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1.
J Am Heart Assoc ; 9(13): e016997, 2020 07 07.
Article in English | MEDLINE | ID: covidwho-683343

ABSTRACT

Medicine and public health have traditionally separated the prevention and treatment of communicable and noncommunicable diseases. The coronavirus disease 2019 (COVID-19) pandemic has challenged this paradigm, particularly in the setting of cardiovascular disease (CVD). Overall, individuals with underlying CVD who acquire severe acute respiratory syndrome coronavirus 2 experience up to a 10-fold higher case-fatality rate compared with the general population. Although the impact of the pandemic on cardiovascular health continues to evolve, few have defined this association from a frontline, public health perspective of populations disproportionately affected by CVD and COVID-19. Louisiana is ranked within the bottom 5 states for cardiovascular health, and it is home to several parishes that have experienced among the highest COVID-19 case-fatality rates nationally. Herein, we review CVD prevention and implications of COVID-19 in New Orleans, LA, a city holding a sobering yet resilient history with previous public health disasters. In particular, we discuss potential pandemic-driven changes in access to health care, preventive pharmacotherapy, and lifestyle behaviors, all of which may adversely affect CVD prevention and management, while amplifying racial disparities. Through this process, we highlight proposed recommendations for how CVD prevention efforts can be improved in the midst of the current COVID-19 pandemic and future public health crises.


Subject(s)
Betacoronavirus , Cardiovascular Diseases/prevention & control , Coronavirus Infections/complications , Delivery of Health Care/methods , Life Style , Pandemics , Pneumonia, Viral/complications , Public Health , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/etiology , Coronavirus Infections/epidemiology , Humans , Incidence , New Orleans/epidemiology , Pneumonia, Viral/epidemiology
2.
Clin Appl Thromb Hemost ; 26: 1076029620936776, 2020.
Article in English | MEDLINE | ID: covidwho-657787

ABSTRACT

COVID-19 has proven to be particularly challenging given the complex pathogenesis of SARS-CoV-2. Early data have demonstrated how the host response to this novel coronavirus leads to the proliferation of pro-inflammatory cytokines, massive endothelial damage, and generalized vascular manifestations. While SARS-CoV-2 primarily targets the upper and lower respiratory tract, other organ systems are also affected. SARS-CoV-2 relies on 2 host cell receptors for successful attachment: angiotensin-converting enzyme 2 and transmembrane protease serine 2. Clinicopathologic reports have demonstrated associations between severe COVID-19 and viral coagulopathy, resulting in pulmonary embolism; venous, arterial, and microvascular thrombosis; lung endothelial injury; and associated thrombotic complications leading to acute respiratory distress syndrome. Viral coagulopathy is not novel given similar observations with SARS classic, including the consumption of platelets, generation of thrombin, and increased fibrin degradation product exhibiting overt disseminated intravascular coagulation-like syndrome. The specific mechanism(s) behind the thrombotic complications in COVID-19 patients has yet to be fully understood. Parenteral anticoagulants, such as heparin and low-molecular-weights heparins, are widely used in the management of COVID-19 patients. Beyond the primary (anticoagulant) effects of these agents, they may exhibit antiviral, anti-inflammatory, and cytoprotective effects. Direct oral anticoagulants and antiplatelet agents are also useful in the management of these patients. Tissue plasminogen activator and other fibrinolytic modalities may also be helpful in the overall management. Catheter-directed thrombolysis can be used in patients developing pulmonary embolism. Further investigations are required to understand the molecular and cellular mechanisms involved in the pathogenesis of COVID-19-associated thrombotic complications.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/complications , Pandemics , Pneumonia, Viral/complications , Thrombophilia/etiology , Angiotensin II Type 1 Receptor Blockers/pharmacology , Angiotensin II Type 1 Receptor Blockers/therapeutic use , Angiotensin-Converting Enzyme Inhibitors/pharmacology , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Anticoagulants/therapeutic use , Arterial Occlusive Diseases/etiology , Arterial Occlusive Diseases/physiopathology , Arterial Occlusive Diseases/virology , Cardiovascular Diseases/etiology , Cardiovascular Diseases/prevention & control , Catheterization, Swan-Ganz , Combined Modality Therapy , Coronavirus Infections/blood , Coronavirus Infections/drug therapy , Endothelium, Vascular/physiopathology , Endothelium, Vascular/virology , Fibrinolytic Agents/therapeutic use , Humans , Hyperbaric Oxygenation , Platelet Aggregation Inhibitors/therapeutic use , Pneumonia, Viral/blood , Pneumonia, Viral/drug therapy , Pulmonary Embolism/etiology , Pulmonary Embolism/therapy , Pulmonary Embolism/virology , Respiratory Distress Syndrome, Adult/etiology , Thrombolytic Therapy/instrumentation , Thrombolytic Therapy/methods , Thrombophilia/physiopathology , Thrombophilia/therapy , Venous Thrombosis/etiology , Venous Thrombosis/physiopathology , Venous Thrombosis/virology , Virus Internalization/drug effects
3.
Front Immunol ; 11: 1439, 2020.
Article in English | MEDLINE | ID: covidwho-644233

