Abstract DP308: The Impact of COVID-19 pandemic on Cerebrovascular disease related Mortality in the United States: A CDC WONDER Analysis

Background: A stroke event occurs every 40 seconds in the United States, leading to one death every 4 minutes. Prior studies have reported a strong association of COVID-19 with cerebrovascular disease (CVD). This study examines the COVID-19 impact on overall CVD mortality rates along with ischemic (IS) and hemorrhagic (HS) stroke subtypes. Methods: CDC WONDER data (2018–2023) was used to calculate age adjusted mortality rates (AAMRs) for overall CVD and subtypes among adults ≥25 years during pre-pandemic (2018–2019), pandemic (2020–2021), post-pandemic (2022–2023) eras. ICD-10 codes for CVD (I60–I69), IS (163, 169.3) and HS (160–162, 169.0–169.2) subtypes were used. Percent AAMR changes classified by demographics and geography were reported. Results: A 15.8% increase in CVD-related mortality during pandemic and a 3.5% post-pandemic decline was observed, with a net 11.8% increase over pre-pandemic rates. IS mortality rates peaked (21.2%) amid COVID and persisted post-COVID (23.5%), with a 49.6% overall increase compared to pre-pandemic baseline. HS rose 6.6% amid COVID, 4.8% decline post-COVID, and a net incline of 1.5% from pre-COVID levels. Males had a higher mortality increase for overall CVD (12.0% vs 11.5%), IS (51.4% vs 49.2%), and HS (1.8% vs 1.7%) than females. Non-Hispanic (NH) Blacks, NH American Indians/Alaskan Natives, and Hispanics exhibited a concerning rise amid COVID (20.1%, 16.4%, and 19.4%, respectively). NH Blacks, NH Whites and Hispanics sustained an overall increase (12.6%, 12.4% and 12%) whereas NH American Indians/Alaskan Natives showed a modest incline from pre-COVID levels (3.1%). Highest net mortality increase for IS was seen in NH Pacific Islanders (80.4%), NH Blacks (58%), and NH Whites (50.4%). Likewise, net mortality rise for HS was seen in NH Pacific Islanders (8.3%), Hispanics (4.4%), and NH Blacks (3.8%) whereas American Indians/Alaskan Natives (-3.5%) and Asians (-3%) showed a modest net decline. Mississippi showed the highest absolute CVD related AAMRs before (133.6), during (163.6), and after pandemic (150.8). Further, Delaware exhibited the steepest percentage increase of 33.6% post-COVID. Conclusion: Amid COVID-19, CVD-related mortality increased, especially among males, NH Blacks, American Indians/Alaskan Natives, and Hispanics. Mississippi and Delaware were most affected amid pandemic era. Future interventions targeting stroke incidence among COVID-19 affected individuals are warranted to reduce disparities in stroke care.