COVID-19 Pandemic Disrupts Healthcare Utilization, Leading to Changes in Mortality and Cardiovascular Disease in People with Diabetes

Strategic Insights -

The COVID-19 pandemic has disrupted healthcare systems globally, with a significant impact on individuals with chronic conditions such as diabetes mellitus (DM). A recent study published in Health Science Reports investigated the indirect impact of the pandemic on all-cause mortality, cardiovascular disease (CVD) diagnoses, and healthcare utilization among people with DM in Korea and Hong Kong.

The study, conducted by researchers from the School of Clinical Medicine, analyzed data from 1,226,685 individuals with a documented diagnosis of DM in 2014 but without any existing CVD or SARS-CoV-2 infection from January 2015 to December 2021. The researchers found that:

  • After the initial COVID-19 outbreak in February 2020, all-cause mortality did not change significantly in either location.
  • In Hong Kong, CVD incidence declined in 2020 (IRR 0.824, 95%CI 0.732-0.929) and rebounded to pre-pandemic levels in 2021 (IRR 1.049, 95%CI 0.915-1.203).
  • In contrast, Korea showed a reversal of the pre-pandemic decline with CVD incidence increasing significantly in 2021 (IRR 1.108, 95%CI 0.996-1.015).
  • Outpatient visits in Korea declined at the start of 2020 (IRR 0.890, 95%CI 0.826-0.958) and remained below expected levels through 2021, while Hong Kong showed no significant changes.
  • Hospital admissions in Korea also declined significantly and did not recover.

The study concluded that the outbreak disrupted healthcare utilization among people with DM, leading to a temporary decline in CVD diagnoses. In Hong Kong, CVD incidence normalized in 2021, while in Korea, the continued increase in CVD incidence may be related to sustained care disruption.

Key Takeaways:

  • The COVID-19 pandemic disrupted healthcare systems globally, with a significant impact on individuals with chronic conditions such as DM.
  • The study analyzed data from 1,226,685 individuals with a documented diagnosis of DM in 2014, without any existing CVD or SARS-CoV-2 infection.
  • In Hong Kong, CVD incidence declined in 2020 and rebounded to pre-pandemic levels in 2021.
  • In contrast, Korea showed a reversal of the pre-pandemic decline with CVD incidence increasing significantly in 2021.
  • Outpatient visits in Korea declined at the start of 2020 and remained below expected levels through 2021.
  • Hospital admissions in Korea also declined significantly and did not recover.
  • The study concluded that the outbreak disrupted healthcare utilization among people with DM, leading to a temporary decline in CVD diagnoses.

Statistics:

  • 1,226,685 individuals with a documented diagnosis of DM in 2014.
  • 926,230 individuals from Korea.
  • 302,455 individuals from Hong Kong.
  • 95% CI for IRR in Hong Kong: 0.732-0.929 (2020) and 0.915-1.203 (2021).
  • 95% CI for IRR in Korea: 0.996-1.015 (2021).
  • IRR for outpatient visits in Korea: 0.890 (95%CI 0.826-0.958).
  • IRR for hospital admissions in Korea: not applicable (declined significantly and did not recover).

Sources:

  • Health Science Reports, Indirect Impact of the COVID-19 Pandemic on All-Cause Mortality and Cardiovascular Disease Among People With Diabetes Mellitus From Korea and Hong Kong: An Interrupted Time Series Analysis, 2025,8(10):n/a-n/a. (https://onlinelibrary.wiley.com/journal/23988835).
  • NewsRx, School of Clinical Medicine Researchers Detail Findings in COVID-19 (Indirect Impact of the COVID-19 Pandemic on All-Cause Mortality and Cardiovascular Disease Among People With Diabetes Mellitus From Korea and Hong Kong: An Interrupted Time ...), Cardiovascular Week, October 20, 2025; p 405.