ABSTRACT

In December 2019, following a cluster of pneumonia cases in China caused by a novel coronavirus (CoV), named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the infection disseminated worldwide and, on March 11th, 2020, the World Health Organization officially declared the pandemic of the relevant disease named coronavirus disease 2019 (COVID-19). In Europe, Italy was the first country facing a true health policy emergency, and, as at 6.00 p.m. on May 2nd, 2020, there have been more than 209,300 confirmed cases of COVID-19. Due to the increasing number of patients experiencing a severe outcome, global scientific efforts are ongoing to find the most appropriate treatment. The usefulness of specific anti-rheumatic drugs came out as a promising treatment option together with antiviral drugs, anticoagulants, and symptomatic and respiratory support. For this reason, we feel a duty to share our experience and our knowledge on the use of these drugs in the immune-rheumatologic field, providing in this review the rationale for their use in the COVID-19 pandemic.


Subject(s)
Betacoronavirus/metabolism , Cardiovascular Diseases/drug therapy , Cardiovascular Diseases/etiology , Coronavirus Infections/complications , Coronavirus Infections/drug therapy , Pneumonia, Viral/complications , Pneumonia, Viral/drug therapy , Adaptive Immunity/drug effects , Adult , Anticoagulants/therapeutic use , Antirheumatic Agents/therapeutic use , Antiviral Agents/therapeutic use , Betacoronavirus/immunology , Coronavirus Infections/immunology , Coronavirus Infections/virology , Humans , Hydroxychloroquine/therapeutic use , Immunity, Innate/drug effects , Interleukin-1/antagonists & inhibitors , Interleukin-6/antagonists & inhibitors , Janus Kinase Inhibitors/therapeutic use , Pandemics , Pneumonia, Viral/immunology , Pneumonia, Viral/virology , Respiratory Distress Syndrome, Adult/drug therapy , Respiratory Distress Syndrome, Adult/etiology
8.
J Am Heart Assoc ; 9(13): e017122, 2020 07 07.
Article in English | MEDLINE | ID: covidwho-342792

ABSTRACT

Background Northern Italy is one of the epicenters of severe acute respiratory syndrome coronavirus 2 (SARS-CoV 2) pandemic in Europe. The impact of the pandemic and the consequent lockdown on medical emergencies other than those SARS-CoV 2 pandemic related is largely unknown. The aim of this study was to analyze the epidemiologic impact of coronavirus disease 2019 pandemic on hospital admission for severe emergent cardiovascular diseases (SECDs) in a single Northern Italy large tertiary referral center. Methods and Results We quantified SECDs admissions to the Cardiology Division of Udine University Hospital between March 1, 2020 and March 31, 2020 and compared them with those of the same time frame during 2019. Compared with March 2019, we observed a significant reduction in all SECDs admissions: -30% for ST-segment-elevation acute coronary syndromes, -66% for non-ST-segment-elevation acute coronary syndromes and -50% for severe bradyarrhythmia. Conclusions A significant decrease in all SECDs admissions has been observed during the SARS-CoV 2. pandemic and was unlikely caused by a reduction in the incidence of cardiovascular diseases. Fear of contagion may have contributed to the unpredictable drop of SECDs. Social education about early recognition of symptoms of life-threatening cardiac conditions requiring appropriate care in a timely fashion may help to reduce this counterproductive phenomenon.


