Mortality from cardiovascular disease in the five mesoregions of the state of pernambuco before and during the covid-19 pandemic

Background: COVID-19, was described as excess cardiovascular death, however, hospitalizations for acute cardiovascular events decreased. Objective: To evaluate cardiovascular excess deaths before and during the pandemic of COVID-19 in the five mesoregions of Pernambuco. Methods: We used public data from the Civil Registry, to assess cardiovascular deaths in the five mesoregions of Pernambuco, stratified into specific cardiovascular deaths (OCE): acute coronary syndrome and stroke and non-specific cardiovascular deaths (OCI), between 2020 and 2021, as a reference the year 2019, as well as hospital and home deaths. Results: There were 927,000 cases with 21,636 deaths from COVID-19 in the mesoregions of Pernambuco. OCE decreased in Zona da Mata, Agreste, and the Metropolitan Region and increased in Sertão in São Francisco, however, there was an increase in OCI in the mesoregions, thus, for hospital OCE of 70%. In the mesoregions; the Sertão in São Francisco deaths, in which 40% were in the home and 44.3% in the hospital. A significant correlation was observed in Zona da Mata between 2019 and 2020, inversely proportional, increase in the Human Development Index (HDI) of the municipality, expecting a lower increase in cardiovascular death rate. A ratio of doctors per inhabitants in the region proved favorable to a lower death rate, due to the collapse of the health system in less developed cities (low HDI). Conclusion: The OCE decreased in most regions, except in the Sertão, occurring an increase. Thus, it increased in household OCI as a result of diagnostic errors. OCE increased in regions with health collapse