Impact of the COVID‐19 Pandemic on Coronary Heart Disease Admissions and Mortality in Mexico: An Ecological Study

ABSTRACT Background and Aims The COVID‐19 pandemic strained healthcare systems, affecting management of coronary heart disease (CHD). This study aims to assess the association between the COVID‐19 pandemic and in‐hospital case fatality rates, emergency department visits, and hospital admissions for CHD in Mexico. Methods We conducted an ecological study utilizing data from the Mexican Ministry of Health, spanning January 2018 to December 2021. CHD was defined using ICD‐10 codes I20–I25. We analyzed monthly and annual trends in CHD‐related emergency visits, hospital admissions, and in‐hospital case fatality rates (CFR), reporting results with 95% confidence intervals. The Kruskal–Wallis test assessed statistical significance. Segmented log‐linear regression models, with a fixed breakpoint in March 2020, were applied to monthly rates to estimate pre‐ and post‐break trends (Annual Percent Change, APC) and immediate level changes, using Newey–West standard errors. Results CHD emergency visits decreased by 9.8% in March 2020% and 60.8% in May 2020, with annual declines of 36.5% in 2020% and 32.3% in 2021 compared to pre‐pandemic levels. Hospital admissions fell by 31.6% in 2020% and 19.4% in 2021. Meanwhile, in‐hospital CFR rose from 8.6% before the pandemic to 12.6% in 2020% and 11.8% in 2021. A similar trend was observed in hospital discharges, where CFR increased from 13.75% pre‐pandemic to 16.63% in 2020% and 16.15% in 2021. Although hospital mortality was higher among women, men experienced greater reductions in emergency visits and larger relative increases in mortality. Segmented regression revealed an immediate drop of −54.6% in emergency visits and −50.8% in discharges, followed by annual post‐break increases of 2.09% and 2.88%, respectively. Conclusion The COVID‐19 pandemic in Mexico was associated with a decline in CHD hospital admissions alongside a significant rise in in‐hospital CFR, with segmented regression showing partial recovery following the initial drop, underscoring the need to strengthen healthcare resilience.