Abstract
Background: This study estimated to what extent the number of measurements of cardiometabolic risk factors (e.g., blood pressure, cholesterol, glycated haemoglobin) were impacted by the COVID-19 pandemic, and whether these have recovered to expected levels.
Methods and Findings: A cohort of individuals aged ≥18 years in England with records in the primary care - COVID-19 General Practice Extraction Service Data for Pandemic Planning and Research (GDPPR) were identified. Their records of 12 risk factor measurements were extracted between November 2018 and March 2024. Number of measurements per 1,000 individuals were calculated by age group, sex, ethnicity, and area deprivation quintile. The observed number of measurements were compared to a composite expectation band, derived as the union of the 95% confidence interval of two estimates: (1) a projected trend based on data prior to the COVID-19 pandemic, and (2) an assumed stable trend from before pandemic. Point estimates were calculated as the mid-point of the expectation band.
A cohort of 49,303,410 individuals aged ≥18 years were included. There was sharp drop in all measurements in March 2020 – February 2022, but overall recovered to the expected levels during March 2022 – February 2023 except for blood pressure, which had prolonged recovery. In March 2023 – March 2024, blood pressure measurements were below expectation by 16% overall (-19 per 1,000), in people aged 18-39 (-23%; -18 per 1,000), 60-79 (-17%; -27 per 1,000), and ≥80 (-31%; -57 per 1,000). There was suggestion that recovery in blood pressure measurements was socioeconomically patterned. The second most deprived quintile had the highest deviation (-20%; -23 per 1,000) from expectation compared to least deprived quintile (-13%; -15 per 1,000).
Conclusions: There has been a substantial reduction in routine measurements of cardiometabolic risk factors following the COVID-19 pandemic. The implications for missed diagnoses, worse prognosis, and health inequality are a concern.
Methods and Findings: A cohort of individuals aged ≥18 years in England with records in the primary care - COVID-19 General Practice Extraction Service Data for Pandemic Planning and Research (GDPPR) were identified. Their records of 12 risk factor measurements were extracted between November 2018 and March 2024. Number of measurements per 1,000 individuals were calculated by age group, sex, ethnicity, and area deprivation quintile. The observed number of measurements were compared to a composite expectation band, derived as the union of the 95% confidence interval of two estimates: (1) a projected trend based on data prior to the COVID-19 pandemic, and (2) an assumed stable trend from before pandemic. Point estimates were calculated as the mid-point of the expectation band.
A cohort of 49,303,410 individuals aged ≥18 years were included. There was sharp drop in all measurements in March 2020 – February 2022, but overall recovered to the expected levels during March 2022 – February 2023 except for blood pressure, which had prolonged recovery. In March 2023 – March 2024, blood pressure measurements were below expectation by 16% overall (-19 per 1,000), in people aged 18-39 (-23%; -18 per 1,000), 60-79 (-17%; -27 per 1,000), and ≥80 (-31%; -57 per 1,000). There was suggestion that recovery in blood pressure measurements was socioeconomically patterned. The second most deprived quintile had the highest deviation (-20%; -23 per 1,000) from expectation compared to least deprived quintile (-13%; -15 per 1,000).
Conclusions: There has been a substantial reduction in routine measurements of cardiometabolic risk factors following the COVID-19 pandemic. The implications for missed diagnoses, worse prognosis, and health inequality are a concern.
| Original language | English |
|---|---|
| Number of pages | 16 |
| Journal | PLoS Medicine |
| DOIs | |
| Publication status | Published - 26 Nov 2024 |