Introduction: During the COVID-19 pandemic, excess mortality has been reported, while hospitalizations for acute cardiovascular events reduced. Brazil is the second country with more deaths due to COVID-19. We aimed to evaluate excess cardiovascular mortality during COVID-19 pandemic in 6 Brazilian capital cities. Methods: Using the Civil Registry public database, we evaluated total and cardiovascular excess deaths, further stratified in ACS, stroke and unspecified cardiovascular deaths in the 6 Brazilian cities with greater number of COVID-19 deaths (Sao Paulo, Rio de Janeiro, Fortaleza, Recife, Belem, Manaus). We compared data from epidemiological weeks 12 to 22 of 2020, with the same period in 2019. We also compared the number of hospital and home deaths during the period. Results: There were 69,328 deaths and 17,877 COVID-19 deaths in the studied period and cities for 2020. Cardiovascular mortality increased in most cities, with greater magnitude in the Northern capitals. However, while there was a reduction in ACS and stroke in the most developed cities, the Northern capitals showed an increase of these events. For unspecified cardiovascular deaths, there was a marked increase in all cities, which strongly correlated to the rise in home deaths (r=0.86, p=0.01). Conclusion: The excess cardiovascular mortality was greater in the less developed cities, possibly associated with healthcare collapse. ACS and stroke deaths decreased in the most developed cities, in parallel with an increase in unspecified cardiovascular and home deaths, presumably as a result of misdiagnosis. Conversely, ACS and stroke deaths increased in cities with a healthcare collapse.
Collection : COVID-19 SARS-CoV-2 preprints from medRxiv and bioRxiv