Recommendations for Cardiovascular Prevention During the Sars-Cov-2 Pandemic: An Executive Document by the Board of the Italian Society of Cardiovascular Prevention

Volpe, Massimo; Battistoni, Allegra; Bellotti, Paolo; Bellone, Simonetta; Bertolotti, Marco; Biffi, Alessandro; Consoli, Agostino; Corsini, Alberto; Desideri, Giovambattista; Ferri, Claudio; Modena, Maria Grazia; Nati, Giulio; Pirro, Matteo; Rubattu, Speranza; Trimarcö, Bruno; Volpe, Roberto; Kreutzenberg, Saula Vigili de

doi:10.1007/s40292-020-00401-1

Cited by 14 publications

(14 citation statements)

References 28 publications

(34 reference statements)

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“…Understanding the evolving epidemiology and transmission dynamics of the outbreak outside of these semiclosed communities would provide appropriate information to guide intervention policy. Prevention is, at this point, the best practice in order to reduce the impact of COVID-19, also taking into account the fact that that there is currently no vaccine available [24,25].…”

Section: Discussionmentioning

confidence: 99%

Characteristics of SARS-CoV-2 positive cases beyond health-care professionals or social and health-care facilities

et al. 2021

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Background During the outbreak of SARS-CoV-2 in Italy, infection among health-care professionals and in the context of welfare and health-care facilities was a significant concern. It is known that the elderly or those with concomitant pathologies are at greater risk of a serious evolution of the disease if affected by COVID-19 and that health workers are a category with greater exposure to SARS-CoV-2 infection. Until now, there has been little information on the epidemiological features and transmission dynamics of the COVID-19 outbreak which did not involve health-care professionals or social and health-care facilities. For this reason, this paper aims to describe the epidemiological characteristics of SARS-CoV-2 infection in the general population outside these semi-closed communities. Methods The study was designed by analyzing the data of the 1371 SARS-CoV-2 positive subjects observed in Sardinia up to 9 July, 2020 and whose data were available in the public health department. Statistical analysis and graphic representation were performed using STATA and Adobe Illustrator, respectively. Results Of the positive cases analyzed, 323 (23.5%) are health-care workers and 563 (41.1%) reside in social or health-care facilities. The number of positive cases among the general population (subjects who do not belong to these semi-closed communities), is 399 (29.1%), 208 females and 191 males. The estimated Case Fatality Rate stands at 5.0%, which is almost half the rate reported for all the SARS-CoV-2 positive cases (9.8%). The geographical distribution of positive cases differs considerably from the distribution of the totality of cases in Sardinia. Conclusions This review provides an insight into the COVID-19 situation in the general community, ie not involving health-care professionals or social and health-care facilities. Understanding the evolving epidemiology and transmission dynamics of the outbreak outside of these semi-closed communities would provide appropriate information to guide intervention policy. The COVID-19 pandemic has exacerbated the vulnerability of our health-care system. Severe disruptions in care, medicine shortages and unequal access to health-care are but a few examples of the challenges faced by people living in Italy and Europe, highlighting the importance of evidence-based approaches in supporting the development of prevention and response strategies for future pandemics.

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Section: Discussionmentioning

confidence: 99%

Characteristics of SARS-CoV-2 positive cases beyond health-care professionals or social and health-care facilities

et al. 2021

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“…122 Several factors that are enhanced during lockdown and/or self-isolation have been identified and include modifications of physical activity, dietary patterns, alcohol consumption, potential increase in body weight, smoking, emotional/psychological stress, changes in sleep patterns, and diurnal rhythms may thus increase BP and promote poor BP control in treated hypertensive patients. 122 , 123 In addition, physician attitude and health care–related factors associated with delayed diagnosis and increased therapeutic inertia during the COVID-19 pandemic could contribute to poorer control of BP and overall cardiovascular risk. 122 In this regard, specific recommendations have been issued to preserve appropriate lifestyle and patient/physician communication.…”

