Zaman Mahvash, Tiong Denise, Saw Jacqueline, Zaman Sarah, Daniels Matthew J
Manchester Heart Centre, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK.
Division of Cardiology, Vancouver General Hospital, University of British Columbia, Vancouver, BC Canada.
Curr Treat Options Cardiovasc Med. 2021;23(3):22. doi: 10.1007/s11936-021-00901-w. Epub 2021 Feb 22.
As second and third waves of the COVID-19 pandemic challenge healthcare in North America and Europe once again, we analyze the impact of the first wave on routine elective cardiovascular care, and the differential COVID risk emerging within our patient groups and staff.
We describe the need to sustainably resume, and temporarily expand, routine elective cardiac services in the face of resurgent COVID-19. Some, but not all, cardiac patient groups are particularly vulnerable to adverse outcomes following COVID-19 infection. We explore mitigation measures at the institutional level to increase resilience within cardiac services to enable them to operate deep into subsequent waves of COVID infection which place unprecedented demands on intensive care infrastructure. As measures to eradicate the virus appear to have failed in many countries, and vaccine roll-out will take many months we take the view that the threat imposed by endemic COVID-19 alters the way elective procedural care should be offered to cardiovascular patients.
Our patients are at definite risk from their cardiovascular disease, and a return to suspension of proven prognostic interventional treatments on an elective basis - the default for the first wave - must be avoided at all costs.
随着新冠疫情的第二波和第三波冲击再次挑战北美和欧洲的医疗保健系统，我们分析了第一波疫情对常规择期心血管护理的影响，以及我们患者群体和工作人员中出现的不同新冠风险。
我们描述了在新冠疫情卷土重来的情况下，可持续恢复并临时扩大常规择期心脏服务的必要性。部分但并非所有心脏患者群体在感染新冠病毒后特别容易出现不良后果。我们探讨了机构层面的缓解措施，以增强心脏服务的恢复力，使其能够在新冠感染后续浪潮中继续运作，这些浪潮对重症监护基础设施提出了前所未有的需求。由于许多国家根除病毒的措施似乎已失败，且疫苗推广需要数月时间，我们认为地方性新冠疫情构成的威胁改变了为心血管患者提供择期手术护理的方式。
我们的患者因心血管疾病面临明确风险，必须不惜一切代价避免恢复第一波疫情时的默认做法，即选择性地暂停已证实具有预后作用的介入治疗。
