Management of Cardiovascular Disease Patients With Confirmed or Suspected COVID-19 in Limited Resource Settings

Prabhakaran, Dorairaj; Perel, Pablo; Roy, Ambuj; Singh, Kavita; Raspail, Lana; Faria-Neto, José Rocha; Gidding, Samuel S.; Ojji, Dike; Hakim, Ferdous; Newby, L. Kristin; Stępińska, Janina; Lam, Carolyn S.P.; Jobe, Modou; Kraus, Sarah; Chuquiure-Valenzuela, Eduardo; Piñeiro, Daniel; Khaw, Kay-Tee; Bahiru, Ehete; Banerjee, Amitava; Narula, Jagat; Sliwa, Karen

In this paper, we provide recommendations on the management of cardiovascular disease (CVD) among patients with confirmed or suspected coronavirus disease (COVID-19) to facilitate the decision making of healthcare professionals in low resource settings. The emergence of novel coronavirus disease, also known as Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), has presented an unprecedented global challenge for the healthcare community. The ability of SARS-CoV-2 to get transmitted during the asymptomatic phase and its high infectivity have led to the rapid transmission of COVID-19 beyond geographic regions, leading to a pandemic. There is concern that COVID-19 is cardiotropic, and it interacts with the cardiovascular system on multiple levels. Individuals with established CVD are more susceptible to severe COVID-19. Through a consensus approach involving an international group this WHF statement summarizes the links between cardiovascular disease and COVID-19 and present some practical recommendations for the management of hypertension and diabetes, acute coronary syndrome, heart failure, rheumatic heart disease, Chagas disease, and myocardial injury for patients with COVID-19 in low-resource settings. This document is not a clinical guideline and it is not intended to replace national clinical guidelines or recommendations. Given the rapidly growing burden posed by COVID-19 illness and the associated severe prognostic implication of CVD involvement, further research is required to understand the potential mechanisms linking COVID-19 and CVD, clinical presentation, and outcomes of various cardiovascular manifestations in COVID-19 patients.