Abstract 15320: Trends in Pulmonary Embolism-Related Mortality in the United States Before and During the COVID-19 Pandemic

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Introduction: Infection with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV2) and the subsequent development of COVID-19 is associated with an increased risk of pulmonary embolisms (PE). We sought to determine the trends in PE-related mortality in the United States from 1999 to 2021. Methods: We analyzed all deaths occurring in the US using the US Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database from 1999 to 2021. The Multiple Cause-of-Death Public Use record death certificates were used to select PEs as the primary or contributing cause of death using relevant ICD-10 codes. PE-related age-adjusted mortality rates (AAMR) per 100,000 persons were calculated and standardized to the US population in 2000. We calculated annual percent changes (APC) and corresponding 95% confidence intervals (CI). We also conducted subgroup analyses to examine mortality trends by age, sex, and racial/ethnic groups. Results: From 1999 to 2013 and between 2013 and 2019, APC for PE-related mortality remained relatively stable, corresponding to -0.4% (95% CI: -0.6 to -0.2) and 1.3% (95% CI: 0.6 to 2.1), respectively. Between 2019 and 2021, PE-related mortality increased from 9.2 to 14.1 per 100,000 populations per year, corresponding to an APC of 21.7% (95% CI: 18.3 to 25.3). There was a similar pattern of increase among individuals < or ≥65 years. Men had a significantly greater increase in APC, 24.6% (95% CI: 20.5 to 28.9), when compared to women, 18.9% (95% CI: 15.0 to 22.9). All racial/ethnic groups experienced an increase in PE-related mortality between 2019 and 2021 but the increase was more pronounced among minority groups including Non-Hispanic Blacks, Hispanics and Native American/Alaskan Natives. Conclusion: PE-related mortality significantly increased during the COVID pandemic, and the increase was disproportionately greater among men and racial/ethnic minorities.

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