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

Institution:	1. New York–Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York;2. Clinical Trials Center, Cardiovascular Research Foundation, New York, New York;3. Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, Connecticut;4. Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy;5. Mediterranea Cardiocentro, Napoli, Italy;6. Massachusetts General Hospital, Boston, Massachusetts;7. Case Western Reserve School of Medicine, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio;8. Vanderbilt University Medical Center, Nashville, Tennessee;9. Icahn School of Medicine at Mount Sinai, New York, New York;10. Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut;11. Department of Health Policy and Administration, Yale School of Public Health, New Haven, Connecticut

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.

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