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Key Strategies for Clinical Management and Improvement of Healthcare Services for Cardiovascular Disease and Diabetes Patients in the Coronavirus (COVID-19) Settings: Recommendations From the REPROGRAM Consortium.
Front Cardiovasc Med. 2020; 7:112.FC

Abstract

Patients with cardiovascular disease and diabetes are at potentially higher risk of infection and fatality due to COVID-19. Given the social and economic costs associated with disability due to these conditions, it is imperative that specific considerations for clinical management of these patients be observed. Moreover, the reorganization of health services around the pandemic response further exacerbates the growing crisis around limited access, treatment compliance, acute medical needs, and mental health of patients in this specific subgroup. Existing recommendations and guidelines emanating from respective bodies have addressed some of the pressure points; however, there are variations and limitations vis a vis patient with multiple comorbidities such as obesity. This article will pull together a comprehensive assessment of the association of cardiovascular disease, diabetes, obesity and COVID-19, its impact on the health systems and how best health systems can respond to mitigate current challenges and future needs. We anticipate that in the context of this pandemic, the cardiovascular disease and diabetes patients need a targeted strategy to ensure the harm to this group does not translate to huge costs to society and to the economy. Finally, we propose a triage and management protocol for patients with cardiovascular disease and diabetes in the COVID-19 settings to minimize harm to patients, health systems and healthcare workers alike.

Authors+Show Affiliations

Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, CVD and Metabolic REPROGRAM Sub-committee†, Sydney, NSW, Australia. Liverpool Hospital & South West Sydney Local Health District (SWSLHD), Department of Neurology & Neurophysiology, Sydney, NSW, Australia. Neurovascular Imaging Laboratory, Ingham Institute for Applied Medical Research, Clinical Sciences Stream, Sydney, NSW, Australia. NSW Brain Clot Bank, NSW Health Statewide Biobank, Sydney, NSW, Australia. South Western Sydney Clinical School, University of New South Wales (UNSW), Sydney, NSW, Australia.Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, CVD and Metabolic REPROGRAM Sub-committee†, Sydney, NSW, Australia. Neurovascular Imaging Laboratory, Ingham Institute for Applied Medical Research, Clinical Sciences Stream, Sydney, NSW, Australia. South Western Sydney Clinical School, University of New South Wales (UNSW), Sydney, NSW, Australia.Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, CVD and Metabolic REPROGRAM Sub-committee†, Sydney, NSW, Australia. Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, CVD and Metabolic REPROGRAM Sub-committee†, Sydney, NSW, Australia. Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, CVD and Metabolic REPROGRAM Sub-committee†, Sydney, NSW, Australia. University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, CVD and Metabolic REPROGRAM Sub-committee†, Sydney, NSW, Australia. Department of Neurophysiology, Instituto Médico Dr. Rodriguez Alfici, Godoy Cruz, Argentina.Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, CVD and Metabolic REPROGRAM Sub-committee†, Sydney, NSW, Australia. Department of Neurology, Faculty of Medicine, Military Hospital of Tunis, University of Tunis El Manar, Tunis, Tunisia.Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, CVD and Metabolic REPROGRAM Sub-committee†, Sydney, NSW, Australia. State Level Virus Research and Diagnostics Laboratory, Bangalore Medical College and Research Institute, Bengaluru, India.Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, CVD and Metabolic REPROGRAM Sub-committee†, Sydney, NSW, Australia. Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, CVD and Metabolic REPROGRAM Sub-committee†, Sydney, NSW, Australia. Department of Hematology, North Middlesex Hospital, King's Thrombosis Center & King's College Hospital NHS Foundation Trust, King's College London, London, United Kingdom.Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, CVD and Metabolic REPROGRAM Sub-committee†, Sydney, NSW, Australia. Department of Cardiothoracic Surgery, Lancashire Cardiac Centre, Blackpool Victoria Hospital, NHS, Blackpool, United Kingdom.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32613010