Subject(s)
Cardiovascular Diseases/etiology , Coronavirus Infections/complications , Emergencies , Emergency Service, Hospital/statistics & numerical data , Pandemics , Patient Admission/trends , Pneumonia, Viral/complications , Aged , Betacoronavirus , Coronavirus Infections/epidemiology , Female , Follow-Up Studies , Humans , Incidence , Italy/epidemiology , Male , Middle Aged , Pneumonia, Viral/epidemiology , Retrospective Studies
10.
J Nutr Health Aging ; 24(6): 550-559, 2020.
Article in English | MEDLINE | ID: covidwho-245005

ABSTRACT

COVID 19 is much more than an infectious disease by SARS-CoV-2 followed by a disproportionate immune response. An older age, diabetes and history of cardiovascular disease, especially hypertension, but also chronic heart failure and coronary artery disease among others, are between the most important risk factors. In addition, during the hospitalization both hyperglycaemia and heart failure are frequent. Less frequent are acute coronary syndrome, arrhythmias and stroke. Accordingly, not all prolonged stays or even deaths are due directly to SARS-CoV-2. To our knowledge, this is the first review, focusing both on cardiovascular and metabolic aspects of this dreadful disease, in an integrated and personalized way, following the guidelines of the Cardiometabolic Health/Medicine. Therefore, current personalized aspects such as ACEIs and ARBs, the place of statins and the most appropriate management of heart failure in diabetics are analysed. Aging, better than old age, as a dynamic process, is also considered in this review for the first time in the literature, and not only as a risk factor attributed to cardiovascular and non-cardiovascular comorbidities. Immunosenescence is also approached to build healthier elders, so they can resist present and future infectious diseases, and not only in epidemics or pandemics. In addition, to do this we must start knowing the molecular mechanisms that underlying Aging process in general, and immunosenescence in particular. Surprisingly, the endoplasmic reticulum stress and autophagy are implicated in both process. Finally, with a training in all the aspects covered in this review, not only the hospital stay, complications and costs of this frightening disease in high-risk population should be reduced. Likely, this paper will open a gate to the future for open-minded physicians.


Subject(s)
Betacoronavirus , Cardiovascular Diseases/etiology , Coronavirus Infections/complications , Pneumonia, Viral/complications , Aged , Aging , Cardiovascular Diseases/epidemiology , Comorbidity , Coronavirus Infections/epidemiology , Diabetes Mellitus/etiology , Humans , Pandemics , Pneumonia, Viral/epidemiology , Precision Medicine
11.
Circ Res ; 126(10): 1456-1474, 2020 05 08.
Article in English | MEDLINE | ID: covidwho-217630

ABSTRACT

ACE2 (angiotensin-converting enzyme 2) has a multiplicity of physiological roles that revolve around its trivalent function: a negative regulator of the renin-angiotensin system, facilitator of amino acid transport, and the severe acute respiratory syndrome-coronavirus (SARS-CoV) and SARS-CoV-2 receptor. ACE2 is widely expressed, including, in the lungs, cardiovascular system, gut, kidneys, central nervous system, and adipose tissue. ACE2 has recently been identified as the SARS-CoV-2 receptor, the infective agent responsible for coronavirus disease 2019, providing a critical link between immunity, inflammation, ACE2, and cardiovascular disease. Although sharing a close evolutionary relationship with SARS-CoV, the receptor-binding domain of SARS-CoV-2 differs in several key amino acid residues, allowing for stronger binding affinity with the human ACE2 receptor, which may account for the greater pathogenicity of SARS-CoV-2. The loss of ACE2 function following binding by SARS-CoV-2 is driven by endocytosis and activation of proteolytic cleavage and processing. The ACE2 system is a critical protective pathway against heart failure with reduced and preserved ejection fraction including, myocardial infarction and hypertension, and against lung disease and diabetes mellitus. The control of gut dysbiosis and vascular permeability by ACE2 has emerged as an essential mechanism of pulmonary hypertension and diabetic cardiovascular complications. Recombinant ACE2, gene-delivery of Ace2, Ang 1-7 analogs, and Mas receptor agonists enhance ACE2 action and serve as potential therapies for disease conditions associated with an activated renin-angiotensin system. rhACE2 (recombinant human ACE2) has completed clinical trials and efficiently lowered or increased plasma angiotensin II and angiotensin 1-7 levels, respectively. Our review summarizes the progress over the past 20 years, highlighting the critical role of ACE2 as the novel SARS-CoV-2 receptor and as the negative regulator of the renin-angiotensin system, together with implications for the coronavirus disease 2019 pandemic and associated cardiovascular diseases.


