Article Impact Level: HIGH Data Quality: STRONG Summary of JAMA Network Open, 8(5), e2512919. https://doi.org/10.1001/jamanetworkopen.2025.12919 Dr. Jason H. Wasfy et al.
Points
- Cardiac mortality in Massachusetts significantly increased after the COVID-19 pandemic began, with rates rising 16 to 17 percent from 2020 to 2022 and 6 percent in 2023.
- Researchers analyzed over 127,000 death certificates and found that reduced hospital admissions did not mean fewer cardiac events but instead reflected a shift in where deaths occurred.
- The data showed a sharp rise in cardiac deaths at home and a sustained increase in hospital deaths, indicating reduced access to timely care during the pandemic.
- These findings emphasize the critical importance of maintaining access to emergency cardiac services, especially during health crises that disrupt regular medical care.
- Limitations such as possible death cause misclassification were noted, but the study highlights the value of death certificate data for identifying overlooked mortality trends.
Summary
This study examined trends in cardiac mortality following the onset of the COVID-19 pandemic, using death certificate data from 127,746 decedents in Massachusetts between 2014 and 2023. Researchers aimed to determine if observed reductions in hospital cardiac admissions reflected an actual decline in events or shifts in the location of deaths, particularly in patients dying at home. The study found that, compared to the expected mortality rates based on data from 2014-2019, cardiac deaths were significantly higher post-pandemic: 16% higher in 2020 (95% CI, 13%-19%), 17% in 2021 (95% CI, 14%-21%), and 17% in 2022 (95% CI, 13%-21%), with a more modest 6% increase in 2023 (95% CI, 2%-11%).
The analysis also revealed shifts in where cardiac deaths occurred. Notably, excess deaths were observed at home, with a significant increase in deaths at home between 2020 and 2022, and hospital deaths remained elevated through 2023. These changes suggest that the pandemic may have limited access to timely cardiac care, with patients opting against or unable to access hospital care. This highlights the broader impact of the pandemic on patient care, especially for individuals with cardiovascular disease who may not have sought medical attention during critical events.
The study’s limitations include potential misclassification of causes of death, particularly during the early pandemic. Despite these limitations, the study’s findings underscore the importance of using death certificate data to track mortality trends accurately, as relying solely on hospital admission data may miss crucial information on deaths outside hospital settings. The results call for improved resilience in cardiac care during future pandemics to address these challenges and ensure that at-risk individuals receive timely and effective treatment.
Link to the article: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2834659
References Wasfy, J. H., Lin, Y., Price, M., Newhouse, J. P., Blacker, D., & Hsu, J. (2025). Postpandemic cardiac mortality rates. JAMA Network Open, 8(5), e2512919. https://doi.org/10.1001/jamanetworkopen.2025.12919
