Cardiovascular Diseases Unit, Department of Internal Medicine, Le Scotte Hospital, University of Siena, Siena, Italy.
Cardiology Division, Regina Montis Regalis Hospital, ASL-CN1, Mondovì, Cuneo, Italy.
Heart Fail Rev. 2021 Jul;26(4):973-979. doi: 10.1007/s10741-020-10068-4. Epub 2021 Jan 6.
Observational studies suggest that a heart failure (HF) diagnosis carries a poor prognosis in subjects with severe SARS-CoV2 (COVID-19) infection, but it is unknown whether this association reflects direct myocardial damage due to COVID-19 or the consequence of preexisting cardiac defects and related cardiovascular disease (CVD) risk burden. Although the close relation between CVD and COVID-19 outcomes is well established, contrasting data exists about the occurrence of HF complications during COVID-19 infection. Therefore, a specific algorithm focused on diagnostic differentiation in acute patients distinguishing between acute HF and acute respiratory distress syndrome related to COVID-19 is needed. Further, several concerns exist for the management of patients with an uncertain diagnosis and acute dyspnea, the exact relationship existing between COVID-19 and HF. Therefore, the treatment for subjects with both COVID-19 and HF and which criteria may be defined for domiciliary or hospital management, remain poorly defined. Herein, we describe practices to be adopted in order to address these concerns and avoid further virus spread among patients, l and their familiars involved in such patients' care.
观察性研究表明,在严重严重急性呼吸综合征冠状病毒 2 型(COVID-19)感染的患者中,心力衰竭(HF)的诊断预后不良,但尚不清楚这种关联是反映 COVID-19 直接导致的心肌损伤,还是反映了先前存在的心脏缺陷和相关心血管疾病(CVD)风险负担的结果。尽管心血管疾病和 COVID-19 结局之间的密切关系已得到充分证实,但关于 COVID-19 感染期间 HF 并发症的发生仍存在相互矛盾的数据。因此,需要针对急性患者制定一种特定的算法,以区分 COVID-19 相关急性 HF 和急性呼吸窘迫综合征。此外,对于诊断不确定和急性呼吸困难的患者的管理存在一些担忧,COVID-19 和 HF 之间的确切关系尚不清楚。因此,对于 COVID-19 和 HF 并存的患者的治疗以及可能定义为居家或住院管理的标准,仍未得到明确界定。在此,我们描述了为解决这些问题并避免患者及其护理人员之间进一步的病毒传播而应采取的措施。