Abstract
Objectives To examine the impact of the COVID-19
pandemic on deprivation-related
inequalities in
hospitalisations for cardiovascular disease (CVD)
conditions in Denmark and England between March 2018
and December 2021.
Design Time-series
studies in England and Denmark.
Setting With the approval of National Health Service
England, we used English primary care electronic health
records, linked to secondary care and death registry data
through the OpenSAFELY platform and nationwide Danish
health registry data.
Participants We included adults aged 18 and over
without missing age, sex or deprivation information. On 1
March 2020, 16 234 700 people in England and 4 491 336
people in Denmark met the inclusion criteria.
Primary outcome measures Hospital admissions
with the primary reason for myocardial infarction (MI),
ischaemic or haemorrhagic stroke, heart failure and
venous thromboembolism (VTE).
Results We saw deprivation gradients in monthly CVD
hospitalisations in both countries, with differences more
pronounced in Denmark. Based on pre-pandemic
trends, in
England, there were an estimated 2608 fewer admissions
than expected for heart failure in the most deprived
quintile during the pandemic compared with an estimated
979 fewer admissions in the least deprived quintile. For all
other outcomes, there was little variation by deprivation
quintile. In Denmark, there were an estimated 1013 fewer
admissions than expected over the pandemic for MI in
the most deprived quintile compared with 619 in the least
deprived quintile. Similar trends were seen for stroke and VTE, though absolute numbers were smaller. Heart failure
admissions were similar to pre-pandemic
levels with little
variation by deprivation quintile.
Conclusions Overall, we did not find that the pandemic
substantially worsened pre-existing
deprivation-related
differences in CVD hospitalisations, though there were
exceptions in both countries