Out of hospital management of LVAD patients during COVID-19 outbreak

Abstract

Coronavirus disease 2019 (COVID-19) is a pandemic touching thousands of people all around the world. Patients supported with left ventricular assist devices (LVADs) are affected by long-standing cardiovascular diseases and subjected to variations of the normal cardiovascular physiology, thus requiring an even closer monitoring during the COVID-19 outbreak. Nevertheless, the COVID-19 pandemic led to a drastic reduction in routine clinical activities and a consequent risk of looser connections between LVAD patients and their referring center. Potential deleterious effects of such a situation can be a delayed recognition of LVAD-related complications, misdiagnosis of COVID-19, and impaired social and psychological well-being for patients and families. As one of the largest LVAD programs worldwide, we designed a sustainable and enforceable telemonitoring algorithm which can be easily adapted to every LVAD center so as to maintain optimal quality of care for LVAD patients during the COVID-19 pandemic.

Keywords: COVID-19; coronavirus; heart failure; left ventricular assist device; mechanical circulatory support.

FIGURE 1

Algorithm for out‐of‐hospital left ventricular assist device (LVAD) management during COVID‐19 outbreak. INR, international normalized ratio; MAP, mean arterial pressure [Color figure can be viewed at wileyonlinelibrary.com]