Bhaskar Sonu, Rastogi Aarushi, Chattu Vijay Kumar, Adisesh Anil, Thomas Pravin, Alvarado Negman, Riahi Anis D, Varun Chakrakodi N, Pai Anupama R, Barsam Sarah, Walker Antony H
Pandemic Health System REsilience PROGRAM (REPROGRAM) Consortium, CVD and Metabolic REPROGRAM Sub-committee†, Sydney, NSW, Australia.
Liverpool Hospital & South West Sydney Local Health District (SWSLHD), Department of Neurology & Neurophysiology, Sydney, NSW, Australia.
Front Cardiovasc Med. 2020 Jun 16;7:112. doi: 10.3389/fcvm.2020.00112. eCollection 2020.
Patients with cardiovascular disease and diabetes are at potentially higher risk of infection and fatality due to COVID-19. Given the social and economic costs associated with disability due to these conditions, it is imperative that specific considerations for clinical management of these patients be observed. Moreover, the reorganization of health services around the pandemic response further exacerbates the growing crisis around limited access, treatment compliance, acute medical needs, and mental health of patients in this specific subgroup. Existing recommendations and guidelines emanating from respective bodies have addressed some of the pressure points; however, there are variations and limitations patient with multiple comorbidities such as obesity. This article will pull together a comprehensive assessment of the association of cardiovascular disease, diabetes, obesity and COVID-19, its impact on the health systems and how best health systems can respond to mitigate current challenges and future needs. We anticipate that in the context of this pandemic, the cardiovascular disease and diabetes patients need a targeted strategy to ensure the harm to this group does not translate to huge costs to society and to the economy. Finally, we propose a triage and management protocol for patients with cardiovascular disease and diabetes in the COVID-19 settings to minimize harm to patients, health systems and healthcare workers alike.
患有心血管疾病和糖尿病的患者因感染新冠病毒而面临更高的感染风险和死亡风险。鉴于这些疾病导致的残疾所带来的社会和经济成本，必须对这些患者的临床管理给予特殊考虑。此外，围绕疫情应对进行的卫生服务重组，进一步加剧了这一特定亚组患者在就医机会有限、治疗依从性、急性医疗需求和心理健康方面日益严重的危机。各相关机构发布的现有建议和指南已经解决了一些关键问题；然而，对于患有多种合并症（如肥胖症）的患者，仍存在差异和局限性。本文将综合评估心血管疾病、糖尿病、肥胖症与新冠病毒之间的关联，其对卫生系统的影响，以及卫生系统如何才能最好地应对，以缓解当前的挑战并满足未来的需求。我们预计，在此次疫情背景下，心血管疾病和糖尿病患者需要一项有针对性的策略，以确保对这一群体造成的危害不会转化为对社会和经济的巨大成本。最后，我们提出了一项针对新冠疫情环境下心血管疾病和糖尿病患者的分诊与管理方案，以尽量减少对患者、卫生系统和医护人员的伤害。
