Short-term Outcomes in Ambulatory Heart Failure during the COVID-19 Pandemic: Insights from Pulmonary Artery Pressure Monitoring

Almufleh, Aws; Ahluwalia, Monica; Givertz, Michael M.; Weintraub, Joseph R.; Young, Michelle; Cooper, Irene; Shea, Elaine L.; Mehra, Mandeep R.; Desai, Akshay S.

doi:10.1016/j.cardfail.2020.05.021

Cited by 17 publications

(17 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 34–39 Rates of heart failure-related hospitalizations decreased 40–50% during the COVID-19 period compared to before; 34 , 40 however, one study found a three-fold increase in mortality related to heart-failure. 41 Overall, these trends are concerning, suggesting that patients with chronic cardiovascular conditions tend to avoid in-person medical visits to hospitals, clinics, and ED possibly due to fear of potential COVID-19 exposure. In a cross-sectional study of 185,000 North American patients, one-third reported cancelling pre-scheduled appointments, and over 40% reported elevated worry regarding in-person medical visits.…”

Section: Healthcare Characteristics and Utilization By Individuals Wimentioning

confidence: 99%

The Effects of the Health System Response to the COVID-19 Pandemic on Chronic Disease Management: A Narrative Review

Kendzerska¹,

Zhu²,

Gershon³

et al. 2021

RMHP

182

143

View full text Add to dashboard Cite

Background Individuals with chronic conditions require ongoing disease management to reduce risks of adverse health outcomes. During the COVID-19 pandemic, health care for non-COVID-19 cases was affected due to the reallocation of resources towards urgent care for COVID-19 patients, resulting in inadequate ongoing care for chronic conditions. Methods A keyword search was conducted in PubMed, Google Scholar, Science Direct, and Scopus for English language articles published between January 2020 and January 2021. Findings During the COVID-19 pandemic, in-person care for individuals with chronic conditions have decreased due to government restriction of elective and non-urgent healthcare visits, greater instilled fear over potential COVID-19 exposure during in-person visits, and higher utilization rates of telemedicine compared to the pre-COVID-19 period. Potential benefits of a virtual-care framework during the pandemic include more effective routine disease monitoring, improved patient satisfaction, and increased treatment compliance and follow-up rates. However, more needs to be done to ensure timely and effective access to telemedicine, particularly for individuals with lower digital literacy. Capitation primary care models have been proposed as a more financially-robust approach during the COVID-19 pandemic than fee-for-service primary care models; however, the interplay between different primary models and the health outcomes is still poorly understood and warrants further investigation. Shortages of medication used to manage chronic conditions were also observed at the beginning of the COVID-19 pandemic due to global supply chain disruptions. Finally, patients with chronic conditions faced lifestyle disruptions due to the COVID-19 pandemic, specifically in physical activity, sleep, stress, and mental health, which need to be better addressed. Interpretation Overall, this review elucidates the disproportionately greater barriers to primary and specialty care that patients with chronic diseases face during the COVID-19 pandemic and emphasizes the urgent need for better chronic disease management strategies moving forward.

show abstract

Section: Healthcare Characteristics and Utilization By Individuals Wimentioning

confidence: 99%

The Effects of the Health System Response to the COVID-19 Pandemic on Chronic Disease Management: A Narrative Review

Kendzerska¹,

Zhu²,

Gershon³

et al. 2021

RMHP

182

143

View full text Add to dashboard Cite

show abstract

“…Interestingly, one recent study indicated a decline in emergency department visits for heart failure during the COVID-19 pandemic, partly due to effective remote clinician–patient interactions [ 89 ]. Since patients with CVD are considered to be more vulnerable to SARS-CoV-2 infection, with higher risk of negative consequences, these patients avoid frequent hospital visits and prefer alternative remote management.…”

Section: Cardiovascular Complications Of Covid-19mentioning

confidence: 99%

Cardiovascular Complications Associated with COVID-19 and Potential Therapeutic Strategies

