Social isolation and risk of fatal cardiovascular events

Since the start of COVID-19 pandemic in March, 2020, in-person contact with family members, friends, and colleagues has been heavily restricted. These mitigation measures can worsen pre-existing social isolation.1Cudjoe TKM Kotwal AA “Social Distancing” amid a crisis isolation loneliness.J Am Geriatr Soc. 2020; 68: e27-e29Crossref PubMed Scopus (45) Google Scholar In this phase widespread insecurity, evidence on prevalence cardiovascular consequences represents an important guideline for estimating health COVID-19. Despite continuous therapeutic progress, coronary heart disease stroke remain leading causes death globally.2WHOThe top 10 death.https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-deathDate: Dec 9, 2020Date accessed: December 14, 2020Google Social previously associated increased risk events,3Gronewold J Engels M van de Velde S et al.Effects life events disease.Stroke. 2021; (published online Jan 15.)https://doi.org/10.1161/STROKEAHA.120.032070Crossref (5) Scholar, 4Valtorta NK Kanaan Gilbody Ronzi Hanratty B Loneliness as factors stroke: systematic review meta-analysis longitudinal observational studies.Heart. 2016; 102: 1009-1016Crossref (588) however, impact survival remains unclear. The Lancet Public Health, Robert Smith colleagues5Smith RW Barnes I Green Reeves GK Beral V Floud analysis two large UK prospective studies.Lancet Health. March 1.)https://doi.org/10.1016/S2468-2667(20)30291-7Google have attempted to address knowledge gap through combined data from 481 946 participants included Million Women Study 456 612 Biobank without previous or stroke. dataset, 42 402 first (1834 fatal events) 19 999 (529 occurred during mean follow-up 7 years (SD 2). was assessed quantitatively via summary index number people living together household frequency family, groups. Based index, were categorised into least isolated (379 031 [40%] 938 558 participants), moderately (429 541 [46%]), most (129 986 [14%]) groups, group defined reference group. Consistent literature,3Gronewold 6Gronewold Kropp R Lehmann N al.Association relationships incident all-cause mortality.Heart. 106: 1317-1323Crossref (6) individuals reported more pronounced health-risk behaviours, such smoking physical inactivity, likely be obese, poor (self-rated), live deprived areas (based Townsend Deprivation index) than Multivariable Cox regression analyses controlling behaviours established (age, sex, region recruitment, deprivation, smoking, alcohol intake, activity, body-mass self-rated health) identified no significant overall association between (most vs isolated) non-fatal (combined ratio [RR] both studies 1·01 [95% CI 0·98–1·04]) (1·13 [1·08–1·18]). contrast, there clear associations (1·86 [1·63–2·12]) (1·91 [1·48–2·46]). When different types analysed separately, stronger alone not (RR 1·60 1·46–1·75] combined) few versus contacts (1·27 [1·16–1·38]). Results did differ significantly studies, by health, profile. Considering that due event hospital admission, observed events, but could imply is mediated absence another person who assist seeking health-care following event. This interpretation supported effect having contacts. sample size analysis, observation provides strong rationale future intervention which potential benefits personal emergency alarms internet-based surveillance reducing are assessed. To date, variety methods evaluating used literature. One limitation study authors only able evaluate contacts, excess also stressful. Furthermore, quality contacts6Gronewold questions about email, phone, whereas contact. achieve better comparability, should seek consensus how aspects best In-person virtual differentiated considering video conferences predominated interactions pandemic. context psychiatric disorders, it already shown protect against mood contacts.7Teo AR Chan BK Saha Nicolaidis C Frequency vs. Facebook: examination symptoms military veterans.J Affect Disord. 2019; 243: 375-380Crossref (9) For assessment consequences, differentiation friends other groups requires attention studies. largely restricted members lockdowns. outcome mortality, support beneficial friends.8Shor E Roelfs DJ Yogev T strength ties: meta-regression self-reported mortality.Soc Networks. 2013; 35: 626-638Crossref (108) suggested acute might explain disease.5Smith Such findings contradict results REGARDS cohort study, showed past months—but anyone care you if become ill disabled—was disease.9Safford MM Reshetnyak Sterling MR al.Number determinants nonfatal Reasons Geographic Racial Differences Stroke (REGARDS) Study.Circulation. 3.)https://doi.org/10.1161/CIRCULATIONAHA.120.048026Google little modification isolation-related men higher long-term mortality myocardial infarction women.10Schmaltz HN Southern D Ghali WA al.Living alone, patient sex after infarction.J Gen Intern Med. 2007; 22: 572-578Crossref (70) addition determinants, character traits, experiences, genetic modify isolation.3Gronewold highlighted need develop comprehensive view isolation. contribution task. With understanding isolation, focus telemedicine interventions, prevention devastating, specifically fatal, effects possible. We declare competing interests. studiesSocial seems direct developing By substantially increases before reaching hospital, particularly among perhaps because immediate help responding attack Full-Text PDF Open Access