Cardiovascular Research Division, Translational and Biosciences Research Institutes, Newcastle University, Newcastle upon Tyne, UK.
Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
ESC Heart Fail. 2021 Feb;8(1):175-182. doi: 10.1002/ehf2.13061. Epub 2020 Nov 24.
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2. The clinical presentation of this virus mainly manifests in the respiratory system but may also lead to severe complications in the cardiovascular system. The global burden of COVID-19 has led to an unprecedented need to gain further insight into patient outcomes, management, and clinical practice. This review aims to provide an overview of the current literature on heart failure (HF) hospitalizations, management, and care pathways for supporting patients during and beyond this pandemic. A literature review of five areas of interest was conducted and included: (i) HF hospitalization; (ii) recognizing the needs and supporting HF patients during COVID-19; (iii) supporting rehabilitation services; (iv) transitioning to a telehealth framework; and (v) the need for evidence. Patients with new-onset or existing HF are particularly vulnerable, but a significant reduction in HF hospital admissions has been reported. During these periods of uncertainty, the current care pathways for acute and elective cardiac patients have had to change with the relocation of HF services to protect the vulnerable and reduce transmission of COVID-19. Optimizing community HF services has the potential to reduce the pressures on secondary care during the recovery from this pandemic. Telemedicine and virtual health care are emerging technologies and overcome the risk of in-person exposure. Successful remote delivery of cardiac rehabilitation services has been reported during the pandemic. Delivery of a robust telehealth framework for HF patients will improve communication between clinician and patient. The reduction in HF admissions is a concern for the future and may result in unintended mortality. New-onset and current HF patients must understand their diagnosis and future prognosis and seek help and support using the appropriate platform when needed. Realigning HF services and the use of telemedicine and virtual health care has great potential but needs to be carefully understood to ensure engagement and approval in this population to overcome barriers and challenges.
新型冠状病毒病（COVID-19）由严重急性呼吸综合征冠状病毒 2 型引起。该病毒的临床特征主要表现在呼吸系统，但也可能导致心血管系统的严重并发症。COVID-19 在全球范围内的流行，使得我们前所未有地需要深入了解患者的结局、管理和临床实践。本综述旨在概述目前关于心力衰竭（HF）住院、管理和支持患者的护理途径的文献，以支持在大流行期间和之后对患者进行管理。对五个感兴趣的领域进行了文献回顾，包括：（i）HF 住院；（ii）在 COVID-19 期间识别和支持 HF 患者的需求；（iii）支持康复服务；（iv）过渡到远程医疗框架；和（v）证据的需求。新发或现有 HF 患者特别脆弱，但据报道 HF 住院人数显著减少。在这些不确定时期，急性和择期心脏患者的当前护理途径必须改变，将 HF 服务转移到以保护弱势群体并减少 COVID-19 传播的地方。优化社区 HF 服务有可能减轻大流行恢复期二级保健的压力。远程医疗和虚拟医疗是新兴技术，可以克服面对面接触的风险。在大流行期间，已经报告了成功远程提供心脏康复服务。为 HF 患者提供强大的远程医疗框架将改善临床医生与患者之间的沟通。HF 入院人数减少令人担忧，可能导致意外死亡。新发和当前 HF 患者必须了解自己的诊断和未来预后，并在需要时使用适当的平台寻求帮助和支持。重新调整 HF 服务以及使用远程医疗和虚拟医疗具有很大的潜力，但需要仔细了解，以确保在这一人群中获得参与和认可，克服障碍和挑战。