Subject(s)
Betacoronavirus/physiology , Cardiovascular Diseases , Coronavirus Infections , Pandemics , Peptidyl-Dipeptidase A/physiology , Pneumonia, Viral , Renin-Angiotensin System/physiology , ADAM17 Protein/physiology , Animals , Cardiovascular Diseases/etiology , Cardiovascular Diseases/physiopathology , Coronavirus Infections/complications , Coronavirus Infections/drug therapy , Coronavirus Infections/metabolism , Coronavirus Infections/physiopathology , Coronavirus Infections/virology , Diabetes Complications/metabolism , Diabetes Complications/physiopathology , Humans , Molecular Targeted Therapy , Pneumonia, Viral/complications , Pneumonia, Viral/metabolism , Pneumonia, Viral/physiopathology , Pneumonia, Viral/virology , Receptors, Virus/physiology , Virus Attachment
13.
Eur Rev Med Pharmacol Sci ; 24(8): 4607-4615, 2020 04.
Article in English | MEDLINE | ID: covidwho-205205

ABSTRACT

COVID-19 pandemic can cause irreparable damage to the involved society. This study aimed to provide a summary of the up-to-dated clinical display, diagnostics, molecular and genetic implications for COVID-19 infected patients. In this review, 73 research articles published before 25 March 2020 were analyzed to better understand the clinical characteristics of patients and to introduce the available serological, hematology and molecular diagnostic methods. Apart from articles extracted from PubMed and Google Scholar, WHO (https://www.who.int/), NHC (National Health Commission of the People's Republic of China (http://www.nhc.gov.cn/), NICE (National Institute for Health and Clinical Excellence, https://www.nice.org.uk/), CDC (Centers for Disease Control and Prevention, https://www.cdc.gov/), and National Administration of Traditional Chinese Medicine (http://www.satcm.gov.cn/) were also accessed to search for eligible studies. Papers published between January 1, 2020, and 25 March 2020 were searched in English and the terms "2019-nCoV, Covid-19, Clinical Characteristics OR manifestation, method of detection, COVID-19 Genome and molecular test" were used. As the pandemic continues to evolve, there have been reports about the possibility of asymptomatic transmission of this newly emerged pneumonia virus. We highlighted the role of HLA haplotype in virus infection as HLA typing will provide susceptibility information for personalized prevention, diagnosis, and treatment in future studies. All the data in this article will assist researchers and clinicians to develop their clinical views regarding infected patients and to emphasize the origin of SARS-CoV-2 for diagnostics.


Subject(s)
Betacoronavirus/genetics , Coronavirus Infections/diagnosis , HLA Antigens/genetics , Pneumonia, Viral/diagnosis , Autopsy , Cardiovascular Diseases/etiology , Coronavirus Infections/complications , Genome, Viral , Haplotypes , Humans , Kidney Diseases/etiology , Liver Diseases/etiology , Pandemics , Pneumonia, Viral/complications , RNA, Viral/isolation & purification , Specimen Handling
14.
Eur J Clin Nutr ; 74(6): 852-855, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-185841

ABSTRACT

COVID-19 is causing a global pandemic with a high number of deaths and infected people. To contain the diffusion of COVID-19 virus, Governments have enforced restrictions on outdoor activities or even collective quarantine on the population. One important consequence of quarantine is a change in lifestyle: reduced physical activity and unhealthy diet. 2019 guidelines for primary prevention of cardiovascular disease indicate that "Adults should engage in at least 150 minute per week of accumulated moderate-intensity or 75 minute per week of vigorous-intensity aerobic physical activity (or an equivalent combination of moderate and vigorous activity) to reduce ASCVD risk." During quarantine, strategies to further increase home-based physical activity and to follow a healthy diet should be implemented. Quarantine carries some long-term effects on cardiovascular disease, mainly related to unhealthy lifestyle and anxiety. Following quarantine a global action supporting healthy diet and physical activity is mandatory to encourage people to return to good lifestyle.


