Course and therapy of cardiovascular diseases during COVID-19 pandemic

ABSTRACT

The COVID-19 pandemic poses a significant burden on national health-care systems with serious impact on patients with cardiovascular disease. The clinical course of COVID-19 is often aggravated by arterial or venous thromboembolic complications due to systemic inflammation and activation of the coagulation system. As a consequence of this prothrombotic milieu, thromboembolic complications occur in up to 30% of patients treated on the intensive care unit. Considering the high rates of thromboembolic complications, antithrombotic therapy plays a decisive role. Several recommendations from different expert panels have been published encouraging routine standard dose and increased intensity thromboprophylaxis with low-molecular weight heparin. Quantification of plasma levels of D-Dimer as a marker of the activated coagulation system and for risk stratification has been demonstrated to be of great value. Patients with cardiovascular diseases are a vulnerable patient cohort with an increased risk for an aggravated clinical course of the COVID-19 disease. Interventional treatment of patients with the diagnosis STEMI or high-risk NSTEMI has to be performed without delay regardless of the current state of the pandemic. Careful precautionary measures need to be implemented to protect the patients, but also the health-care personnel and the infrastructure of the hospital.