Social Isolation, Hospitalization, and Deaths from Cardiovascular Diseases during the COVID-19 Epidemic in São Paulo Metropolitan Area in 2020

Background: The COVID-19 epidemic overloaded the São Paulo metropolitan area (SPMA) health system in 2020. The leading hospitals directed their attention to patients with COVID-19. At the same time, the SPMA Health Secretary decreed social isolation (SI), which compromised the care for cardiovascular diseases (CVD), even though higher cardiovascular events were expected. Methods: This study analyzed mortality from CVD, ischemic heart disease (IHD), and stroke, along with hospital admissions for CVD, IHD, stroke, and SI in the SPMA in 2020. Data regarding hospitalization and mortality from CVD were obtained from the SPMA Health Department, and data regarding SI was obtained from the São Paulo Intelligent Monitoring System. Time-series trends were analyzed by linear regression, as well as comparisons between these trends. Results: there was an inverse correlation between SI and hospitalizations for CVD (R(2) = 0.70; p < 0.001), IHD (R(2) = 0.70; p < 0.001), and stroke (R(2) = 0.39; p < 0.001). The most significant hospitalization reduction was from March to May, when the SI increased from 43.07% to 50.71%. The increase in SI was also associated with a reduction in CVD deaths (R(2) = 0.49; p < 0.001), IHD (R(2) = 0.50; p < 0.001), and stroke (R(2) = 0.26; p < 0.001). Conclusions: Increased social isolation was associated with reduced hospitalizations and deaths from CVD, IHD, and stroke.