ESC guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 2—care pathways, treatment, and follow-up

Colin Baigent , Stephan Windecker (1) , Daniele Andreini (2) , Elena Arbelo , Emanuele Barbato (3) , Antonio Bartorelli , Andreas Baumbach , Elijah Behr (4) , Sergio Berti (5) , Héctor Bueno (6, 7) , Davide Capodanno (8) , Riccardo Cappato , Alaide Chieffo (9) , Jean-Philippe Collet (10) , Thomas Cuisset (11) , Giovanni de Simone , Victoria Delgado (12) , Paul Dendale (13, 14) , Dariusz Dudek (15) , Thor Edvardsen (16) , Arif Elvan , José González-Juanatey , Mauro Gori , Diederick Grobbee , Tomasz Guzik , Sigrun Halvorsen , Michael Haude , Hein Heidbuchel , Gerhard Hindricks , Borja Ibanez , Nicole Karam (17) , Hugo Katus , Fredrikus Klok , Stavros Konstantinides , Ulf Landmesser , Christophe Leclercq (18, 19) , Sergio Leonardi , Maddalena Lettino , Giancarlo Marenzi , Josepa Mauri , Marco Metra , Nuccia Morici , Christian Mueller , Anna Sonia Petronio , Marija Polovina , Tatjana Potpara , Fabien Praz , Bernard Prendergast , Eva Prescott , Susanna Price , Piotr Pruszczyk , Oriol Rodríguez-Leor , Marco Roffi , Rafael Romaguera , Stephan Rosenkranz , Andrea Sarkozy , Martijn Scherrenberg , Petar Seferovic , Michele Senni , Francesco Spera , Giulio Stefanini , Holger Thiele , Daniela Tomasoni , Lucia Torracca , Rhian Touyz , Arthur Wilde , Bryan Williams (20)

1 Inselspital - Bern University Hospital [Berne]
2 Centro Cardiologico Monzino [Milano]
3 "Federico II" University of Naples Medical School
4 St George's, University of London
5 Fondazione Toscana Gabriele Monasterio
6 Hospital Universitario 12 de Octubre [Madrid]
7 CNIC - Centro Nacional de Investigaciones Cardiovasculares Carlos III [Madrid, Spain]
8 University of Catania [Italy]
9 IRCCS San Raffaele Scientific Institute [Milan, Italie]
10 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases
11 TIMONE - Hôpital de la Timone [CHU - APHM]
12 Leiden University Medical Center (LUMC)
13 UHasselt - Hasselt University
14 Jessa Ziekenhuis [Hasselt]
15 UJ - Uniwersytet Jagielloński w Krakowie = Jagiellonian University
16 Oslo University Hospital [Oslo]
17 PARCC (UMR_S 970/ U970) - Paris-Centre de Recherche Cardiovasculaire
18 CHU Pontchaillou [Rennes]
19 LTSI - Laboratoire Traitement du Signal et de l'Image
20 UCL - University College of London [London]

Aims - Since its emergence in early 2020, the novel severe acute respiratory syndrome coronavirus 2 causing coronavirus disease 2019 (COVID-19) has reached pandemic levels, and there have been repeated outbreaks across the globe. The aim of this two part series is to provide practical knowledge and guidance to aid clinicians in the diagnosis and management of cardiovascular (CV) disease in association with COVID-19. Methods and results - A narrative literature review of the available evidence has been performed, and the resulting information has been organized into two parts. The first, which was reported previously, focused on the epidemiology, pathophysiology, and diagnosis of CV conditions that may be manifest in patients with COVID-19. This second part addresses the topics of: care pathways and triage systems and management and treatment pathways, both of the most commonly encountered CV conditions and of COVID-19; and information that may be considered useful to help patients with CV disease (CVD) to avoid exposure to COVID-19. Conclusion - This comprehensive review is not a formal guideline but rather a document that provides a summary of current knowledge and guidance to practicing clinicians managing patients with CVD and COVID-19. The recommendations are mainly the result of observations and personal experience from healthcare providers. Therefore, the information provided here may be subject to change with increasing knowledge, evidence from prospective studies, and changes in the pandemic. Likewise, the guidance provided in the document should not interfere with recommendations provided by local and national healthcare authorities.

Keywords: ACE2; Acute coronary syndromes; Arrhythmias; Biomarkers; Cardiogenic shock; COVID-19; Heart failure; Myocarditis; Venous thromboembolism; Pulmonary embolism; Thrombosis

Domains: Life Sciences [q-bio]; Life Sciences [q-bio]; Human health and pathology; Cardiology and cardiovascular system

Colin Baigent, Stephan Windecker, Daniele Andreini, Elena Arbelo, Emanuele Barbato, et al.. ESC guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 2—care pathways, treatment, and follow-up. European Heart Journal, 2022, 43 (11), pp.1059-1103. ⟨10.1093/eurheartj/ehab697⟩. ⟨hal-03656882⟩