Covid and poor access to NHS care ‘may be driving irregular heartbeat deaths’

Covid is probably part of the reason for more people dying due to an irregular heartbeat this year, an expert has said.

Christina Pagel, professor of operational research at University College London (UCL), commented on new figures from the Office for National Statistics (ONS) suggesting deaths due to an irregular heartbeat are likely to be one of the reasons more people than usual have been dying in the first half of 2022.

She also said poor access to NHS care could be a factor driving up deaths.

The number of deaths registered in England and Wales due to cardiac arrhythmias was well above average for much of the first half of 2022, according to the ONS.

Deaths in this category had the second highest excess mortality figures in March and April, up from being the eighth highest in February and the fourth highest in January.

Excess deaths, or extra deaths, are the number of deaths that are above the long-term average for a particular week or month of the year.

There were 234 excess deaths due to an irregular heartbeat registered in March and 138 in April.

In both months this was the second highest number of excess deaths by cause, behind only those due to “ill-defined conditions” – a definition often used to cover symptoms such as old age and frailty.

The total number of deaths due to an irregular heartbeat was 37.1% above average in March and 23.1% in April – a sharp jump from 13.7% in January and 9.2% in February.

The percentages remained high in May and June (39.0% and 17.9%), but the number of excess deaths for this category ranked lower, in fifth and eighth place respectively.

Professor Pagel said: “Covid is definitely a possibility – there have been lots of studies showing there can be long-term damage to the heart after Covid.”

She said US studies had also shown there was still excess mortality occurring in the population even a year after people had suffered Covid.

“So it’s certainly possible,” she said. “But the problem that we’ve got is that … we didn’t really have a flu season in 2020 or last year so, fortunately, a there are a lot of people who would have died from flu who didn’t, but the question is, are they now just dying of other things?

“And we also know that the NHS has been pretty much in crisis now for eight months.

“It’s so hard to get an ambulance to go to A&E, to get a GP appointment, and all the stories about delays mean people are less likely to seek care.

“You can imagine that with arrhythmias, if people aren’t exactly sure of the symptoms, they won’t go and seek care quickly enough … so it could be that as well.”

Summing up, she said: “I think there’s good evidence that Covid will contribute to deaths from other causes in older, more vulnerable people, but the extent of that we don’t yet know.

“This is now probably the first time it might start feeding into the data – a year or two after a big wave.”

In the ONS figures, other leading causes to have contributed to excess deaths this year include ischaemic heart disease, diabetes, and dementia and Alzheimer’s disease.

Overall, 3,848 excess deaths were registered in England and Wales in the first half of 2022.

Sarah Caul, ONS head of mortality analysis, said the figure had been “driven by higher than expected numbers of deaths since March, which could be caused by a combination of factors.

“Across March, April and May we saw increases in deaths due to cardiac arrhythmias, predominantly among those aged 80 and above.

“Further work needs to be done to understand any link between the long-term effects of Covid and increasing cardiac deaths.”

It is also possible that there has been some “mortality displacement”, with the number of deaths higher than average now because of below-average deaths earlier in the year.

“Excess deaths do fluctuate over time and when looking at individual months in 2022, the number of deaths was below expected levels in January and February,” she added.

Total deaths registered in England and Wales were 10.3% below average in January and 7.3% below in February, but were but above average in every month from March to June.

May and June saw a particularly high level of excess mortality, with deaths 15.4% and 8.6% above average respectively.

Covid-19 has been only partly responsible for extra deaths in recent months, the ONS said.

It comes as research from the universities of Bristol, Cambridge, Edinburgh and Swansea found that Covid increases the risk of potentially life-threatening blood clots for at least 49 weeks after infection.

The findings suggest the pandemic may have led to an additional 10,500 cases of heart attacks, strokes and other blood clot complications in England and Wales in 2020 alone.