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Cardiovascular disease and COVID-19: Australian and New Zealand consensus statement
Sarah Zaman1,2, Andrew I MacIsaac3, Garry Lr Jennings4,5
1MonashHeart, Monash Health, Melbourne, VIC.
Insights
The COVID-19 pandemic poses significant risks to patients with cardiovascular disease (CVD), increasing their mortality. New strategies are essential for healthcare workers and cardiac patients to minimize viral transmission while ensuring high-quality cardiac care.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- The COVID-19 pandemic, caused by SARS-CoV-2, significantly impacts individuals with pre-existing cardiovascular disease (CVD).
- COVID-19 infection can lead to serious cardiac complications, including left ventricular dysfunction, heart failure, arrhythmias, and acute coronary syndromes.
- Patients with CVD face a substantially higher mortality rate when infected with SARS-CoV-2.
Purpose of the Study:
- To address the urgent need for strategies minimizing viral transmission to healthcare workers and cardiac patients.
- To outline adaptive healthcare delivery models and resource allocation for cardiovascular health services during the pandemic.
- To propose practical approaches for cardiovascular healthcare delivery to patients with and without SARS-CoV-2 infection.
Main Methods:
- A rapid literature appraisal and review of key documents were conducted.
- Input was gathered from leaders in cardiology, cardiac surgery, and public health.
- Endorsements were obtained from major Australian and New Zealand cardiac societies and research councils.
Main Results:
- COVID-19 presents acute cardiac manifestations, including left ventricular dysfunction, heart failure, arrhythmias, and acute coronary syndromes.
- Underlying CVD increases COVID-19 case fatality rates five- to tenfold.
- Adaptive healthcare models and special precautions are necessary to protect at-risk populations.
Conclusions:
- Cardiovascular health services must recognize the heightened risk for CVD patients and enhance their management of COVID-19's cardiac effects.
- Healthcare providers need to reorganize and innovate service delivery models to meet pandemic-related demands.
- This consensus statement provides a framework for managing cardiovascular health during the SARS-CoV-2 pandemic.
Introduction:
The coronavirus 2019 disease (COVID-19) pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Pre-existing cardiovascular disease (CVD) increases the morbidity and mortality of COVID-19, and COVID-19 itself causes serious cardiac sequelae. Strategies to minimise the risk of viral transmission to health care workers and uninfected cardiac patients while prioritising high quality cardiac care are urgently needed. We conducted a rapid literature appraisal and review of key documents identified by the Cardiac Society of Australia and New Zealand Board and Council members, the Australian and New Zealand Society of Cardiac and Thoracic Surgeons, and key cardiology, surgical and public health opinion leaders.
Main Recommendations:
Common acute cardiac manifestations of COVID-19 include left ventricular dysfunction, heart failure, arrhythmias and acute coronary syndromes. The presence of underlying CVD confers a five- to tenfold higher case fatality rate with COVID-19 disease. Special precautions are needed to avoid viral transmission to this population at risk. Adaptive health care delivery models and resource allocation are required throughout the health care system to address this need.
Changes In Management As A Result Of This Statement:
Cardiovascular health services and cardiovascular health care providers need to recognise the increased risk of COVID-19 among CVD patients, upskill in the management of COVID-19 cardiac manifestations, and reorganise and innovate in service delivery models to meet demands. This consensus statement, endorsed by the Cardiac Society of Australia and New Zealand, the Australian and New Zealand Society of Cardiac and Thoracic Surgeons, the National Heart Foundation of Australia and the High Blood Pressure Research Council of Australia summarises important issues and proposes practical approaches to cardiovascular health care delivery to patients with and without SARS-CoV-2 infection.
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