European Primary Care Cardiovascular Society

Coronavirus COVID-19 clinical guidance for CV care team issued by ACC

News - Mar. 10, 2020

ACC President Richard J Kovacs announced the release of an updated ACC Clinical Bulletin on coronavirus COVID-19 Clinical Guidance for the CV care team. This bulletin contains an overview of COVID-19, information on acute cardiac complications of COVID-19 and implications for CV patients. It also provides clinical guidance and recommendations for cardiac-specific preparedness. It is intended as a supplement to relevant guidance from the Centers for Disease Control and Prevention, state, local health authorities and institution’s infectious disease containment, mitigation, and response plan.

Patients with underlying comorbid conditions have a increased risk for contracting COVID-19 and a worse prognosis. An estimated 25% to 50% of COVID-19 patients present with underlying conditions. Case fatality rate for comorbid patients is substantially higher than the average population (2.3%), with an estimated rate of 6.0% in those with hypertension, 7.3% in diabetes patients, and 10.5% in CVD patients.

A case study of 138 hospitalized COVID-19 patients reported that 16.7% of patients developed arrhythmia and 7.2% had acute cardiac injury, in addition to other COVID-19 related complications. Other reports indicate cases of acute onset HF, MI, myocarditis and cardiac arrest (may be precipitated by higher cardiometabolic demand). Reports do not describe cardiac complication in CVD naïve patients (vs. comorbid patients).

Recommendations include:

Source: ACC Clinical Bulletin, March 6, 2020

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