Safe Reintroduction of Cardiovascular Services During COVID-19 Pandemic

May 12, 2020   |  Salim Hayek, MD, FACC
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Authors:
Wood DA, Mahmud E, Thourani VH, et al.
Citation:
Safe Reintroduction of Cardiovascular Services During the COVID-19 Pandemic: Guidance From North American Society Leadership. J Am Coll Cardiol 2020;May 4:[Epub ahead of print].

This review summarizes the guidance of various societies regarding the management of cardiovascular disease during the coronavirus disease 2019 (COVID-19) pandemic. The highlight is the Table, where recommendations are provided and classified by subspecialty, disease, and regional response level. The following are eight key points to remember:

  1. Restrictions on routine medical care placed in compliance with public health guidance has helped preserve and redirect limited resources during the COVID-19 crisis, however, resulting in delays in the treatment of patients with cardiovascular disease.
  2. Decisions to ration or reintroduce care must balance benefits of treatment to risk of exacerbating the spread of COVID-19, while following the values of fairness and consistency.
  3. Reintroduction of services should follow a sustained reduction in the rate of COVID-19 admissions and death as determined by public health officials, with protocols in place to cease elective procedures in the event of resurgence of the disease.
  4. Strategies for the reintroduction of cardiovascular services should be regionalized and depend on the close collaboration between public health officials and healthcare institutions.
  5. Measures for protection of patients and healthcare workers including routine COVID-19 screening, physical distancing, and ensuring the availability of personal protective equipment form the foundation for reintroducing care.
  6. Institutional infrastructure and local COVID-19 penetrance should dictate the availability of certain procedures or diagnostic tests.
  7. In individual patient management, the procedure or test that would minimize patient and healthcare worker exposure should be prioritized.
  8. Any reintroduction plan should ensure that reserve capacity is maintained in the event of a second surge of COVID-19.

Clinical Topics: COVID-19 Hub, Prevention

Keywords: Cardiology Interventions, Coronavirus, Coronavirus Infections, COVID-19, Delivery of Health Care, Diagnostic Tests, Routine, Health Personnel, Personal Protective Equipment, Primary Prevention, Public Health, severe acute respiratory syndrome coronavirus 2


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