Impact of the COVID-19 Pandemic on Primary Health Care Disease Incidence Rates: 2017 to 2020

Antoni Sisó-Almirall; Belchin Kostov; Encarna Sánchez; Jaume Benavent-Àreu; Luis González-de Paz

doi:10.1370/afm.2731

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Figure 1.
Trends in incidence rates of selected diseases and conditions commonly seen in primary care, 2017-2020.

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Table 1.

Incidence Rates of Diseases and Conditions Commonly Seen in Primary Care, 2017–2020

	Incidence Rate (95% CI), Cases per 1,000 Persons				2020 vs 2019, IRR (95% CI)	2020 vs 2017–2019, IRR (95% CI)
Disease/condition	2017	2018	2019	2020	2020 vs 2019, IRR (95% CI)	2020 vs 2017–2019, IRR (95% CI)
Cardiovascular risk factors and diseases
Hypercholesterolemia	17.11	15.88	17.69	10.78	0.61	0.64
	(15.88-18.42)	(14.72-17.11)	(16.47-18.97)	(9.86-11.77)	(0.54-0.68)	(0.57-0.72)
Hypertension	14.06	14.20	13.35	8.26	0.62	0.60
	(12.96-15.22)	(13.11-15.34)	(12.31-14.46)	(7.46-9.12)	(0.54-0.70)	(0.52-0.68)
Type 2 diabetes	6.10	6.36	6.71	3.93	0.59	0.61
	(5.46-6.81)	(5.71-7.06)	(6.05-7.42)	(3.44-4.47)	(0.50-0.69)	(0.52-0.73)
Chronic kidney disease	6.77	5.33	7.03	3.64	0.52	0.57
	(6.10-7.48)	(4.75-5.96)	(6.37-7.75)	(3.18-4.15)	(0.44-0.61)	(0.48-0.68)
Heart failure	2.15	2.97	3.31	2.54	0.77	0.90
	(1.79-2.57)	(2.54-3.44)	(2.87-3.81)	(2.16-2.96)	(0.62-0.95)	(0.72-1.12)
Stroke	1.86	2.22	1.74	1.86	1.07	0.96
	(1.52-2.25)	(1.86-2.64)	(1.42-2.11)	(1.54-2.23)	(0.81-1.40)	(0.73-1.25)
Ischemic cardiomyopathy	3.24	2.23	2.24	1.32	0.59	0.52
	(2.79-3.75)	(1.86-2.64)	(1.87-2.65)	(1.05-1.64)	(0.44-0.78)	(0.39-0.68)
Acute myocardial infarction	0.99	0.96	0.87	1.14	1.31	1.22
	(0.75-1.29)	(0.72-1.24)	(0.65-1.14)	(0.89-1.44)	(0.91-1.91)	(0.84-1.76)
Chronic noncardiovascular diseases
Dementia	6.25	7.40	9.64	6.77	0.70	0.87
	(5.60-6.95)	(6.71-8.14)	(8.85-10.47)	(6.13-7.45)	(0.62-0.80)	(0.76-1.00)
Asthma	5.34	6.86	5.68	5.07	0.89	0.85
	(4.74-5.99)	(6.19-7.59)	(5.07-6.33)	(4.51-5.68)	(0.76-1.05)	(0.72-1.00)
Benign prostatic	9.00	9.23	8.25	5.47	0.66	0.62
hypertrophy	(8.23-9.83)	(8.46-10.06)	(7.52-9.03)	(4.89-6.10)	(0.57-0.77)	(0.54-0.72)
Hypothyroidism/thyroiditis	7.39	7.32	7.92	4.07	0.51	0.54
	(6.67-8.16)	(6.62-8.08)	(7.20-8.70)	(3.57-4.63)	(0.44-0.60)	(0.46-0.63)
Osteoporosis	5.83	4.92	5.76	3.31	0.57	0.60
	(5.20-6.52)	(4.35-5.54)	(5.15-6.43)	(2.86-3.81)	(0.48-0.69)	(0.50-0.72)
COPD	2.73	2.75	3.22	1.46	0.45	0.50
	(2.31-3.20)	(2.33-3.21)	(2.78-3.72)	(1.18-1.80)	(0.35-0.59)	(0.39-0.65)
Mental health disorders and health problems
Anxiety	24.03	26.37	32.37	31.94	0.99	1.16
	(22.65-25.46)	(24.95-27.84)	(30.81-33.98)	(30.4-33.53)	(0.92-1.06)	(1.07-1.24)
