Cardiovascular diseases cause 17.9 million deaths worldwide annually. In Germany, coronary heart disease (CHD) is the leading cause of death and, despite declining incidence and mortality rates since the 1990s, remains at a high level. The COVID-19 pandemic affected healthcare services, leading to a reduction in hospitalizations and procedures due to limited access to healthcare and fear of infection. Outpatient care was also restricted, which could foster future CHD events. However, population-based studies in Germany that observe the occurrence of CHD using comprehensive outpatient data over the long term are lacking. Particularly, there is currently no clear scientific consensus on the pandemic's influence on CHD incidence.
This research gap is addressed by the study led by Prof. Dr. Stefanie J. Klug, head of the Chair of Epidemiology. The study is part of the DFG-funded research project ChroVID, which the Chair of Epidemiology is currently conducting in collaboration with the Chair of Health Economics, led by Prof. Dr. Leonie Sundmacher.
The research team, led by Dr. Gunther Schauberger, research associate under Prof. Dr. Klug, conducted a comprehensive data analysis examining the incidence of coronary heart disease in the Bavarian population over ten years and the potential influence of the COVID-19 pandemic on incidence rates. The study results were published under the title “Impact of the COVID-19 pandemic on incidence of coronary heart disease in Bavaria, Germany: an analysis of health claims data” in the international journal Heart, which has an impact factor of 5.1.
Prof. Dr. Klug summarizes: “The overarching goal of the ChroVID study is to investigate how healthcare for chronically ill patients has changed and to analyze the potential influence of the pandemic. In addition to coronary heart disease, we are also examining other chronic diseases, such as type 2 diabetes and various cancer entities in our ChroVID study.”
The present data analysis is based on a retrospective evaluation of billing data from the Bavarian Association of Statutory Health Insurance Physicians (KVB) and examines epidemiological and healthcare-related patterns among patients newly diagnosed with coronary diseases in Bavaria. The analysis is based on anonymized data from approximately nine million statutory insured persons aged 20 and older. The data were aggregated for the period from 2012 to 2021 by region, gender, quarter, and five-year age groups. This enabled comprehensive and detailed analyses of long-term trends and healthcare patterns on a regional level in Bavaria.
“What is exceptional about our research is the data basis and our ability to present trends over ten years. The high representativeness is also noteworthy – the data cover nearly 85 percent of the population in Bavaria. Patient data from the KVB are a highly valuable data source,” highlights Dr. Schauberger, emphasizing the study’s importance.
The research results show a decline in incidence before the pandemic, with seasonal fluctuations that were higher in the fourth quarter. During the pandemic, these seasonal patterns did not occur, and the overall decline in CHD incidence was smaller, particularly among women. The pandemic's impact on incidence rates was therefore less pronounced than expected. Despite initial restrictions due to lockdowns and closed medical practices, there were no statistically significant changes in CHD incidence during the pandemic. The more pronounced slowing of the decline in CHD incidence among women could be related to gender-specific risk profiles.
“The trend shows that CHD incidence has decreased significantly over the years. However, this decline was less evident during the pandemic,” summarizes Dr. Schauberger and explains: “As a population-wide analysis, the study provides a good insight into how the disease develops and how the healthcare system is burdened.” For future research, he suggests: “We plan to compare prevalence and incidence and to reanalyze incidence rates at a greater distance from the pandemic.”
The findings highlight the importance of ongoing monitoring and prevention of CHD, particularly during crises such as a pandemic, to ensure care for patients with chronic diseases. Further research is needed to better understand the underlying factors and the long-term effects of the pandemic on CHD, as well as to develop effective prevention strategies.
Link to the Chair of Epidemiology website
Contact:
Prof. Dr. Stefanie J. Klug, MPH
Ordinaria
Chair of Epidemiology
Georg-Brauchle-Ring 56
D-80992 München
Tel.: 089 289 24951
E-Mail: stefanie.klug(at)tum.de
Dr. Gunther Schauberger
Chair of Epidemiology
Georg-Brauchle-Ring 56
D-80992 München
Tel.: 089 289 24955
E-Mail: gunther.schauberger(at)tum.de
Text: Jasmin Schol
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