Subject(s)
Cardiovascular Diseases/etiology , Coronavirus Infections/prevention & control , Diet/adverse effects , Exercise , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Quarantine/methods , Betacoronavirus , Cardiovascular Diseases/prevention & control , Coronavirus Infections/virology , Diet/methods , Diet/psychology , Exercise/psychology , Feeding Behavior/physiology , Feeding Behavior/psychology , Humans , Pneumonia, Viral/virology , Quarantine/psychology , Risk Factors
17.
Kardiol Pol ; 78(4): 278-283, 2020 04 24.
Article in English | MEDLINE | ID: covidwho-139507

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS­CoV­2) is the cause of coronavirus disease 2019 (COVID­19). The most common symptoms of COVID­19 are: fever (81.8%-100%), cough (46.3%-86.2%), myalgia and fatigue (11%-50%), expectoration (4.4%-72%), and dyspnea (18.6%-59%). The most common laboratory abnormalities in COVID­19 include decreased lymphocyte count (35%-82.1%), thrombocytopenia (17%-36.2%), elevated serum C­reactive protein (60.7%-93%), lactate dehydrogenase (41%-76%), and D­dimer concentrations (36%-46.4%). Among comorbidities in patients with COVID­19, cardiovascular disease is most commonly found. In addition, patients with concomitant cardiovascular diseases have worse prognosis and more often require admission to the intensive care unit (ICU), compared with patients without such comorbidities. It is estimated that about 20% of patients with COVID­19 develop cardiac injury. Cardiac injury is more prevalent among patients with COVID­19 who require ICU care. In a group of critically ill patients, 27.5% had an elevated N­terminal pro-B­type natriuretic peptide concentration, and increased cardiac troponin level was found in 10% of patients. One of the life­threatening cardiac manifestations is coronavirus fulminant myocarditis, which may also occur without accompanying symptoms of pulmonary involvement. Early recognition and treatment is crucial in these cases. So far, data on the incidence of arrhythmias in patients with COVID­19 are limited. Coronavirus disease 2019 impacts patients with cardiovascular comorbidities and affects daily practice of cardiologists. Thus, it is important to know typical COVID­19 symptoms, possible clinical manifestations, complications, and recommended treatment.


Subject(s)
Cardiovascular Diseases/epidemiology , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Angiotensin Receptor Antagonists/adverse effects , Angiotensin Receptor Antagonists/therapeutic use , Angiotensin-Converting Enzyme Inhibitors/adverse effects , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Antiviral Agents/adverse effects , Antiviral Agents/therapeutic use , Cardiology , Cardiovascular Diseases/drug therapy , Cardiovascular Diseases/etiology , Comorbidity , Coronavirus Infections/drug therapy , Coronavirus Infections/metabolism , Cost of Illness , Critical Care , Diabetes Mellitus/epidemiology , Humans , Pandemics , Peptidyl-Dipeptidase A/metabolism , Pneumonia, Viral/drug therapy , Pneumonia, Viral/metabolism , Professional Practice , Prognosis , Tomography, X-Ray Computed
18.
Zhongguo Dang Dai Er Ke Za Zhi ; 22(4): 299-304, 2020 Apr.
Article in Chinese | MEDLINE | ID: covidwho-103522

ABSTRACT

The outbreak of coronavirus disease 2019 (COVID-19) started in December 2019 in China and the epidemic is still going on at present. Since children are the susceptible population, the number of cases is gradually increasing. In addition to the typical respiratory symptoms, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection also has the clinical symptoms of cardiovascular system damage. Based on a literature review, this article discusses the possible cardiovascular system damage caused by SARS-CoV-2 in children and related mechanisms, in order to provide help for the timely treatment and prevention of cardiovascular system damage caused by SARS-CoV-2 in children.


Subject(s)
Betacoronavirus/pathogenicity , Cardiovascular Diseases/etiology , Coronavirus Infections/complications , Pneumonia, Viral/complications , Cardiovascular System/physiopathology , Child , China , Humans , Pandemics
19.
Ann Cardiol Angeiol (Paris) ; 69(3): 107-114, 2020 May.
Article in French | MEDLINE | ID: covidwho-78184

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects host cells with angiotensin receptors, leading to pneumonia linked to COVID-19. The virus has a double impact on the cardiovascular system, the infection will be more intense if the host has cardiovascular co-morbidities and the virus can cause life-threatening cardiovascular lesions. Therapies associated with COVID-19 may have adverse cardiovascular effects. Therefore, special attention should be given to cardiovascular protection during COVID-19 infection.


