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Review
. 2021 May;37(5):722-732.
doi: 10.1016/j.cjca.2020.11.001. Epub 2020 Nov 16.

Implications of the COVID-19 Pandemic for Cardiovascular Disease and Risk-Factor Management

Darren Lau  1 , Finlay A McAlister  2
Affiliations
Review

Implications of the COVID-19 Pandemic for Cardiovascular Disease and Risk-Factor Management

Darren Lau et al. Can J Cardiol. 2021 May.

Abstract
in English, French

COVID-19 and our public health responses to the pandemic may have far-reaching implications for cardiovascular (CV) risk, affecting the general population and not only survivors of COVID-19. In this narrative review, we discuss how the pandemic may affect general CV risk for years to come and explore the mitigating potential of telehealth interventions. From a health care perspective, the shift away from in-person office visits may have led many to defer routine risk- factor management and may have had unforeseen effects on continuity of care and adherence. Fear of COVID-19 has led some patients to forego care for acute CV events. Curtailment of routine outpatient laboratory testing has likely delayed intensification of risk-factor-modifying medical therapy, and drug shortages and misinformation may have negative impacts on adherence to antihypertensive, glucose-lowering, and lipid-lowering agents. From a societal perspective, the unprecedented curtailment of social and economic activities has led to loss of income, unemployment, social isolation, decreased physical activity, and increased frequency of depression and anxiety, all of which are known to be associated with worse CV risk-factor control and outcomes. We must embrace and evaluate measures to mitigate these potential harms to avoid an epidemic of CV morbidity and mortality in the coming years that could dwarf the initial health effects of COVID-19.

La pandémie de COVID-19 et les mesures prises par les autorités de santé publique pourraient avoir de lourdes conséquences sur le risque cardiovasculaire (CV) dans l’ensemble de la population, et non seulement pour les personnes qui auront survécu à la COVID-19. Dans cette revue non systématique, nous analysons les répercussions possibles de la pandémie sur le risque CV général au cours des années à venir et nous explorons le potentiel d’atténuation de ces répercussions grâce à la télémédecine. Du point de vue des soins de santé, le délaissement des consultations en personne pourrait en avoir incité plusieurs à reporter la prise en charge courante des facteurs de risque, ce qui pourrait avoir des effets imprévus sur le maintien des soins et l’observance thérapeutique. La peur de la COVID-19 a en outre incité certains patients ayant subi une manifestation CV aiguë à se passer de soins. La limitation de l’exécution des tests de laboratoire de contrôle pour les patients ambulatoires a vraisemblablement retardé l’intensification des traitements médicaux visant à atténuer les facteurs de risques, et les pénuries de médicaments et la mésinformation pourraient avoir des répercussions défavorables sur l’observance des traitements antihypertenseurs, hypoglycémiants et hypolipidémiants. D’un point de vue sociétal, la restriction sans précédent des activités sociales et économiques a entraîné des pertes de revenus, des pertes d’emploi, de l’isolement social, une diminution de l’activité physique et une augmentation des cas de dépression et d’anxiété, qui sont tous associés à une détérioration du contrôle des facteurs de risques et des résultats sur le plan de la santé CV. Nous devons évaluer la situation et adopter des mesures pour atténuer ces méfaits potentiels afin d’éviter au cours des prochaines années une épidémie de morbidité et de mortalité CV qui pourrait bien éclipser les effets initiaux de la COVID-19 sur la santé.

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Figures

Figure 1
Figure 1
Potential effects of the COVID-19 pandemic on cardiovascular morbidity and mortality. The height and time scale of the 3 waves in this figure are uncertain and not to scale. Waves of cardiovascular mortality and morbidity should be distinguished from “waves” of pandemic COVID-19. We expect each additional “wave” of pandemic COVID-19 to create echoing waves of cardiovascular mortality and morbidity, owing to primary, secondary, and tertiary effects, particularly to the extent that previously relaxed pandemic precautions and curtailments of normal socioeconomic and health care-related activities are reinstated.
See this image and copyright information in PMC

References

    1. Government of Canada Coronavirus disease (COVID-19): outbreak update. August 6, 2020. Ottawa, ON: Government of Canada; 2020. https://www.canada.ca/en/public-health/services/diseases/2019-novel-coro... Available at:
    1. Puntmann V.O., Carerj M.L., Wieters I. Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from coronavirus disease 2019 (COVID-19) JAMA Cardiol. 2020;5:1265–1273. - PMC - PubMed
    1. Driggin E., Madhavan M.V., Bikdeli B. Cardiovascular considerations for patients, health care workers, and health systems during the COVID-19 pandemic. J Am Coll Cardiol. 2020;75:2352–2371. - PMC - PubMed
    1. Nicolai L., Leunig A., Brambs S. Immunothrombotic dysregulation in Covid-19 pneumonia is associated with respiratory failure and coagulopathy. Circulation. 2020;142:1176–1189. - PMC - PubMed
    1. Verdecchia P., Cavallini C., Spanevello A., Angeli F. COVID-19: ACE2-centric infective disease? Hypertension. 2020;76:294–299. - PubMed