Coronavirus and Heart & Circulatory Diseases Factsheet - Our vision is a world free from the fear of heart and circulatory diseases.
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Coronavirus and Heart & Circulatory Diseases Factsheet January 2022 Our vision is a world free from the fear of heart and circulatory diseases.1
Heart & Circulatory Diseases (Cardiovascular Disease; CVD)
Heart and circulatory diseases is an umbrella term for all diseases of the heart and circulation – from
those that are inherited or that a person is born with, to those that are developed later, such as
coronary heart disease, atrial fibrillation, heart failure, stroke and vascular dementia.
• There are around 7.6 million people living with heart and circulatory diseases in the UK - an ageing and growing population
and improved survival rates from heart attacks and strokes, could see these numbers rise still further.
• Normally in the UK there are an average of around 22,000 hospital admissions each week where a heart or circulatory disease
is the main diagnosis, including 2,500 due to stroke and 2,000 due to a heart attack.
Coronavirus (COVID-19; SARS-CoV-2)
COVID-19 is a novel disease that can affect your lungs and airways. It's caused by coronavirus.
• The illness can affect anyone, and the experience can vary from asymptomatic (no symptoms) or mild, to critical and fatal.
• Severe illness can cause widespread inflammation and affect the heart, blood pressure and other functions.
• Because the virus is new, there’s a lot we don’t yet know. But thanks to research, we are learning quickly.
For more information please visit the BHF website:
What does coronavirus do to your body?
2Coronavirus and Heart & Circulatory Diseases
Here are some key statistics – for sources and references see pages 7-8.
• International research during 2020 suggested that people living with heart and circulatory (cardiovascular) diseases were
at significantly increased risk of severe outcomes (3.9 times higher) and death (2.7) from Covid-19.
• UK research shows increased coronavirus risk for people living with chronic heart disease, stroke and dementia, plus their
risk factors (e.g. diabetes, obesity).
Fig 1 - UK coronavirus mortality risk research (2020)
• Research suggests that people with heart failure are at increased risk of mortality if infected with coronavirus.
3• Evidence suggests that people with hypertension (high blood pressure) may be at greater risk of getting severely ill with
COVID-19 - especially if uncontrolled or untreated.
• The pandemic has highlighted health inequalities by age, gender and ethnicity and more research is required to understand
these, including how heart and circulatory diseases and their risk factors affect Covid-19 risk and outcomes.
• A 2020 study of severe Covid-19 cases in hospitals across the UK showed that chronic cardiac disease was the most common
comorbidity [other conditions that someone has been diagnosed with, e.g. high blood pressure and diabetes].
• A global study suggests that around half of heart scans from coronavirus patients in hospital show abnormalities, with one
in seven showing severe abnormalities likely to impact on patients’ survival and recovery.
• Around 9 out of 10 deaths in 2020 in Great Britain that mentioned coronavirus also record a pre-existing health condition.
• Coronary heart disease (CHD) is one of the most common pre-existing conditions for deaths involving coronavirus – others
include dementia, cerebrovascular disease (stroke), hypertensive heart disease, diabetes and heart failure.
• 45 per cent of Covid-19 death certificates in England in Spring 2020 mentioned cardiovascular (heart/circulatory) disease.
800
• In just one week in April 2020, there were more than 700 excess deaths 700
Number of excess
Other
from heart and circulatory diseases in England, including around 300 from coronary heart 600 circulatory
500 diseases
disease and nearly 200 from stroke.
deaths
400 Stroke
• In the first year of the pandemic there were over 5,800 excess deaths from heart 300
and circulatory diseases in England, some of which will also have included Covid-19 diagnoses. 200 Coronary
heart
100
disease
To read the full story, and to find out exactly what excess deaths are, please read our blog post. 0
10 Apr 20
Week ending 4• Data for out-of-hospital cardiac arrests (OHCAs) suggest that periods of high coronavirus transmission have led to
increased OHCA volumes and lower survival rates.
• Visits to accident and emergency (A&E) departments in England for suspected heart attacks dropped by around 50% in
Spring 2020, suggesting that people in urgent need may have decided not to go to hospital.
• BHF-funded research suggests that an estimated 5,000 heart attack sufferers in England may have missed out on life saving
hospital treatment in Spring 2020 due to the Covid-19 pandemic.
