VERY HIGH MORTALITY OF CARDIOMETABOLIC DISEASE IN COVID-19 AND NON-COVID-19 POPULATION DURING THE PANDEMIC FIRST WAVE IN PERU

Volume 6, Issue 1, February 2022     |     PP. 1-27      |     PDF (560 K)    |     Pub. Date: March 7, 2022
DOI: 10.54647/pmh33190    76 Downloads     49154 Views  

Author(s)

Segundo Nicolas Seclen, Unidad de Diabetes, Hipertensión y Lipidos, Instituto de Gerontologia, Universidad Peruana Cayetano Heredia, Lima, Perú
Marlon Yovera-Aldana, Grupo de Investigación en Neurociencias, Efectividad Clínica y Salud Pública, Universidad Científica del Sur, Lima, Perú

Abstract
OBJECTIVE: To describe the mortality of cardio-metabolic diseases by non-COVID-19 during the pandemic first wave 2020.
METHODOLOGY: We analyzed open data from Peruvian death certificates from March 01 to December 31, 2020, and 2019. Confirmed and suspected cases of COVID-19 by ICD-10 and the text of the diagnosis were included. We calculate the excess mortality 2020/2019 according to demographic characteristics, cardiometabolic disease, a primary cause of death. We performed a Poisson regression analysis for the prevalence rates of non-communicable diseases non-COVID-19 / COVID-19 adjusted to sex, age, place of deaths, Insurance, altitude, poverty quintile, precedence regio, degree of instruction.
RESULTS: Deaths registered in first wave compared to 2019 resulted excess of 92,395 (+ 96%). The mortality rate was 25.1/10,000 inhabitants,  60% were male, 72.6% were older than 60 years and 38% died in Lima/Callao.  57% of deaths were due non-COVID disease. In this population, stroke was 51% more frequent (PR 1.51; CI95% 1.49-1.52; p<0.001); coronary disease was 29% (PR 1.29 CI95% 1.28-1.30;p<0.001), an diabetes was 5% (PR 1.06; CI95% 1.05-1.08;p<0.001). In COVID subjects, only obesity was more frequent in 37% (PR 1.37; CI95%1.35-1.-39;p<0.001). There was an increase in cardiovascular death of 113% compared to 2019. Likewise, it was 13.9 times more frequent in non-COVID-19 compared to COVID-19 .(PR 13.29; CI95% 12.32 – 14.34; p<0.001) adjusted a epidemiological characteristics. 
CONCLUSION: During the first wave of COVID-19 in Peru, six out of ten were unrelated to COVID-19. The associated cardiometabolic diseases in COVID-19 deaths were obesity, while non-COVID-19 deaths were stroke, coronary disease, and diabetes mellitus.

Keywords
COVID-19; mortality; diabetes mellitus; hypertension; coronary disease; stroke; obesity; cardiovascular diseases.

Cite this paper
Segundo Nicolas Seclen, Marlon Yovera-Aldana, VERY HIGH MORTALITY OF CARDIOMETABOLIC DISEASE IN COVID-19 AND NON-COVID-19 POPULATION DURING THE PANDEMIC FIRST WAVE IN PERU , SCIREA Journal of Health. Volume 6, Issue 1, February 2022 | PP. 1-27. 10.54647/pmh33190

