Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the COVID-19 Pandemic

J Am Coll Cardiol. 2020 May 12;75(18):2352-2371. doi: 10.1016/j.jacc.2020.03.031. Epub 2020 Mar 19.

Abstract

The coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 that has significant implications for the cardiovascular care of patients. First, those with COVID-19 and pre-existing cardiovascular disease have an increased risk of severe disease and death. Second, infection has been associated with multiple direct and indirect cardiovascular complications including acute myocardial injury, myocarditis, arrhythmias, and venous thromboembolism. Third, therapies under investigation for COVID-19 may have cardiovascular side effects. Fourth, the response to COVID-19 can compromise the rapid triage of non-COVID-19 patients with cardiovascular conditions. Finally, the provision of cardiovascular care may place health care workers in a position of vulnerability as they become hosts or vectors of virus transmission. We hereby review the peer-reviewed and pre-print reports pertaining to cardiovascular considerations related to COVID-19 and highlight gaps in knowledge that require further study pertinent to patients, health care workers, and health systems.

Keywords: cardiovascular therapy; coronavirus; health system.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Arrhythmias, Cardiac / complications
  • Arrhythmias, Cardiac / virology
  • Betacoronavirus
  • COVID-19
  • Coronavirus Infections* / complications
  • Coronavirus Infections* / epidemiology
  • Coronavirus Infections* / therapy
  • Health Personnel
  • Heart Diseases* / complications
  • Heart Diseases* / virology
  • Humans
  • Myocarditis / complications
  • Myocarditis / virology
  • Pandemics*
  • Pneumonia, Viral* / complications
  • Pneumonia, Viral* / epidemiology
  • Pneumonia, Viral* / therapy
  • Risk Factors
  • SARS-CoV-2
  • Triage