Practical considerations for cardiovascular care during COVID-19 pandemic

Coronavirus disease 2019 (COVID-19), caused by a strain of coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has triggered a global pandemic affecting billions of lives and posing a stiff challenge to the delivery of routine healthcare across the world. The new second wave of COVID-19 in India presents with higher rate of infection and percentage of asymptomatic and mildly symptomatic cases is much higher than before, which means more people are spreading the disease. People with co-morbidities such as pre-existing cardiovascular conditions are at risk of suffering from severe complications of COVID-19 including acute respiratory distress and multi-organ failure. The pandemic has also resulted in people deferring routine care for conditions such as hypertension, diabetes and other cardiometabolic diseases. Initial reports also linked major CV drug classes such as the angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) to adverse outcomes in COVID-19 patients. While subsequent reports have disproved these earlier findings, the science is rapidly evolving and the information overload has served to confuse general practitioners and consultant physicians alike. This review examined the practical considerations in terms of cardiocascular complications, effect of drugs, older adults and tele-consultation for CV care during COVID-19 pandemic.