References

[ 1 ] The Economist. Tracking covid-19 excess deaths across countries. Econ 2021. https://www.economist.com/graphic-detail/coronavirus-excess-deaths-tracker (accessed March 11, 2021).
[ 2 ] Adjwanou V, Alam N, Alkerna L, Asiki G, Bawah A, Beguy D. Measuring excess mortality during the COVID-19 pandemic in low- and lower-middle income countries: the need for mobile phone surveys. SocArXiv 2020. https://doi.org/https://doi.org/10.31235/osf.io/4bu3q.
[ 3 ] Magnani C, Azzolina D, Gallo E, Ferrante D, Gregori D. How large was the mortality increase directly and indirectly caused by the COVID-19 epidemic? An analysis on all-causes mortality data in Italy. Int J Environ Res Public Health 2020;17:3452. https://doi.org/10.3390/ijerph17103452.
[ 4 ] Woolf SH, Chapman DA, Sabo RT, Weinberger DM, Hill L, Taylor DSDH. Excess Deaths from COVID-19 and Other Causes, March-July 2020. JAMA - J Am Med Assoc 2020;324:1562–4. https://doi.org/10.1001/jama.2020.19545.
[ 5 ] Nogueirai PJ, De Araújo Nobre M, Nicola PJ, Furtado C, Vaz Carneiro A. Excess mortality estimation during the COVID-19 pandemic: Preliminary data from Portugal. Acta Med Port 2020;33:376–83. https://doi.org/10.20344/amp.13928.
[ 6 ] Lima E, Vilela E, Peralta A, Rocha MG, Queiroz BL, Gonzaga MR. Exploring Excess of Deaths in the Context of Covid Pandemic in Selected Countries of Latin America. OSF Prepr 2020. https://doi.org/https://doi.org/10.31219/osf.io/xhkp4.
[ 7 ] Grillo-Rojas PF, Romero-Onofre R. Estimate of the excess of the total deaths reported in 2020 versus the reported deaths from COVID-19 (SARS-CoV2) in Peru during the months of March, April and May 2020. Rev Fac Med Hum 2020;20:646–50. https://doi.org/https://doi.org/10.25176/RFMH.v20i4.3220.
[ 8 ] Taylor L. Covid-19: Why Peru suffers from one of the highest excess death rates in the world. BMJ 2021:372:n611. https://doi.org/https://doi.org/10.1136/bmj.n611.
[ 9 ] Bernabé-Ortiz A, Carrillo-Larco RM. La transición epidemiológica en el Perú: análisis de los registros de mortalidad del 2003 al 2016. ACTA MEDICA Peru 2020;37. https://doi.org/10.35663/amp.2020.373.1550.
[ 10 ] Atamari-Anahui N, Ccorahua-Rios M, Taype-Rondan A, Mejia CR. Mortalidad atribuida a diabetes mellitus registrada en el Ministerio de Salud de Perú, 2005-2014. Rev Panam Salud Pública 2018;42:e50. https://doi.org/10.26633/rpsp.2018.50.
[ 11 ] Ministerio de Salud. Directiva Administrativa 216-MINSA/OGTI-V.01: Directiva Administrativa que establece el Procedimiento para la Certificación de las Defunciones, aprobada mediante Resolución Ministerial 280-2016/MINSA Perú 2016:38. ftp://ftp2.minsa.gob.pe/descargas/ogei/SINADEF/RM_280-2016-DIRECTIVA_DEFUNCIONES.pdf (accessed January 15, 2021).
[ 12 ] Ministerio de Salud. Información de Fallecidos del Sistema Informático Nacional de Defunciones - SINADEF - [Ministerio de Salud] 2021. https://www.datosabiertos.gob.pe/dataset/información-de-fallecidos-del-sistema-informático-nacional-de-defunciones-sinadef-ministerio (accessed January 15, 2021).
[ 13 ] Ministerio de Salud. Directiva Sanitaria para la Vigilancia Epidemiológica de la Enfermedad por Coronavirus (COVID-19) en el Perú. 2020:1–40. https://www.dge.gob.pe/portalnuevo/wp-content/uploads/2021/01/Directiva-de-vigilancia-de-COVID-19.pdf (accessed January 15, 2021).
[ 14 ] Instituto Nacional de Estadística e Informática. Perú: Estimaciones y Proyecciones de Población por Departamento, Provincia y Distrito, 2018-2020. Boletín Espec N°26 2020:110. https://www.inei.gob.pe/media/MenuRecursivo/publicaciones_digitales/Est/Lib1715/libro.pdf (accessed January 15, 2021).
[ 15 ] Instituto Nacional de Estadística e Informática. Compendio Estadístico del Perú 2013:1523. https://www.inei.gob.pe/media/MenuRecursivo/publicaciones_digitales/Est/Lib1097/libro.pdf.
[ 16 ] Instituto Nacional de Estadística e Informática. Mapa de pobreza monetaria provincial y distrital 2018. 2020:303 pp. https://www.inei.gob.pe/media/MenuRecursivo/publicaciones_digitales/Est/Lib1718/Libro.pdf.
[ 17 ] Ministerio de Salud – Dirección General de Tecnologías de la Información. Guía técnica para el correcto llenado del certificado de defunción 2018:69 pp. http://bvs.minsa.gob.pe/local/MINSA/4459.pdf.
