Clinics (Dec 2021)

Cardiology referral during the COVID-19 pandemic

  • Nathalia Conci Santorio,
  • Francisco Akira Malta Cardozo,
  • Rodrigo Freddi Miada,
  • Fabio Grunspun Pitta,
  • Caio de Assis Moura Tavares,
  • Fabio Cetinic Habrum,
  • Henrique Trombini Pinesi,
  • Iuri Resedá Magalhães,
  • Maria Clara Saad Menezes,
  • Bruno Caramelli,
  • Daniela Calderaro

DOI
https://doi.org/10.6061/clinics/2021/e3538
Journal volume & issue
Vol. 76

Abstract

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OBJECTIVES: This study presents the cardiology referral model adopted at the University of São Paulo-Hospital das Clínicas complex during the initial period of the coronavirus disease (COVID-19) pandemic, main reasons for requesting a cardiologic evaluation, and clinical profile of and prognostic predictors in patients with COVID-19. METHODS: In this observational study, data of all cardiology referral requests between March 30, 2020 and July 6, 2020 were collected prospectively. A descriptive analysis of the reasons for cardiologic evaluation requests and the most common cardiologic diagnoses was performed. A multivariable model was used to identify independent predictors of in-hospital mortality among patients with COVID-19. RESULTS: Cardiologic evaluation was requested for 206 patients admitted to the ICHC-COVID. A diagnosis of COVID-19 was confirmed for 180 patients. Cardiologic complications occurred in 77.7% of the patients. Among these, decompensated heart failure was the most common complication (38.8%), followed by myocardial injury (35%), and arrhythmias, especially high ventricular response atrial fibrillation (17.7%). Advanced age, greater need of ventilatory support on admission, and pre-existing heart failure were independently associated with in-hospital mortality. CONCLUSIONS: A hybrid model combining in-person referral with remote discussion and teaching is a viable alternative to overcome COVID-19 limitations. Cardiologic evaluation remains important during the pandemic, as patients with COVID-19 frequently develop cardiovascular complications or decompensation of the underlying heart disease.

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