In-Hospital Mortality from Cardiovascular Diseases in Brazil during the First Year of The COVID-19 Pandemic.

Background: The COVID-19 pandemic has had an impact on mortality from several diseases worldwide, especially cardiovascular diseases (CVD). Brazil is a continent-sized country with significant differences in the health care structure between its federative units.

Objective: Analyze in-hospital mortality from CVDs in the Brazilian public health system during the first year of the COVID-19 pandemic (2020).

Methods: This is an ecological study analyzing the absolute number of in-hospital deaths and the rate of in-hospital mortality in Brazil, its macro-regions, and federative units. Data were obtained from the Hospital Information System of the Brazilian Ministry of Health. To analyze excess mortality, the P-score was used. It compares the events observed with those expected for a given place and period. The P-score was corrected by the joinpoint regression model, with a 95% confidence interval and 5% significance level.

Results: There were 93,104 in-hospital deaths due to CVD in Brazil in 2020, representing 1,495 fewer deaths (P score: -1.58) than expected. The central-west region had a positive P-score, with a 15.1% increase in the number of deaths. Ten federative units showed a greater number of deaths in 2020. There was also a 13.3% excess in-hospital mortality at the country level, and an excess in-hospital mortality in all macro-regions.

Conclusions: There was a decrease in the absolute number of in-hospital deaths, as well as an increase in in-hospital mortality from CVD in Brazil, in 2020, after the COVID-19 pandemic onset.