Post Covid-19 Upturn in Acute MI Related Mortality Trends in Young to Middle Aged Type-2 Diabetics: Observations from CDC Wonder

Abstract

COVID-19 outbreak negatively impacted all aspects of adequate delivery of healthcare by overburdening the modalities. Care for acute myocardial infarction was heavily impacted attributable, in part, to reduced hospitalizations and cardiac care units not being able to function at full capacity. This paper attempts to elicit the resultant trend shift in Acute myocardial infarction (AMI) related mortality in young to middle-aged diabetics.

CDC WONDER database was queried from 1999-2021. Only patients younger than 54 years old were included. Age-adjusted mortality rates (AAMR) per 100,000 with 95% confidence intervals were obtained. Joinpoint 5.0 software was used to analyze trend shift with average annual percent change (AAPC) values.

A total of 10,011 AMI related deaths were encountered in the young/middle aged diabetics during our study period. Of which, around 14% (1,381) deaths were recorded in the years 2020 & 2021 alone. In these 2 years, 20.24% of subjects passed away in their homes vs only 11.06% deaths recorded in-patient. Overall AAMR more than doubled from 1999 (AAMR: 0.14 [0.13,0.16]) to 2021 (AAMR: 0.32 [0.3,0.34]) (AAPC: 3.7 [2.9,5.5]). Males had higher mortality rates (AAMR1999-2020: 2.55 [2.52,2.57]) than females (AAMR1999-2020: 1.49 [1.47-1.50]). Rural counties (AAMR1999-2020: 3.68 [3.63,3.74]) had nearly triple the mortality rates of large metropolitans (AAMR1999-2020: 1.70 [1.68,1.72]). AAMR were highest in the Midwest (AAMR1999-2020:2.3 [2.27,2.32]) and lowest in the Northeast (AAMR1999-2020: 1.41 [1.39,1.43]).

COVID-19 had profound effects on cardiovascular healthcare. Post-pandemic, developing robust mechanisms to reverse the damage dealt in terms of increased morbidity and mortality has become imperative.