Evidence map›Paper›PMID 42232005›Full record

ArticleCureus2026

Out-of-Hospital Excess Mortality From Cardiovascular Diseases During the COVID-19 Pandemic in Brazil.

Humberto G Moreira, Thiago C Barreto

Abstract read
In one paragraph

Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Humberto G MoreiraMedical School, Federal University of Goias, Goiania, BRA.
Thiago C BarretoMedical School, Federal University of Goias, Goiania, BRA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe COVID-19 pandemic disrupted health systems worldwide; yet, the magnitude of collateral mortality occurring outside hospitals, particularly from cardiovascular disease (CVD), remains poorly characterized in low- and middle-income countries (LMICs). Brazil, which experienced one of the highest cumulative death tolls globally, offers a critical setting for quantifying this indirect burden.

methodsWe conducted an ecological time-series analysis of all deaths recorded outside health care facilities (domicile or public thoroughfare) in Brazil from 2015 through 2021 using national mortality data from the Mortality Information System (SIM)/Department of Informatics of the Brazilian Unified Health System (DATASUS). Crude mortality rates and age-sex adjusted mortality rates were calculated and standardized to the 2022 Census population structure. Pre-pandemic (2015-2019) and pandemic (2020-2021) periods were compared descriptively.

resultsOut-of-hospital deaths increased from a pre-pandemic mean of 313660 per year (151.6 per 100000 inhabitants) to 381720 per year (180.2 per 100000 inhabitants) during 2020-2021, representing an 18.8% increase. Age-sex adjusted cardiovascular out-of-hospital mortality rates, which had declined steadily from 53.43 per 100000 in 2015 to 47.16 per 100 000 in 2019, rose sharply to 53.48 per 100000 in 2020 and 54.53 per 100000 in 2021. The Southeast exhibited the steepest rate increase (+23%), whereas the Northeast maintained the highest overall proportion of out-of-hospital cardiovascular deaths. CVD remained the leading cause of death (115228; 29.8%), followed by external causes (65009; 16.8%) and ill-defined causes (62433; 16.1%). Ill-defined deaths increased by 44% between 2019 and 2021, suggesting substantial diagnostic gaps.

conclusionsThe pandemic period was associated with a substantial rise in out-of-hospital mortality in Brazil, reversing the prior declining trend in age-sex adjusted cardiovascular mortality. These findings underscore the need for resilient primary care networks and decentralized emergency response systems during public health emergencies.

Indexed as

cardiovascular deathcovid-19excess mortalityout-of-hospitalpublic health system

Identifiers

PMID42232005
PMCPMC13225081

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.