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Heart health in the time of the coronavirus pandemic

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People with underlying health conditions, such as heart disease, are more vulnerable to COVID-19

By the beginning of 2020, when we heard of a novel coronavirus with potentially severe consequences, the race was on to learn everything we could and should about it. Before long, and with so much still to be discovered, an unfortunate trend emerged: COVID-19 posed a particular risk to patients with underlying issues such as heart disease, which is already the leading cause of death on the planet.

Also emerging was a worrying trend that heart patients, who would usually seek routine care or need to access emergency services for non-COVID-related issues, were avoiding hospitals and doctors. Across the board, countries noted this dramatic drop, attributing it to fear of contracting the virus.

CVD and COVID-19

Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), at the root of coronavirus disease or COVID-19, has been claiming lives in ways as diverse as the patient complications observed. It is highly transmissible and strikes with varying forms of severity.

About CVD and COVID-19

Cardiovascular disease (CVD) patients are more susceptible to severe COVID-19. Diseases affecting some form of heart condition or heart function include hypertension and diabetes, acute coronary syndrome, injury to muscles tissues of the heart, (myocardial injury), heart failure, and less heard of but prevalent diseases such as rheumatic heart disease and Chagas disease.

Some practical recommendations, also summed up in the article “Understanding the COVID-19 heart connection in low-resource settings,” aims to support care-giving and treatment, with guidelines across the board. Some key takeaways are:

  • COVID-19 patients need to be triaged or designated for care based on disease severity so that patients with moderate and severe disease are admitted in a separate ward or hospital depending on the available infrastructure.
  • Further, patients also need to be triaged based on underlying health risks such as hypertension, diabetes, prior cardiovascular or respiratory disease, kidney failure and cancer as part of the process to identify patients with a higher likelihood of developing a severe form of COVID-19 and implement targeted care.
  • Special attention must be given to ensuring that there are separate facilities in place for dealing with COVID-19 cardiac patients and non-COVID-19 cardiac patients including catheterization laboratories for performing invasive heart examinations.

Two ways to approach the double-edged threat of CVD & COVID-19

AWARENESS & PREVENTION

The World Heart Federation has produced lots of resources to spread the word on CVD & COVID-19, including prevention, transmission and vulnerability. You can find some of these on the World Heart Day website and others on the World Heart Federation website. Please download them and amplify our messaging on your own digital channels.

WHF Emerging Leaders have been contributing their global perspectives and helping us get a picture in real-time. Check out their rolling blog and the briefing on Prevention: Coronavirus Disease 2019 (COVID-19) in Low-Income Countries that takes into account the greater risk faced by those most vulnerable.

REASSURANCE

For people who have underlying health conditions such as heart disease, the message has to be that your hospital, emergency room, or doctor’s surgery is safe, and if you need to go, you should. The risks of heart attacks and stroke far outweigh the risks of contracting COVID-19 and time is truly of the essence when heart troubles hit. While telemedicine has been an important resource, it should not be seen as a replacement for in-person care nor should it be interpreted as a measure taken because hospital visits have become unsafe.

The Heart in The Time of COVID-19

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