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Observational Study
. 2021 Dec 6:76:e3538.
doi: 10.6061/clinics/2021/e3538. eCollection 2021.

Cardiology referral during the COVID-19 pandemic

Nathalia Conci Santorio  1 , Francisco Akira Malta Cardozo  1 , Rodrigo Freddi Miada  1 , Fabio Grunspun Pitta  1 , Caio de Assis Moura Tavares  1 , Fabio Cetinic Habrum  1 , Henrique Trombini Pinesi  1 , Iuri Resedá Magalhães  1 , Maria Clara Saad Menezes  1 , Bruno Caramelli  1 , Daniela Calderaro  1
Affiliations
Observational Study

Cardiology referral during the COVID-19 pandemic

Nathalia Conci Santorio et al. Clinics (Sao Paulo). .

Abstract

Objectives: This study presents the cardiology referral model adopted at the University of São Paulo-Hospital das Clínicas complex during the initial period of the coronavirus disease (COVID-19) pandemic, main reasons for requesting a cardiologic evaluation, and clinical profile of and prognostic predictors in patients with COVID-19.

Methods: In this observational study, data of all cardiology referral requests between March 30, 2020 and July 6, 2020 were collected prospectively. A descriptive analysis of the reasons for cardiologic evaluation requests and the most common cardiologic diagnoses was performed. A multivariable model was used to identify independent predictors of in-hospital mortality among patients with COVID-19.

Results: Cardiologic evaluation was requested for 206 patients admitted to the ICHC-COVID. A diagnosis of COVID-19 was confirmed for 180 patients. Cardiologic complications occurred in 77.7% of the patients. Among these, decompensated heart failure was the most common complication (38.8%), followed by myocardial injury (35%), and arrhythmias, especially high ventricular response atrial fibrillation (17.7%). Advanced age, greater need of ventilatory support on admission, and pre-existing heart failure were independently associated with in-hospital mortality.

Conclusions: A hybrid model combining in-person referral with remote discussion and teaching is a viable alternative to overcome COVID-19 limitations. Cardiologic evaluation remains important during the pandemic, as patients with COVID-19 frequently develop cardiovascular complications or decompensation of the underlying heart disease.

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Conflict of interest statement

No potential conflict of interest was reported.

Figures

Figure 1
Figure 1. Reasons for requesting a cardiology referral. Other reasons: syncope, pericardial effusion, congenital heart disease, hypertension, and endocarditis. Data labels display the absolute number of patients.
Figure 2
Figure 2. Cardiovascular manifestations in patients diagnosed with COVID-19. HF: heart failure, MI: myocardial infarction. Data labels display absolute number of patients.
Figure 3
Figure 3. Obstructive patterns found in patients with coronavirus disease and acute myocardial infarction submitted to invasive stratification.
See this image and copyright information in PMC

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