Subject(s)
Betacoronavirus/pathogenicity , Cardiovascular Diseases/complications , Coronavirus Infections/complications , Pneumonia, Viral/complications , Antimalarials/adverse effects , Antimalarials/therapeutic use , Antiviral Agents/adverse effects , Antiviral Agents/therapeutic use , Azithromycin/adverse effects , Azithromycin/therapeutic use , Betacoronavirus/immunology , Cardiomyopathies/virology , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/etiology , Cardiovascular Diseases/prevention & control , Cerebrovascular Disorders/complications , Cerebrovascular Disorders/prevention & control , Cerebrovascular Disorders/virology , Chloroquine/adverse effects , Chloroquine/therapeutic use , Comorbidity , Coronary Disease/complications , Coronary Disease/prevention & control , Coronary Disease/virology , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Drug Interactions , Drug Therapy, Combination/adverse effects , Female , Humans , Hydroxychloroquine/adverse effects , Hydroxychloroquine/therapeutic use , Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects , Male , Methylprednisolone/adverse effects , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Risk Factors , Virus Internalization/drug effects
20.
Circulation ; 141(23): 1903-1914, 2020 06 09.
Article in English | MEDLINE | ID: covidwho-66430

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a rapidly expanding global pandemic caused by severe acute respiratory syndrome coronavirus 2, resulting in significant morbidity and mortality. A substantial minority of patients hospitalized develop an acute COVID-19 cardiovascular syndrome, which can manifest with a variety of clinical presentations but often presents as an acute cardiac injury with cardiomyopathy, ventricular arrhythmias, and hemodynamic instability in the absence of obstructive coronary artery disease. The cause of this injury is uncertain but is suspected to be related to myocarditis, microvascular injury, systemic cytokine-mediated injury, or stress-related cardiomyopathy. Although histologically unproven, severe acute respiratory syndrome coronavirus 2 has the potential to directly replicate within cardiomyocytes and pericytes, leading to viral myocarditis. Systemically elevated cytokines are also known to be cardiotoxic and have the potential to result in profound myocardial injury. Prior experience with severe acute respiratory syndrome coronavirus 1 has helped expedite the evaluation of several promising therapies, including antiviral agents, interleukin-6 inhibitors, and convalescent serum. Management of acute COVID-19 cardiovascular syndrome should involve a multidisciplinary team including intensive care specialists, infectious disease specialists, and cardiologists. Priorities for managing acute COVID-19 cardiovascular syndrome include balancing the goals of minimizing healthcare staff exposure for testing that will not change clinical management with early recognition of the syndrome at a time point at which intervention may be most effective. This article aims to review the best available data on acute COVID-19 cardiovascular syndrome epidemiology, pathogenesis, diagnosis, and treatment. From these data, we propose a surveillance, diagnostic, and management strategy that balances potential patient risks and healthcare staff exposure with improvement in meaningful clinical outcomes.


Subject(s)
Cardiovascular Diseases/etiology , Coronavirus Infections/complications , Pneumonia, Viral/complications , Antiviral Agents/therapeutic use , Arrhythmias, Cardiac/etiology , Arrhythmias, Cardiac/physiopathology , Arrhythmias, Cardiac/therapy , Biomarkers , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/physiopathology , Cardiovascular Diseases/therapy , Coronavirus Infections/drug therapy , Coronavirus Infections/therapy , Cytokine Release Syndrome/etiology , Cytokine Release Syndrome/physiopathology , Cytokine Release Syndrome/therapy , Cytokines/metabolism , Disease Management , Hemodynamics , Humans , Immunization, Passive , Immunoglobulins, Intravenous/therapeutic use , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Interleukin-6/antagonists & inhibitors , Molecular Targeted Therapy , Myocarditis/diagnosis , Myocarditis/etiology , Myocarditis/physiopathology , Myocarditis/therapy , Organ Specificity , Pandemics , Peptidyl-Dipeptidase A/physiology , Pneumonia, Viral/drug therapy , Receptors, Virus/physiology , Risk Factors , Serine Endopeptidases/physiology , Severe Acute Respiratory Syndrome/therapy , Spike Glycoprotein, Coronavirus/physiology , Viral Tropism
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