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The authors discuss the safe reintroduction of cardiovascular (CV) services following the deferment of many CV procedures and diagnostic tests due to the COVID-19 pandemic. Delays in diagnosis and treatment will adversely impact outcomes. CV patients may require prioritization as services begin to increase capacity. The authors propose stepwise reintroduction of CV care with three levels of service to facilitate the safe gradual reintroduction of invasive CV procedures, diagnostic tests, and regular CV care.
Collaboration between healthcare professionals is required to reduce the burden of undiagnosed and untreated CV disease during the COVID-19 pandemic.
This abstract is available on the publisher's site.
The coronavirus disease-2019 (COVID-19) pandemic has led to marked global morbidity and mortality (1–3). There have been appropriate but significant restrictions on routine medical care to comply with public health guidance on physical distancing and to help preserve or redirect limited resources. Most invasive cardiovascular (CV) procedures and diagnostic tests have been deferred with North American CV societies advocating for intensified triage and management of patients on waiting lists (4). Unfortunately, patients with untreated CV disease are at increased risk of adverse outcomes (5). Delays in the treatment of patients with confirmed CV disease will be detrimental. Similarly, reduced access to diagnostic testing will lead to a high burden of undiagnosed CV disease that will further delay time to treatment. Although there will be a myriad of competing demands from multiple disciplines, this risk warrants the prioritization of CV patients as health care systems return to normal capacity (4). Although COVID-19 has had a global impact, there are regional differences in the burden of the pandemic. Some regions have not experienced a significant surge of cases variably related to social and health care adaptation measures, or the surge has passed and was less substantial than predicted. In these areas, there are available health sector resources that can be redeployed quickly. As regions move along the journey of managing the COVID-19 pandemic, there is an opportunity to reintroduce regular CV care in a progressive manner with appropriate safeguards.
JACC: Journal of the American College of Cardiology
Safe Reintroduction of Cardiovascular Services During the COVID-19 Pandemic: From the North American Society Leadership
J Am Coll Cardiol 2020 Jun 30;75(25)3177-3183, DA Wood, E Mahmud, VH Thourani, J Sathananthan, A Virani, A Poppas, RA Harrington, JA Dearani, M Swaminathan, AM Russo, R Blankstein, S Dorbala, J Carr, S Virani, K Gin, A Packard, V Dilsizian, JF Légaré, J Leipsic, JG Webb, AD Krahn