Abstract P455: Effects of COVID-19 Pandemic on Racial Disparities in Coronary Artery Disease Mortality: Has the Existing Gap Worsened?

Abstract

Background: Previous studies have indicated that the novel coronavirus SARS-CoV-2 (COVID-19) pandemic resulted in an increase of coronary artery disease (CAD) mortality across various population groups. However, it remains unknown whether the pandemic changed the dynamic of earlier documented existing racial disparities in CAD mortality. Study Objective: To investigate racial disparities in the magnitude of changes in CAD mortality rates from the pre-pandemic to COVID-19 pandemic era. Methods: Using the Centers for Disease Control and Prevention (CDC) Wide-Ranging Online Data for Epidemiologic Research (WONDER) database on underlying causes of death in the U.S., we analyzed CAD mortality rates in relation to race, adjusting for age and gender. CAD deaths were identified using the ICD-10 codes I20-I25 for the first three years of the pandemic (from March 2020 through February 2023; COVID-era CAD mortality) and for the three years immediately preceding the pandemic (2017-2019; pre-COVID CAD mortality). General linear modeling (GLM) analysis was conducted using SAS (version 9.4). Results: During the first three years of the pandemic, the overall crude CAD mortality rates increased from 160.619/100,000 in pre-COVID era to 164.773/100,000 (p<0.001). Age-adjusted analyses demonstrated that African Americans and Asians experienced a more pronounced increase in age-adjusted CAD mortality rates than whites, when comparing the change in CAD mortality rates from the pre-COVID to COVID era. While age-adjusted CAD mortality rates increased from the pre-COVID to COVID era both in African Americans, Asians and whites, the magnitude of the change (the mortality rate increase) in African Americans was 19.538/100,000 greater than the magnitude of the mortality rate change in whites (p=0.08). Asians experienced a similar gap: the magnitude of the pre-COVID/COVID-era increase in their age-adjusted CAD mortality rate was 19.560/100,000 greater than the magnitude of the pre-COVID/COVID-era increase experienced by whites (p=0.09). Conclusions: While the magnitude of the change in racial CAD mortality disparities in relation to COVID-19 pandemic has not reached the conventional statistical significance level, the worsening of gap is alarming and warrants further investigation.