[ 18 ] Organización Panamericana de la Salud. Lineamientos básicos para el análisis de la mortalidad 2017:145. https://iris.paho.org/bitstream/handle/10665.2/34492/9789275319819-spa.pdf?sequence=7 (accessed January 15, 2021).
[ 19 ] Dirección General de Epidemiología - Ministerio de Salud. Metodología para el análisis de situación de salud local 2015:97. http://bvs.minsa.gob.pe/local/MINSA/3399.pdf (accessed January 15, 2021).
[ 20 ] Ministerio de Salud. Fallecidos por COVID-19 - [Ministerio de Salud - MINSA] 2021. https://www.datosabiertos.gob.pe/dataset/fallecidos-por-covid-19-ministerio-de-salud-minsa (accessed January 15, 2021).
[ 21 ] Karlinsky A, Kobak D. Tracking excess mortality across countries during the covid-19 pandemic with the world mortality dataset. Elife 2021;10. https://doi.org/10.7554/ELIFE.69336.
[ 22 ] Liu J, Zhang L, Yan Y, Zhou Y, Yin P, Qi J, et al. Excess mortality in Wuhan city and other parts of China during the three months of the covid-19 outbreak: Findings from nationwide mortality registries. BMJ 2021;372. https://doi.org/10.1136/bmj.n415.
[ 23 ] Wu J, Mamas MA, Mohamed MO, Kwok CS, Roebuck C, Humberstone B, et al. Place and causes of acute cardiovascular mortality during the COVID-19 pandemic. Heart 2021;107:113–9. https://doi.org/10.1136/heartjnl-2020-317912.
[ 24 ] Butt JH, Fosbøl EL, Gerds TA, Andersson C, Kragholm K, Biering-Sørensen T, et al. All-cause mortality and location of death in patients with established cardiovascular disease before, during, and after the COVID-19 lockdown: a Danish Nationwide Cohort Study. Eur Heart J 2021. https://doi.org/10.1093/eurheartj/ehab028.
[ 25 ] Siriaco M. La estrategia olvidada: ¿qué pasó con los centros de atención primaria? Salud Con Lupa 2020. https://saludconlupa.com/noticias/la-estrategia-olvidada-que-paso-con-los-centros-de-atencion-primaria/ (accessed February 12, 2021).
[ 26 ] Pesantes MA, Lazo-Porras M, Cárdenas MK, Diez-Canseco F, Tanaka-Zafra JH, Carrillo-Larco RM, et al. Los retos del cuidado de las personas con diabetes durante el estado de emergencia nacional por la COVID-19 en Lima, Perú: recomendaciones para la atención primaria. Rev Peru Med Exp Salud Publica 2020;37:541–6. https://doi.org/10.17843/rpmesp.2020.373.5980
[ 27 ] World Health Organization. Pulse survey on continuity of essential health services during the COVID-19 pandemic: interim report, 27 August 2020 2020:21. https://www.who.int/publications/i/item/WHO-2019-nCoV-EHS_continuity-survey-2020.1 (accessed February 12, 2021).
[ 28 ] Wichmann D, Sperhake J-P, Lütgehetmann M, Steurer S, Edler C, Heinemann A, et al. Autopsy Findings and Venous Thromboembolism in Patients With COVID-19. Https://DoiOrg/107326/M20-2003 2020;173:268–77. https://doi.org/10.7326/M20-2003.
[ 29 ] Elezkurtaj S, Greuel S, Ihlow J, Michaelis EG, Bischoff P, Kunze CA, et al. Causes of death and comorbidities in hospitalized patients with COVID-19. Sci Reports 2021 111 2021;11:1–9. https://doi.org/10.1038/s41598-021-82862-5.
[ 30 ] Banerjee A, Chen S, Pasea L, Lai AG, Katsoulis M, Denaxas S, et al. Excess deaths in people with cardiovascular diseases during the COVID-19 pandemic. Eur J Prev Cardiol 2021. https://doi.org/10.1093/EURJPC/ZWAA155.
[ 31 ] Rao GH. Cardiometabolic Diseases: A Global Perspective. J Cardiol Cardiovasc Ther 2018;12:1–6. https://doi.org/10.19080/jocct.2018.12.555834.
[ 32 ] Lau H, Khosrawipour T, Kocbach P, Ichii H, Bania J, Khosrawipour V. Evaluating the massive underreporting and undertesting of COVID-19 cases in multiple global epicenters. Pulmonology 2021;27:110–5. https://doi.org/10.1016/J.PULMOE.2020.05.015.
[ 33 ] Soto Cáceres Cabanillas R, Fernandez- Mogollón JL, Daniel VV. Calidad de llenado del certificado de defunción en dos hospitales de Chiclayo,Perú, 2016. Rev Exp En Med Del Hosp Reg Lambayeque 2019;5. https://doi.org/10.37065/rem.v5i2.344.
[ 34 ] Mesa de Concertación para la Lucha contra la Pobreza. Informe Nacional sobre el impacto del COVID.19 en ls dimensiones económica, social y en salud en el Perú. n.d.:88. https://www.mesadeconcertacion.org.pe/storage/documentos/2020-08-17/informe-salud-mclcp-2020-7-de-julio.pdf (accessed February 12, 2021).