreak. The shortage of medical resources for hospital care and stress reactions to the pandemic might have partially contributed to the excess CVD-related mortality, underscoring the need of sufficient healthcare resources and improved instructions to the public about seeking healthcare in a timely way.Data used in this study was from the UK Biobank (http://www.ukbiobank.ac.uk/), which are available to all researchers on making an application. Part of this research was conducted using the UK Biobank Resource under Application 54803.