Samidurai

Das

2020

IJMS

View full text Add to dashboard Cite

The outbreak of coronavirus disease 2019 (COVID-19), an infectious disease with severe acute respiratory syndrome, has now become a worldwide pandemic. Despite the respiratory complication, COVID-19 is also associated with significant multiple organ dysfunction, including severe cardiac impairment. Emerging evidence reveals a direct interplay between COVID-19 and dire cardiovascular complications, including myocardial injury, heart failure, heart attack, myocarditis, arrhythmias as well as blood clots, which are accompanied with elevated risk and adverse outcome among infected patients, even sudden death. The proposed pathophysiological mechanisms of myocardial impairment include invasion of SARS-CoV-2 virus via angiotensin-converting enzyme 2 to cardiovascular cells/tissue, which leads to endothelial inflammation and dysfunction, de-stabilization of vulnerable atherosclerotic plaques, stent thrombosis, cardiac stress due to diminish oxygen supply and cardiac muscle damage, and myocardial infarction. Several promising therapeutics are under investigation to the overall prognosis of COVID-19 patients with high risk of cardiovascular impairment, nevertheless to date, none have shown proven clinical efficacy. In this comprehensive review, we aimed to highlight the current integrated therapeutic approaches for COVID-19 and we summarized the potential therapeutic options, currently under clinical trials, with their mechanisms of action and associated adverse cardiac events in highly infectious COVID-19 patients.

show abstract

“…Several strategies can be applied to perform home monitoring of HF patients. Two small studies performed in Boston and New York City showed initial encouraging results of implantable hemodynamic monitoring in COVID-19 ( 18 , 19 ). However, device and hemodynamic monitoring can only be performed in those patients, which had implanted a device or hemodynamic sensor before the lockdown, which are a minority of the HF population.…”

Section: Telemedicine Strategies During Covid-19mentioning

confidence: 99%

Telemedicine in Heart Failure During COVID-19: A Step Into the Future

Tersalvi

Winterton

Cioffi

et al. 2020

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

During the Coronavirus Disease 2019 worldwide pandemic, patients with heart failure are a high-risk group with potential higher mortality if infected. Although lockdown represents a solution to prevent viral spreading, it endangers regular follow-up visits and precludes direct medical assessment in order to detect heart failure progression and optimize treatment. Furthermore, lifestyle changes during quarantine may trigger heart failure decompensations. During the pandemic, a paradoxical reduction of heart failure hospitalization rates was observed, supposedly caused by patient reluctance to visit emergency departments and hospitals. This may result in an increased patient mortality and/or in more complicated heart failure admissions in the future. In this scenario, different telemedicine strategies can be implemented to ensure continuity of care to patients with heart failure. Patients at home can be monitored through dedicated apps, telephone calls, or devices. Virtual visits and forward triage screen the patients with signs or symptoms of decompensated heart failure. In-hospital care may benefit from remote communication platforms. After discharge, patients may undergo remote follow-up or telerehabilitation to prevent early readmissions. This review provides a comprehensive appraisal of the many possible applications of telemedicine for patients with heart failure during Coronavirus disease 2019 and elucidates practical limitations and challenges regarding specific telemedicine modalities.

show abstract

Short-term Outcomes in Ambulatory Heart Failure during the COVID-19 Pandemic: Insights from Pulmonary Artery Pressure Monitoring

Cited by 17 publications

References 7 publications

The Effects of the Health System Response to the COVID-19 Pandemic on Chronic Disease Management: A Narrative Review

The Effects of the Health System Response to the COVID-19 Pandemic on Chronic Disease Management: A Narrative Review

Cardiovascular Complications Associated with COVID-19 and Potential Therapeutic Strategies

Telemedicine in Heart Failure During COVID-19: A Step Into the Future

Contact Info

Product

Resources

About