Citation

Bhaskar, Sonu, et al. "Key Strategies for Clinical Management and Improvement of Healthcare Services for Cardiovascular Disease and Diabetes Patients in the Coronavirus (COVID-19) Settings: Recommendations From the REPROGRAM Consortium." Frontiers in Cardiovascular Medicine, vol. 7, 2020, p. 112.
Bhaskar S, Rastogi A, Chattu VK, et al. Key Strategies for Clinical Management and Improvement of Healthcare Services for Cardiovascular Disease and Diabetes Patients in the Coronavirus (COVID-19) Settings: Recommendations From the REPROGRAM Consortium. Front Cardiovasc Med. 2020;7:112.
Bhaskar, S., Rastogi, A., Chattu, V. K., Adisesh, A., Thomas, P., Alvarado, N., Riahi, A. D., Varun, C. N., Pai, A. R., Barsam, S., & Walker, A. H. (2020). Key Strategies for Clinical Management and Improvement of Healthcare Services for Cardiovascular Disease and Diabetes Patients in the Coronavirus (COVID-19) Settings: Recommendations From the REPROGRAM Consortium. Frontiers in Cardiovascular Medicine, 7, 112. https://doi.org/10.3389/fcvm.2020.00112
Bhaskar S, et al. Key Strategies for Clinical Management and Improvement of Healthcare Services for Cardiovascular Disease and Diabetes Patients in the Coronavirus (COVID-19) Settings: Recommendations From the REPROGRAM Consortium. Front Cardiovasc Med. 2020;7:112. PubMed PMID: 32613010.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Key Strategies for Clinical Management and Improvement of Healthcare Services for Cardiovascular Disease and Diabetes Patients in the Coronavirus (COVID-19) Settings: Recommendations From the REPROGRAM Consortium. AU - Bhaskar,Sonu, AU - Rastogi,Aarushi, AU - Chattu,Vijay Kumar, AU - Adisesh,Anil, AU - Thomas,Pravin, AU - Alvarado,Negman, AU - Riahi,Anis D, AU - Varun,Chakrakodi N, AU - Pai,Anupama R, AU - Barsam,Sarah, AU - Walker,Antony H, Y1 - 2020/06/16/ PY - 2020/04/16/received PY - 2020/06/01/accepted PY - 2020/7/3/entrez PY - 2020/7/3/pubmed PY - 2020/7/3/medline KW - cardiovascular diseases (CVDs) KW - clinical algorithm KW - coronavirus disease 2019 (COVID-19) KW - diabetes KW - healthcare services KW - obesity KW - personal protective equipment (PPE) SP - 112 EP - 112 JF - Frontiers in cardiovascular medicine JO - Front Cardiovasc Med VL - 7 N2 - Patients with cardiovascular disease and diabetes are at potentially higher risk of infection and fatality due to COVID-19. Given the social and economic costs associated with disability due to these conditions, it is imperative that specific considerations for clinical management of these patients be observed. Moreover, the reorganization of health services around the pandemic response further exacerbates the growing crisis around limited access, treatment compliance, acute medical needs, and mental health of patients in this specific subgroup. Existing recommendations and guidelines emanating from respective bodies have addressed some of the pressure points; however, there are variations and limitations vis a vis patient with multiple comorbidities such as obesity. This article will pull together a comprehensive assessment of the association of cardiovascular disease, diabetes, obesity and COVID-19, its impact on the health systems and how best health systems can respond to mitigate current challenges and future needs. We anticipate that in the context of this pandemic, the cardiovascular disease and diabetes patients need a targeted strategy to ensure the harm to this group does not translate to huge costs to society and to the economy. Finally, we propose a triage and management protocol for patients with cardiovascular disease and diabetes in the COVID-19 settings to minimize harm to patients, health systems and healthcare workers alike. SN - 2297-055X UR - https://www.unboundmedicine.com/medline/citation/32613010/Key_Strategies_for_Clinical_Management_and_Improvement_of_Healthcare_Services_for_Cardiovascular_Disease_and_Diabetes_Patients_in_the_Coronavirus_(COVID-19)_Settings:_Recommendations_From_the_REPROGRAM_Consortium L2 - https://doi.org/10.3389/fcvm.2020.00112 DB - PRIME DP - Unbound Medicine ER -
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