Abstract Body: Introduction:
Ischemic Stroke (IS) and Chronic Kidney Disease (CKD) are two of the major causes of mortality across the US. COVID-19 has significantly influenced their mortality trends, which remain unexplored.

Hypothesis:
We assessed whether the onset of the COVID-19 pandemic accelerated mortality trends in IS and CKD.

Aims:
To determine whether the COVID-19 pandemic accelerated mortality trends for IS and CKD.

Methods:
National mortality data were extracted from the CDC WONDER database (1999–2024) using underlying cause of death (UCOD) and multiple cause of death (MCOD) files. UCOD included all-cause mortality, while MCOD identified deaths involving IS (ICD-10:I63) and CKD (ICD-10: N18). Age-Adjusted Mortality Rates were calculated per 100,000 and standardized to the 2000 U.S. population. Trends were identified using Joinpoint Regression to estimate the Annual Percent Change across the study period.

Results:
We identified 17,367 deaths during the study period. 10,595 deaths pre-COVID (1999-2019) vs. 6,772 post-COVID (2020-2024). AAMR doubled from 0.24 to 0.48 per 100,000 pre- to post-COVID. In the post-COVID period, adults aged 64–85+ had the highest rate (2.14 per 100,000). Men had greater rates than women (0.56 vs 0.43), and non-Hispanic Black people had the greatest rates. AAMRs were greater in the South and West census regions, and were not significantly affected by urban/rural regions.

Conclusion:
In conclusion, the COVID-19 pandemic significantly accelerated a pre-existing upward mortality trend for ischemic stroke and CKD. These findings highlight the need for targeted cardiovascular and renal health interventions to address the disparities.