Lessons Learned by a Multidisciplinary Heart Failure Clinic In The Midst Of A Pandemic

Abstract

In addition to the deaths caused by coronavirus disease (COVID-19), several countries also observed an increase in the overall number of cardiovascular deaths during the pandemics compared with the same period in previous years. The presence of heart failure (HF) in the context of COVID-19 identifies a subgroup with complex management and may represent both a risk factor for worse infection outcomes and a severe cardiovascular complication caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Patients with advanced HF require regular rigorous multidisciplinary medical follow-up, performed ideally through face-to-face consultation. However, due to the reallocation of health care professionals and the implementation of measures of isolation and social distancing, telemedicine strategies have strengthened as important allies in the management of HF patients. In the present document, we report the brief experience of the unit of advanced HF and heart transplant of Hospital de Messejana, a reference center in the confrontation of COVID-19 in the state of Ceará, Brazil, with the primarily remote monitoring rather than face-to-face consultation from March to July 2020.

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“…This finding can be explained by the large number of procedures that transplant recipients have to undergo in the first months and years after transplantation, including EMB and rescue immunosuppressive therapies, which in general require hospitalization. 17 Although there was no difference in reported deaths between 2019 and 2020, there was a relative increase of 5 times more deaths in HF patients hospitalized during the pandemic. This may be due to greater prioritization for hospitalized individuals with more severe disease and a worse prognosis.…”