• The fall in the number of patients presenting to hospital in England & Wales with heart failure was even more marked than
for heart attacks, dropping by two thirds (66 per cent) by the end of April 2020.
• In Scotland, heart and circulatory A&E attendances in March and April 2020 were almost 60% lower
(compared to the previous year)
Fig 2 - A&E heart and circulatory attendances, Scotland
5• Emergency cardiology admissions in Scotland declined by up to 40% during the first wave of the pandemic.
• Data from Scotland suggest that the proportion of heart attack deaths in the home increased during Spring 2020.
• The pandemic has significantly reduced capacity for cardiac surgery and procedures, with thousands postponed or
cancelled across the country.
• NHS data show that over 280,000 people were waiting for investigations or treatment in cardiology or cardiothoracic
surgery in England at the end of November 2021 - around 77,000 had been waiting longer than 18 weeks, and more than
3,500 had been waiting for at least a year – up from just 28 before the pandemic started (at the end of February 2020).
• There has been a dramatic increase in waiting times for diagnostic care in England, with tens of thousands of people
waiting more than three months for an echocardiogram – activity dropped to as low as one third of pre-pandemic levels.
• BHF-funded research aims to help understand “long Covid” – specifically the link between Covid-19 and many heart and
circulatory diseases, and to protect health against the damaging and potentially long-term effects of Covid-19.
COVID-19, research and the BHF
Blog by Professor Sir Nilesh Samani, Medical Director
BHF Coronavirus Hub – support and information
Compiled by the British Heart Foundation.
Reviewed and updated January 2022.
For any queries, contact us and we will do our best to help -
please mark for the attention of the Health Intelligence team.
6References
STATISTIC REFERENCE
HEART AND CIRCULATORY DISEASES (H&CD; CARDIOVASCULAR DISEASE; CVD) AND CORONAVIRUS (COVID-19)
7.6m living w/ heart/circulatory diseases p2 BHF UK estimate based on latest GP/prevalence and population survey data
Pre-pandemic hospital admissions data p2 UK hospital statistics; NHS Digital/Public Health Scotland/NHS Wales/DH Northern Ireland
Cardiovascular risk and COVID-19 p3 PHE umbrella review – 2020 analysis - https://www.healthcheck.nhs.uk/commissioners-and-providers/evidence/
Luo et al (2020) Clin Cardiol -The potential association between common comorbidities and severity and mortality of coronavirus disease
2019: a pooled analysis https://onlinelibrary.wiley.com/doi/10.1002/clc.23465
Mortality risk in hospitalised COVID-19 p3 The OpenSAFELY Collaborative (2020) Factors associated with COVID-19-related hospital death in the linked electronic health records of
patients; Fig 1 17 million adult NHS patients www.medrxiv.org/content/10.1101/2020.05.06.20092999v1
Obesity risk Yang et al (2020) J Med Virol - Obesity aggravates COVID‐19 doi.org/10.1002/jmv.26237;
(additional references) Hussain et al (2020) Obesity and mortality of COVID19. www.sciencedirect.com/science/article/pii/S1871403X20305500
Heart failure risk & COVID-19 p3 Rey et al (2020) Eur J Heat Failure - Heart Failure In Covid‐19 Patients: Prevalence, Incidence And Prognostic Implications
onlinelibrary.wiley.com/doi/abs/10.1002/ejhf.1990
Hypertension (high blood pressure) risk & p4 Chao Gao et al (2020) Eur Heart J - Association of hypertension and antihypertensive treatment with COVID-19 mortality: a retrospective
COVID-19 observational study academic.oup.com/eurheartj/article/41/22/2058/5851436
Health inequalities and COVID-19 p4 ISARIC (2020) Ethnicity & Outcomes from COVID-19: ISARIC CCP-UK Prospective Observational Cohort Study of Hospitalised Patients
isaric.tghn.org/articles/ethnicity-and-outcomes-covid-19-isaric-ccp-uk-prospective-observational-cohort-study-hospitalised-patients
Hospital comorbidities – p4 Docherty et al (2020) BMJ - Features of 20 ,133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation
most common in COVID-19 patients Protocol: prospective observational cohort study www.bmj.com/content/369/bmj.m1985
Heart scan abnormalities in COVID-19 p4 Dweck et al (2020) EHJ Cardiovascular Imaging - Global evaluation of echocardiography in patients with COVID-19
