Trends in the Incidence of Cardiovascular Diagnoses and Procedures over the Years 2012–2021 in Israel: The Impact of the COVID-19 Pandemic

Abstract

Prior studies found reduced incidences of cardiovascular diagnoses and treatments in the initial phase of the COVID-19 pandemic. However, these studies included a limited number of outcomes and did not consider pre-pandemic trends. This study aimed to describe trends in the incidence of cardiovascular diagnoses and treatments over the years 2012–2021 in Israel and to compare the two years of the COVID-19 period with the preceding 8 years. In this retrospective, population-based study, carried out within Clalit Health Services, the incidence rates of cardiovascular outcomes were calculated for individuals aged ≥ 25 (~2.7 million adults per year) during the first (Y1, 3/2020–2/2021) and second (Y2, 3/2021–2/2022) years of COVID-19 and the 8 years prior (3/2012–2/2020). Declines were observed in Y1 compared to 2019 in all diagnoses and treatments: STEMI (−16.3%; 95% CI: −16.6, −16.1), non-STEMI (−16.4%; −16.6, −16.2), AF (−14.1%; −14.2, −14.0), CHF (−7.8%; −7.9, −7.7), CVA (−5.0%; −5.0, −4.9), catheterization (−64.7%; −65.2, −64.2), CABG (−77.7%; −79.2, −76.2), ablation (−21.2%; −22.0, −20.4), pacemaker implantation (−39.3%; −40.7, −37.9), and defibrillator insertion (−12.5%; −13.1, −12.0). Compared with expected rates based on pre-pandemic trends, observed rates were within expected ranges (CHF, CVA, and ablation), less than expected (STEMI, non-STEMI, AF, catheterization, CABG, and pacemaker insertion), or more than expected (defibrillator insertion). In Y2, STEMI, catheterization, and CABG returned to expected rates; non-STEMI and AF were lower than expected; and CHF, CVA, ablation, and pacemaker and defibrillator implantations were higher than expected. Several cardiovascular diagnoses and treatment trends were interrupted by COVID-19. The long-term consequences of these changes should be considered by health policymakers.