COVID-19 & cardiovascular disease

People with CVD are at higher risk of the most severe COVID-19 complications

People with CVD are more susceptible to severe complications if infected with COVID-19, including intensive care admission and death. Emerging data suggests that people with CVD may have a five-fold higher case fatality rate compared to the overall COVID-19 infected population¹.

While it’s largely a respiratory disease, COVID-19 can also damage the heart and worsen existing heart conditions. For those infected with COVID-19, acute cardiac injury can manifest as left ventricular dysfunction, heart failure, ventricular arrhythmias and ECG changes¹.

Stay connected with your patients living with CVD, now more than ever

The COVID-19 pandemic has created an unprecedented global impact on public health and health care delivery. Outside of direct health consequences, social distancing restrictions have also disrupted the delivery of routine health care across the country.

The changes have fast-tracked digital and health policy innovations unlike any the primary care sector has seen over such a short period of time. However, there is growing concern that people with chronic diseases are avoiding their regular medical visits, investigations or vaccinations in a bid to avoid contracting COVID-19.

• Encourage your patients to continue their current treatment and management plans
• Utilise new telehealth MBS items to keep connected with your patients while they are in isolation, but face to face visits may still be necessary
• Continue to offer your eligible patients chronic disease management plans which are now covered by telehealth MBS items and can be claimed by GPs and contributed to by practice nurses
• Make the most of new special arrangements which allow for prescriptions to be sent to pharmacies via fax, email or text message where necessary
• Encourage eligible patients, including those living with CVD, to have their medicines delivered to their homes under the new Home Medicines Service where appropriate

Don’t discontinue ACE inhibitor or ARB therapy

There have been early concerns about the safety and value of angiotensin converting enzyme inhibitors (ACE-I) and angiotensin receptor blockers (ARBs) in the context of the COVID-19 pandemic. This was speculated because the SARS-CoV-2 virus enters cells by binding to human angiotensin-converting enzyme 2 (ACE2)¹. There is insufficient clinical evidence that ACE-I, ARBs or other inhibitors of the renin angiotensin system are either harmful or beneficial to COVID-19 infection or its complications². 

Prioritise influenza vaccination for your patients living with CVD

People with CVD are at increased risk of hospitalisation or death associated with influenza infection. Influenza vaccination can reduce risk of myocardial infarction by between 15 - 45%, which is on par with or better than many established preventative therapies including statins, antihypertensives and smoking cessation³.

Resources

For Health Professionals

• Australian consensus statement on cardiovascular disease and COVID-19 by the Cardiac Society of Australia/New Zealand (CSANZ), Australian/NZ Society of Cardiac and Thoracic Surgeons (ANZSCTS), National Heart Foundation (NHF) and the High Blood Pressure Research Council of Australia (HBPRCA)
• Cardiac Society of Australia/New Zealand (CSANZ) position statements on COVID-19
• Medical Journal of Australia editorial on COVID, ACE inhibitors/ARBs, and cardiovascular diseases
• COVID-19 Temporary MBS Telehealth Services
• COVID-19 Home Medicines Service

For Consumers

• Consumer resource on COVID-19 & CVD
• Heart Foundation COVID-19 & CVD consumer web page
• For any specific queries please encourge people to call our Helpline for heart health information or support on 13 11 12, Monday - Sunday, 9am - 5pm.

References