Cardio-Oncology in the Era of the COVID-19 Pandemic and Beyond

Abstract

Coronavirus disease 2019 (COVID-19) has emerged as a global pandemic and public health crisis. Increasing waves of intermittent infectious outbreaks have dramatically influenced care among broad populations. Over the past 2 decades, there has been a rapid increase in cancer survival, with >400 000 new survivors each year. The increasingly common presence of cardiovascular disease in patients during or after cancer treatment led to the rapid growth of the field of cardio-oncology with a mandate of identifying, treating, and preventing the various forms of cardiovascular disease seen among this population. This review evaluates the implications of the pandemic on the practice and study of cardio-oncology. The evolving understanding of the relationship between comorbid disease and clinical outcomes among this population is assessed. With the impetus of the pandemic, cardio-oncology can be deliberate in embracing changes to cardiac screening, monitoring, and intervention during oncology care. Bridging 2 specialties, consideration of the lessons learned in cancer and cardiovascular may pivotally inform ongoing therapeutic efforts. Further, the development of multicenter registries focused on understanding and optimizing outcomes among these patients should be considered. Together, these insights may critically inform strategies for the care of cardio-oncology patients in future phases of the COVID-19 pandemic and beyond.

Keywords: COVID‐19; cancer; cardiac imaging; cardio‐oncology; targeted therapies.

Figure 1. Suggested triage algorithm for cardio‐oncology referrals, and care in the coronavirus disease 2019 (COVID‐19) pandemic and early recovery.

Figure 2. General phases (stages) in cardio‐oncology care during the coronavirus disease 2019 (COVID‐19) pandemic and recovery.

ACS indicates acute coronary syndrome; CT, computed tomography; echo, echocardiogram; MRI, magnetic resonance imaging; and TEE, transesophageal echocardiogram.