Depression	6.90	7.05	7.60	6.21	0.82	0.86
	(6.20-7.66)	(6.35-7.80)	(6.88-8.37)	(5.58-6.90)	(0.71-0.95)	(0.74-1.00)
Alcohol use disorder	1.32	1.54	1.78	0.84	0.47	0.54
	(1.04-1.66)	(1.23-1.89)	(1.45-2.15)	(0.62-1.10)	(0.33-0.66)	(0.38-0.77)
Violence against women^{^a}	1.05	0.78	0.89	0.91	1.03	1.01
	(0.73-1.46)	(0.52-1.14)	(0.60-1.26)	(0.63-1.28)	(0.61-1.74)	(0.60-1.70)
Cancer
Screening-detected cancers/tumors	8.76	9.89	8.01	5.82	0.73	0.65
	(7.99-9.58)	(9.08-10.75)	(7.29-8.78)	(5.22-6.47)	(0.63-0.84)	(0.57-0.75)
Breast cancer^{^a}	3.61	2.68	3.11	2.44	0.78	0.78
	(2.98-4.32)	(2.15-3.29)	(2.54-3.76)	(1.95-3.01)	(0.58-1.05)	(0.58-1.05)
Colon cancer	0.65	0.96	0.65	0.68	1.05	0.91
	(0.46-0.90)	(0.72-1.24)	(0.47-0.89)	(0.50-0.92)	(0.66-1.66)	(0.58-1.41)
Benign colon polyps/tumors	5.76	7.06	5.27	3.51	0.67	0.58
	(5.14-6.42)	(6.39-7.78)	(4.70-5.89)	(3.05-4.01)	(0.56-0.80)	(0.49-0.69)
Cancers normally symptom detected	4.46	4.04	4.81	3.63	0.75	0.82
	(3.92-5.05)	(3.54-4.60)	(4.27-5.41)	(3.17-4.14)	(0.63-0.90)	(0.68-0.98)
Prostate cancer	3.25	3.12	2.88	2.26	0.78	0.73
	(2.56-4.08)	(2.45-3.91)	(2.25-3.64)	(1.72-2.91)	(0.54-1.12)	(0.51-1.05)
Lung cancer	0.55	0.43	0.60	0.74	1.24	1.42
	(0.37-0.77)	(0.28-0.63)	(0.42-0.83)	(0.55-0.99)	(0.79-1.97)	(0.88-2.32)
Bladder cancer	0.69	0.75	0.87	0.67	0.77	0.87
	(0.49-0.94)	(0.55-1.01)	(0.65-1.14)	(0.48-0.90)	(0.50-1.17)	(0.55-1.35)
Liver cancer	0.09	0.20	0.08	0.11	1.33	0.88
	(0.03-0.20)	(0.11-0.36)	(0.03-0.19)	(0.04-0.23)	(0.36-5.31)	(0.27-2.89)
Thyroid cancer	0.33	0.12	0.32	0.09	0.30	0.37
	(0.20-0.52)	(0.05-0.25)	(0.19-0.49)	(0.03-0.21)	(0.10-0.78)	(0.12-1.01)
Melanoma	0.69	0.68	0.80	0.40	0.49	0.55
	(0.49-0.94)	(0.49-0.93)	(0.59-1.06)	(0.26-0.59)	(0.29-0.82)	(0.32-0.92)
Stomach cancer	0.12	0.07	0.13	0.11	0.83	1.02
	(0.05-0.25)	(0.02-0.17)	(0.06-0.26)	(0.04-0.23)	(0.26-2.62)	(0.30-3.59)
Kidney cancer	0.46	0.32	0.57	0.27	0.47	0.60
	(0.30-0.67)	(0.19-0.50)	(0.39-0.79)	(0.16-0.43)	(0.25-0.87)	(0.31-1.14)
Lymphoma/leukemia	0.11	0.10	0.13	0.17	1.30	1.53
	(0.04-0.23)	(0.04-0.22)	(0.06-0.26)	(0.09-0.31)	(0.48-3.74)	(0.53-4.76)

COPD = chronic obstructive pulmonary disease; IRR = incidence rate ratio.
Note: Bold denotes statistically significant (P < .05) incidence rate ratios.
↵^aIn women.

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Supplemental Table 1. The number of total and new cases of cardiovascular diseases, chronic non-cardiovascular diseases, mental disorders, health problems and cancer diseases during the period from 2017 to 2020. At-risk population is taken as total population minus the number of people who have already developed the disease of interest (total cases – new cases).

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