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Health Care Implications of the COVID-19 Pandemic for the Cardiovascular Practitioner
Finlay A McAlister1, Harsh Parikh2, Douglas S Lee3
1The Division of General Internal Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; The Alberta Strategy for Patient Oriented Research Support Unit, Edmonton, Alberta, Canada.
Insights
The COVID-19 pandemic significantly increased cardiovascular disease and risk factors, impacting both infected individuals and the uninfected. Healthcare system disruptions further exacerbated these cardiovascular health challenges.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic caused excess morbidity and mortality, with many non-COVID-19 deaths being cardiovascular.
- Indirect pandemic effects profoundly increased cardiovascular disease and risk factors in both COVID-19 survivors and never-infected individuals.
Purpose of the Study:
- To review the direct effects of SARS-CoV-2 on cardiovascular and cardiometabolic disease in survivors.
- To examine the indirect effects of the pandemic on cardiovascular health in the general population.
- To analyze pandemic-related healthcare system deficits impacting cardiovascular care.
Main Methods:
- Literature review of direct and indirect pandemic effects on cardiovascular health.
- Analysis of healthcare system disruptions, including delayed care and resource shortages.
- Examination of consequences for diagnostic testing, cardiac rehabilitation, and homecare.
Main Results:
- SARS-CoV-2 infection directly impacts cardiovascular health in survivors.
- The pandemic indirectly elevated cardiovascular disease burden and risk factors across populations.
- Significant care deficits arose from delayed acute care, shifts to virtual services, and reduced access to diagnostics and rehabilitation.
Conclusions:
- The COVID-19 pandemic has had profound and lasting effects on cardiovascular health.
- Healthcare system disruptions have created substantial deficits in cardiovascular disease management.
- Understanding these impacts is crucial for future pandemic preparedness and cardiovascular care strategies.
Abstract:
There has been substantial excess morbidity and mortality during the COVID-19 pandemic, not all of which was directly attributable to SARS-CoV-2 infection, and many non-COVID-19 deaths were cardiovascular. The indirect effects of the pandemic have been profound, resulting in a substantial increase in the burden of cardiovascular disease and cardiovascular risk factors, both in individuals who survived SARS-CoV-2 infection and in people never infected. In this report, we review the direct effect of SARS-CoV-2 infection on cardiovascular and cardiometabolic disease burden in COVID-19 survivors as well as the indirect effects of the COVID-19 pandemic on the cardiovascular health of people who were never infected with SARS-CoV-2. We also examine the pandemic effects on health care systems and particularly the care deficits caused (or exacerbated) by health care delayed or foregone during the COVID-19 pandemic. We review the consequences of: (1) deferred/delayed acute care for urgent conditions; (2) the shift to virtual provision of outpatient care; (3) shortages of drugs and devices, and reduced access to: (4) diagnostic testing, (5) cardiac rehabilitation, and (6) homecare services. We discuss the broader implications of the COVID-19 pandemic for cardiovascular health and cardiovascular practitioners as we move forward into the next phase of the pandemic.
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Medical History
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