The Covid-19 pandemic did not only cause harm through viral infection but also increased mortality from non-communicable diseases worldwide, including cardiovascular and cerebrovascular diseases, diabetes, and mental disorders.

A research team led by Professor Suh Hae-sun of the Kyung Hee University College of Pharmacy published the results of their analysis on the pandemic's impact on mortality rates, healthcare utilization, and disease burden in the international journal “eClinicalMedicine,” a sister publication of The Lancet. Mortality rates were analyzed using data from 31 countries, while healthcare use and disease burden were assessed using National Health Insurance Service (NHIS) claims data.

The researchers analyzed data on 20 disease groups between 2014 and 2022.

The results showed that after the pandemic, mortality rates for at least one disease increased statistically significantly in 27 of the 31 countries. The increase in cardiovascular disease mortality was particularly pronounced. The researchers classified the period up to January 2020 as pre-pandemic and the period from February 2020 onwards as the pandemic period.

In Hungary, for instance, mortality from circulatory diseases increased by an average of 0.017 per 100,000 population per month during the pandemic period. Lithuania showed a similar level of increase. Korea experienced a relatively smaller increase, averaging only 0.0004 additional deaths per month, but this was statistically significant. Japan saw mortality rates for several diseases, including circulatory diseases, decrease in early 2020, but they subsequently reversed and began rising again.

Besides, mortality rates increased during the pandemic for ischemic heart disease in nine countries, diabetes in 13 countries, dementia in 11 countries, pneumonia in eight countries, liver disease (including cirrhosis) in seven countries, and renal failure in nine countries.

In Korea, while mortality increases were smaller compared to other nations, the pandemic significantly disrupted healthcare utilization. Analysis of health insurance claims data revealed that during the pandemic, the number of patients decreased for 13 disease groups, including infectious diseases and respiratory diseases, and outpatient visits decreased for eight disease groups. The number of hospitalization days decreased for 12 disease groups, including infectious diseases, endocrine and metabolic diseases, and obstetrics and gynecology diseases.

However, the number of patients with cancer, mental disorders, congenital anomalies, and unexplained symptoms increased. Mental disorders, in particular, initially decreased but then rapidly increased. Specific disorders like bipolar disorder, eating disorders, and menstrual disorders showed a distinct upward trend after the pandemic.

Medical costs also revealed interesting results. Despite fewer patients, total medical costs increased during the pandemic for cancer, neurological, cardiovascular, respiratory, urological, and ophthalmological diseases. Subsequently, medical costs for ophthalmic, cardiovascular, and urological diseases continued to rise steadily. Notably, per capita medical costs for eight disease groups, including neurological, respiratory, and obstetrics/gynecology conditions, increased immediately during the pandemic period. The research team interpreted this as a result of mild patients being unable to access hospitals, leading to care being focused primarily on severe cases.

The researchers emphasized the significance of this study as the first to demonstrate, using multinational data, that Covid-19 not only caused infectious disease damage but simultaneously increased mortality and burden from chronic and mental illnesses. It also revealed substantial country-specific differences, highlighting the limitations of uniform pandemic policies. Furthermore, the pandemic impacted women's health and mental health, underscoring the need for future countermeasures.

“To ensure the resilience of healthcare systems, policy considerations are needed to guarantee continuity of care so that chronic disease management is not interrupted during pandemics,” the researchers said. “Solutions for this could include remote monitoring, home-based care, and simplifying medication delivery systems.”

They continued, "Many countries still face healthcare workforce shortages, which hinder effective infectious disease responses. Therefore, strengthening the global public health workforce and improving communication among stakeholders are key tasks.”

Professor Suh said, “This study is the first comprehensive investigation, through cross-national comparison, of the impact the Covid-19 pandemic had on various diseases and healthcare utilization worldwide.”

It can serve as important scientific evidence for setting public health crisis response policies in the future, she added.

Dr. Choi Kyung-sun and student Jang Min-seol of the Department of Regulatory Science at Kyung Hee University, Professor Park Sang-jun of the Seoul National University College of Medicine, and Professor Kim Si-in of the Kyungsung University College of Pharmacy also participated in the study.

The paper detailing the findings, "Impact of COVID-19 on disease-specific mortality, healthcare resource utilization, and disease burden across a population over 1 billion in 31 countries: an interrupted time-series analysis," was published last July.