Temporal and spatial variation in hospitalizations and mortality from acute myocardial infarction in Brazil during the COVID-19 pandemic period (2020–2023)

The COVID-19 pandemic emerged as a major public health challenge, not only due to the high number of victims but also because of the significant rise in cardiovascular emergencies associated with the infection. We investigated the temporal and spatial variation in hospitalizations (2020–2023) and deaths (2020–2022) from Acute Myocardial Infarction (AMI) in Brazil during the COVID-19 pandemic. We analyzed hospitalizations (between 2015 and 2023) and deaths (between 2015 and 2022), using data from the Mortality Information System (SIM) and the Hospital Information System (SIH) of the Brazilian Ministry of Health. Percentage change was calculated to assess whether there was an increase or decrease in hospitalizations and deaths from AMI, considering the average of the previous five years. Additionally, a Joinpoint regression model was applied to evaluate temporal trends before and after the onset of the pandemic. Spatial variations were visualized through choropleth maps. A consistent rise in AMI hospitalizations was observed nationwide, with percentage increases of 13.4% in 2020, 21.2% in 2021, 36.9% in 2022, and 30.9% in 2023. The Central-West region showed the highest growth rates. Regarding mortality, there was a reduction in AMI deaths in 2020 (-3.0%), followed by increases in 2021 (2.2%) and 2022 (4.6%), particularly in the North and Central-West regions. Temporal trend analysis revealed a significant increase in AMI hospitalizations in Brazil (APC = 5.7%; p < 0.05). The most pronounced growth was observed in the Central-West (APC = 10.4%; p < 0.05) and North (APC = 6.3%; p < 0.05) regions. For mortality, trends were stable during the pre-pandemic period in Brazil and in most regions, but they increased in the pandemic period in the North (APC = 2.6%; p < 0.05) and Central-west (APC = 1.6%; p < 0.05) regions. Overall, this study identified an increase in the number of hospitalizations (between 2020 and 2023) and deaths (between 2020 and 2022) due to AMI in Brazil, highlighting COVID-19’s significant impact on cardiovascular health. The findings underscore the urgent need for stronger investments in health infrastructure, as well as strategic interventions to mitigate the effects of the pandemic and reduce hospitalizations and deaths in the coming years.