Mental health of patients with chronic diseases during the covid-19 pandemic

During the pandemic of coronavirus disease 2019 (COVID-19) it has been shown that, in comparison with the general population, elderly adults, patients with chronic diseases (CD), and patients with severe mental disorders are among the groups with greater risk of complications. Although stress and anxiety are normal reactions in a crisis situation, the negative effect the COVID-19 pandemic may influence the clinical evolution of patients with CD, whose development and management is intimately linked with mental health. The therapeutic management of CD demands ac-tive participation from patients, with a notorious emphasis on self-care, encompassing the adherence to pharmaco-logical schemes, specific dietary patterns, physical activity prescriptions, and other elements. This high degree of re-sponsibility, added to the effects of the CD themselves on patients’ quality of life, may represent a powerful detriment on their mental health;constituting a vicious circle in regards to their self-care. The COVID-19 pandemic, the quarantine, and other related measures may magnify the impact of these factors on mental health. This has created new challenges and the need for novel strategies of psychosocial support from the healthcare personnel, family members, and care-takers to guarantee treatment adherence, improve care from home, and achieve adequate control of the evolution of the disease.

Covid-19 and cardiovascular disease: An underestimated link?

Coronavirus disease 2019 (COVID-19) has become an emerging pandemic, dominating the current outlook in pub- lic health. The typical clinical picture of COVID-19 encom- passes flu-like symptoms;including fever predominantly dry cough, dyspnea, asthenia, odynophagia, rhinorrhea, and headache. However, some patients may also develop cardiovascular manifestations, such as acute cardiac injury, heart failure, shock, and arrhythmias, among others. The pa- thogeny underlying this link has not been clarified;however, SARS-CoV-2 has been observed to penetrate cells via the angiotensin-converting enzyme 2, an important participant in the renin-angiotensin-aldosterone systemand the regulation of the cardiovascular system. The use of angiotensin-con- verting enzymeinhibitors and angiotensin II receptor antago- nistsmay cause upregulation of ACE2 and facilitate viral en- try. COVID-19 has also been related to various forms of co- agulopathy, with a tendency to favor pro-thrombotic states, increasing cardiovascular risk. The objective of this article is to explore the link between COVID-19 and cardiovascular disease, and its repercussions in clinical management.

Impact of the covid-19 pandemic in the healthcare of cancer patients

The pandemic of coronavirus disease 2019 (COVID-19) has represented historical phenomenon in worldwide epidemiology. Groups with increased risk have been iden-tified, including the elderly and subjects with chronic diseases, among these, cancer. The rate of COVID-19 cases appears to be higher in patients with cancer in comparison with the general population;and they tend to exhibit a higher risk of developing severe cases of COVID-19 and complications like hospitalization, respiratory failure, and death. Multiple factors contribute to this scenario. Firstly, cancer patients are of older age in average, as well as more comorbidities. However, during the pandemic, the greatest danger for these patients is their incapacity to access health institutions and concrete services upon arrival. Various treatment protocols have been modified to avoid or delay procedures such as surgeries and chemotherapy to reduce potential risks. In parallel, some aspects of these patients’ follow-up have been superseded in order to respond to the pandemic, resulting in suboptimal care for cancer patients. This review aims to assess the essential epidemiological aspects concerning cancer and COVID-19, and their impact on the healthcare of these patients.