Management of Cardiovascular Disease Patients With Confirmed or Suspected COVID-19 in Limited Resource Settings
Dorairaj Prabhakaran,
Pablo Perel,
Ambuj Roy,
Kavita Singh,
Lana Raspail,
José Rocha Faria-Neto,
Samuel S. Gidding,
Dike Ojji,
Ferdous Hakim,
L. Kristin Newby,
Janina Stępińska,
Carolyn S.P. Lam,
Modou Jobe,
Sarah Kraus,
Eduardo Chuquiure-Valenzuela,
Daniel Piñeiro,
Kay-Tee Khaw,
Ehete Bahiru,
Amitava Banerjee,
Jagat Narula,
Karen Sliwa
Affiliations
Dorairaj Prabhakaran
Centre for Control of Chronic Conditions, Public Health Foundation India
Pablo Perel
Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine
Ambuj Roy
All India Institute of Medical Sciences New Delhi
Kavita Singh
Public Health Foundation of India
Lana Raspail
World Heart Federation
José Rocha Faria-Neto
Pontifical Catholic University of Parana, Curitiba (Brazil)
Samuel S. Gidding
World Heart Federation
Dike Ojji
Department of Medicine, Faculty of Clinical Sciences, University of Abuja and University of Abuja Teaching Hospital
Ferdous Hakim
L. Kristin Newby
Duke Clinical Research Institute, Durham
Janina Stępińska
Department of Intensive Cardiac Therapy, National Institute of Cardiology, Warsaw
Carolyn S.P. Lam
National Heart Center Singapore and Duke-National University of Singapore, SG; Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen
Modou Jobe
Medical Research Council Unit
Sarah Kraus
Department of Medicine and the Hatter Institute for Cardiovascular Research in Africa, University of Cape Town, ZA; Radcliffe Department of Medicine, University of Oxford
Eduardo Chuquiure-Valenzuela
Instituto Nacional de Cardiología
Daniel Piñeiro
Universidad de Buenos Aires
Kay-Tee Khaw
Strangeways Research Laboratory, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Worts Causeway, Cambridge
Ehete Bahiru
Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center
Amitava Banerjee
University College London
Jagat Narula
Icahn School of Medicine at Mount Sinai|MSSM • Mount Sinai Heart
Karen Sliwa
Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Groote Schuur Hospital, Cape Town; Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, Faculty of Health Sciences, Groote Schuur Hospital and University of Cape Town
In this paper, we provide recommendations on the management of cardiovascular disease (CVD) among patients with confirmed or suspected coronavirus disease (COVID-19) to facilitate the decision making of healthcare professionals in low resource settings. The emergence of novel coronavirus disease, also known as Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), has presented an unprecedented global challenge for the healthcare community. The ability of SARS-CoV-2 to get transmitted during the asymptomatic phase and its high infectivity have led to the rapid transmission of COVID-19 beyond geographic regions, leading to a pandemic. There is concern that COVID-19 is cardiotropic, and it interacts with the cardiovascular system on multiple levels. Individuals with established CVD are more susceptible to severe COVID-19. Through a consensus approach involving an international group this WHF statement summarizes the links between cardiovascular disease and COVID-19 and present some practical recommendations for the management of hypertension and diabetes, acute coronary syndrome, heart failure, rheumatic heart disease, Chagas disease, and myocardial injury for patients with COVID-19 in low-resource settings. This document is not a clinical guideline and it is not intended to replace national clinical guidelines or recommendations. Given the rapidly growing burden posed by COVID-19 illness and the associated severe prognostic implication of CVD involvement, further research is required to understand the potential mechanisms linking COVID-19 and CVD, clinical presentation, and outcomes of various cardiovascular manifestations in COVID-19 patients.