Cardiology referral during the COVID-19 pandemic
OBJECTIVES: This study presents the cardiology referral model adopted at the University of Sa˜o Paulo-Hospital das Clı´nicas 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...
| Autores: | , , , , , , , , , , |
|---|---|
| Tipo de documento: | artigo |
| Estado: | Versão publicada |
| Data de publicação: | 2021 |
| País: | Brasil |
| Recursos: | Universidade de São Paulo (USP) |
| Repositório: | Clinics |
| Idioma: | inglês |
| OAI Identifier: | oai:revistas.usp.br:article/212783 |
| Acesso em linha: | https://www.revistas.usp.br/clinics/article/view/212783 |
| Access Level: | Acceso aberto |
| Palavra-chave: | Cardiology Referral COVID-19 Myocardial Injury Referral Cardiology Training |
| Resumo: | OBJECTIVES: This study presents the cardiology referral model adopted at the University of Sa˜o Paulo-Hospital das Clı´nicas 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 inhospital 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. |
|---|