Section: Impact Of Covid-19 On Hypertension Managementmentioning

confidence: 99%

“…122 In this regard, specific recommendations have been issued to preserve appropriate lifestyle and patient/physician communication. 122 , 123 …”

Section: Impact Of Covid-19 On Hypertension Managementmentioning

confidence: 99%

Hypertension, a Moving Target in COVID-19

Savoia

Volpe

Kreutz

2021

Circulation Research

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Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) associates with a considerable high rate of mortality and represents currently the most important concern in global health. The risk of more severe clinical manifestation of COVID-19 is higher in males and steeply raised with age but also increased by the presence of chronic comorbidities. Among the latter, early reports suggested that arterial hypertension associates with higher susceptibility to SARS-CoV-2 infection, more severe course and increased COVID-19–related deaths. Furthermore, experimental studies suggested that key pathophysiological hypertension mechanisms, such as activation of the renin-angiotensin system (RAS), may play a role in COVID-19. In fact, ACE2 (angiotensin-converting-enzyme 2) is the pivotal receptor for SARS-CoV-2 to enter host cells and provides thus a link between COVID-19 and RAS. It was thus anticipated that drugs modulating the RAS including an upregulation of ACE2 may increase the risk for infection with SARS-CoV-2 and poorer outcomes in COVID-19. Since the use of RAS-blockers, ACE inhibitors or angiotensin receptor blockers, represents the backbone of recommended antihypertensive therapy and intense debate about their use in the COVID-19 pandemic has developed. Currently, a direct role of hypertension, independent of age and other comorbidities, as a risk factor for the SARS-COV-2 infection and COVID-19 outcome, particularly death, has not been established. Similarly, both current experimental and clinical studies do not support an unfavorable effect of RAS-blockers or other classes of first line blood pressure lowering drugs in COVID-19. Here, we review available data on the role of hypertension and its management on COVID-19. Conversely, some aspects as to how the COVID-19 affects hypertension management and impacts on future developments are also briefly discussed. COVID-19 has and continues to proof the critical importance of hypertension research to address questions that are important for global health.

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“…Given the fact that hypertensive and diabetic patients are most often treated with those medications, this news had a great wake on media and socials [ 2 ], leading to social alarm among chronic patients receiving this class of drugs. The reaction of many scientific societies around the world including the Italian Society of Hypertension was to provide reassuring statements of lack of scientific evidence to support the detrimental role of ACE/ARBS, waiting for scientific data exploring the deep analysis and understanding of the complex phenomenon of COVID-19 infection with specific regards of the safety of ACE-I or ARBs [ 3 ] and give practical advices for the cardiovascular prevention during this pandemic [ 4 ]. Up to now, the whole scientific community is actively involved in hectic activities regarding all aspects of disease pathogenesis, epidemiology, and treatment.…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics and Outcomes of Patients with COVID-19 Infection: The Results of the SARS-RAS Study of the Italian Society of Hypertension

Mancusi

Borghi

Ferri

et al. 2021

High Blood Press Cardiovasc Prev

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The COVID-19 infection has rapidly spread around the world and a second wave is sweeping in many countries. Different clinical and epidemiological aspects characterize the disease and their understanding is necessary to better face the management of the pandemic in progress. The Italian society of arterial hypertension with the SARS-RAS study has contributed significantly to the knowledge of the interaction between inhibition of the renin-angiotensin system and COVID-19 infection. Furthermore, the study results help to understand some of the main aspects related to mortality and morbidity deriving from the infection through a multicentre analysis throughout the national territory.

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Recommendations for Cardiovascular Prevention During the Sars-Cov-2 Pandemic: An Executive Document by the Board of the Italian Society of Cardiovascular Prevention

Cited by 14 publications

References 28 publications

Characteristics of SARS-CoV-2 positive cases beyond health-care professionals or social and health-care facilities

Characteristics of SARS-CoV-2 positive cases beyond health-care professionals or social and health-care facilities

Hypertension, a Moving Target in COVID-19

Clinical Characteristics and Outcomes of Patients with COVID-19 Infection: The Results of the SARS-RAS Study of the Italian Society of Hypertension

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