The Impact of the Coronavirus Disease-2019 Pandemic and Italian Lockdown Measures on Clinical Presentation and Management of Acute Heart Failure

Colivicchi, Furio; Fusco, Stefania Angela Di; Magnanti, Massimo; Cipriani, Manlio; Imperoli, Giuseppe

doi:10.1016/j.cardfail.2020.05.007

Cited by 63 publications

(88 citation statements)

References 5 publications

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“…43 Likewise, in Italy, a 49% decrease in acute HF admissions was recorded from February to April 2020 compared with the same period in 2019. 44 A similar trend has been reported in Denmark with significantly lower rates of new-onset HF diagnoses and hospital admissions for worsening HF during the lockdown period of 2020 vs. the same period in 2019. 45 In Germany, emergency admissions for HF declined by 22% between March and April 2020 vs. the same period in 2019.…”

Section: Heart Failure Hospitalizationsupporting

confidence: 69%

“…In London, admission rates for acute HF have been significantly lower during the peak of the pandemic vs. the same period in 2019 43 . Likewise, in Italy, a 49% decrease in acute HF admissions was recorded from February to April 2020 compared with the same period in 2019 44 . A similar trend has been reported in Denmark with significantly lower rates of new‐onset HF diagnoses and hospital admissions for worsening HF during the lockdown period of 2020 vs. the same period in 2019 45 .…”

Section: Heart Failure Hospitalizationmentioning

confidence: 93%

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Insights into heart failure hospitalizations, management, and services during and beyond COVID‐19

et al. 2020

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Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2. The clinical presentation of this virus mainly manifests in the respiratory system but may also lead to severe complications in the cardiovascular system. The global burden of COVID-19 has led to an unprecedented need to gain further insight into patient outcomes, management, and clinical practice. This review aims to provide an overview of the current literature on heart failure (HF) hospitalizations, management, and care pathways for supporting patients during and beyond this pandemic. A literature review of five areas of interest was conducted and included: (i) HF hospitalization; (ii) recognizing the needs and supporting HF patients during COVID-19; (iii) supporting rehabilitation services; (iv) transitioning to a telehealth framework; and (v) the need for evidence. Patients with new-onset or existing HF are particularly vulnerable, but a significant reduction in HF hospital admissions has been reported. During these periods of uncertainty, the current care pathways for acute and elective cardiac patients have had to change with the relocation of HF services to protect the vulnerable and reduce transmission of COVID-19. Optimizing community HF services has the potential to reduce the pressures on secondary care during the recovery from this pandemic. Telemedicine and virtual health care are emerging technologies and overcome the risk of in-person exposure. Successful remote delivery of cardiac rehabilitation services has been reported during the pandemic. Delivery of a robust telehealth framework for HF patients will improve communication between clinician and patient. The reduction in HF admissions is a concern for the future and may result in unintended mortality. New-onset and current HF patients must understand their diagnosis and future prognosis and seek help and support using the appropriate platform when needed. Realigning HF services and the use of telemedicine and virtual health care has great potential but needs to be carefully understood to ensure engagement and approval in this population to overcome barriers and challenges.

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Section: Heart Failure Hospitalizationsupporting

confidence: 69%

Section: Heart Failure Hospitalizationmentioning

confidence: 93%

Insights into heart failure hospitalizations, management, and services during and beyond COVID‐19

et al. 2020

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“…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. However, analyzing the clinical records during the COVID-19 pandemic (between 20 February and 20 April 2020) of emergency department of San Filippo Neri Hospital in Rome, Italy, a study revealed patients with acute heart failure often reported to the emergency department after significant clinical deterioration with high mortality due to failure of routine clinical assessment [ 90 ].…”

Section: Cardiovascular Complications Of Covid-19mentioning

confidence: 99%

Cardiovascular Complications Associated with COVID-19 and Potential Therapeutic Strategies

Samidurai

Das

2020

IJMS

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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.

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“…The long-term morbidity from these untreated or unrecognized acute neurovascular or cardiovascular events poses a large indirect burden associated with the pandemic. A study in Italy showed a decrease of 55% in the number of emergency department visits between February and April 2020 compared to the same period in 2019 [28]. With this decrease in presentations, there was a concomitant increase in patients presenting with acute or chronic heart failure, an increase in those requiring intensive care, and higher rates of atrial fibrillation, ischemic heart disease, and severe renal dysfunction, all suggesting that delayed presentation to health care led to decompensation of chronic comorbidities [28].…”

Section: Indirect Consequences Of Covid-19mentioning

confidence: 97%

The Emerging Chronic Sequelae of COVID-19 and Implications for North Carolina

Rolfe¹,

Smith²,

Wolfe³

2021

North Carolina Medical Journal

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The Impact of the Coronavirus Disease-2019 Pandemic and Italian Lockdown Measures on Clinical Presentation and Management of Acute Heart Failure

Cited by 63 publications

References 5 publications

Insights into heart failure hospitalizations, management, and services during and beyond COVID‐19

Insights into heart failure hospitalizations, management, and services during and beyond COVID‐19

Cardiovascular Complications Associated with COVID-19 and Potential Therapeutic Strategies

The Emerging Chronic Sequelae of COVID-19 and Implications for North Carolina

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