patients https://academic.oup.com/ehjcimaging/article/doi/10.1093/ehjci/jeaa178/5859292
Sandoval et al (2020) ACC - Key points about myocardial injury and cardiac troponin in COVID-19
www.acc.org/latest-in-cardiology/articles/2020/07/17/08/00/key-points-about-myocardial-injury-and-cardiac-troponin-in-covid-19
also Kotecha et al (2021) EHJ https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehab075/6140994
Pre-existing conditions in p4 Office for National Statistics (2020) Deaths involving COVID-19, England & Wales (Spring 2020 releases) [NI not available]
9 out of 10 COVID-19 deaths [GB]; www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths
CHD one of most common National Records of Scotland (2021) Deaths involving COVID-19, Scotland, pre-existing conditions analysis updated monthly around third
week of month (other mortality statistics are updated weekly) www.nrscotland.gov.uk/news
7STATISTIC REFERENCE
HEART AND CIRCULATORY DISEASES (H&CD; CARDIOVASCULAR DISEASE; CVD) AND CORONAVIRUS (COVID-19)
CVD (H&CD) mentions on COVID-19 p4 Office for Health Improvement and Disparities (OHID; formerly PHE) (2020) Disparities in the risk and outcomes of COVID-19
death certificates, England www.gov.uk/government/publications/covid-19-review-of-disparities-in-risks-and-outcomes
Excess CVD mortality during pandemic, p4 Office for Health Improvement and Disparities (OHID; formerly PHE) (2021) Excess mortality in England: weekly reports to 26 Feb 2021
England; blog https://fingertips.phe.org.uk/static-reports/mortality-surveillance/excess-mortality-in-england-latest.html
Out-of-hospital cardiac arrests p5 Fothergill et al (2021) Out-of-Hospital Cardiac Arrest in London during the COVID-19 pandemic
(OHCAs) www.sciencedirect.com/science/article/pii/S2666520420300679
NHS England (2022) Ambulance Quality Indicators - see Clinical Outcomes series for 2020 & 2021 data
www.england.nhs.uk/statistics/statistical-work-areas/ambulance-quality-indicators/
also Baldi et al (2020) www.nejm.org/doi/full/10.1056/NEJMc2010418
and McVaney et al (2021) www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00095-X/fulltext
English hospital A&E visits p5 Office for Health Improvement and Disparities (OHID; formerly PHE) (2020) Emergency department: weekly bulletins for 2020, weekly bulletin
for 9 April 2020 (week 14) www.gov.uk/government/publications/emergency-department-weekly-bulletins-for-2020
England 5k heart attack (MI) patients p5 Mafham et al (2020) Lancet - COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England
www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31356-8/fulltext
MI and heart failure admissions Wu et al (2021) JACC - Second decline in admissions with heart failure and myocardial infarction during the COVID-19 pandemic
https://www.sciencedirect.com/science/article/pii/S0735109720381961
England & Wales heart failure p5 NICOR (2020) Rapid cardiovascular data: We need it now (and in the future) – based on Heart Failure Audit data
admissions www.nicor.org.uk/wp-content/uploads/2020/09/NICOR-COVID-2020-Report-FINAL.pdf
Scottish A&E; admissions p5 Public Health Scotland (2020) Cardiovascular A&E attendances and admissions scotland.shinyapps.io/phs-covid-wider-impact/
Scottish heart attack deaths/home p5 BHF analysis of 2020 data from NRS (National Records of Scotland); BHF Scotland correspondence
delayed heart procedures; p6 NHS England (2022) Consultant Led Referral-to-Treatment Waiting Times (Incomplete Pathways) 2020 & 2021
cardio waiting list England http://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times
NB hospital waiting lists are also published for Scotland, Wales and Northern Ireland, but criteria are not directly comparable.
echo waiting times, England p6 NHS England (2022) Monthly Diagnostics Data 2020 & 2021
http://www.england.nhs.uk/statistics/statistical-work-areas/diagnostics-waiting-times-and-activity
NB echocardiogram waiting lists are also published for Wales and Northern Ireland
long COVID research; p6 www.hdruk.ac.uk/news/research-begins-to-rapidly-understand-deadly-link-between-covid-19-and-cardiovascular-diseases/
prevalence ONS (2020 to present) various series and surveys – suggested search: site:ons.gov.uk long covid
Imperial College (2021) Persistent symptoms following SARS-CoV-2 infection www.imperial.ac.uk/news/224853
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