ACC/AHA report details CV, non-CV complications, treatment options in COVID-19
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The American College of Cardiology and American Heart Association released a joint report detailing both CV and non-CV complications of COVID-19 as well as the respective diagnosis and treatment options.
Published in the Journal of the American College of Cardiology and Circulation: Cardiovascular Quality and Outcomes, the report form the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards was endorsed by the Heart Failure Society of America and Society for Cardiac Angiography and Interventions.
“There is increased importance of understanding acute and longitudinal impact of COVID-19 on cardiovascular health. Unfortunately, there has not been clarity or consensus on definitions of cardiovascular conditions related to COVID-19. Different diagnostic terminologies are being used for overlapping conditions such as ‘myocardial injury,’ ‘myocarditis,’ ‘type II myocardial infarction,’ ‘stress cardiomyopathy,’ or ‘inflammatory cardiomyopathy,’” Biykem Bozkurt, MD, PhD, The Mary and Gordon Cain Chair and Professor of Medicine and director of the Winters Center for Heart Failure Research at Baylor College of Medicine, and colleagues wrote. “These data standards will help standardize definitions and set the framework to capture and better understand how COVID-19 impacts cardiovascular health.”
This document provides data elements and definition for both CV and non-CV complications of COVID-19.
Topics covered include:
- patient demographics including age, sex, race, ethnicity and social determinants of health;
- COVID-19 diagnosis;
- COVID-19 CV complications;
- COVID-19 non-CV complications;
- symptoms and signs;
- diagnostic procedures;
- pharmacological therapy;
- preventive, therapeutic and supportive procedures for COVID-19; and
- end-of-life management.
The document provides insight on the differences between confirmed, probable and suspected acute COVID-19 case definitions; postacute sequelae of COVID-19 were also included; and acute CV complications related to COVID-19.
“Acute cardiovascular presentations are varied and include myocardial injury, myocarditis, ACS, heart failure, cardiogenic shock, arrhythmia, thromboembolic and cerebrovascular complications, and cardiac involvement and coronary artery ectasia in the setting of MIS in children (MIS-C),” the researchers wrote. “COVID-19 can trigger acute heart failure or cardiogenic shock. New-onset left ventricular systolic dysfunction is hypothesized to be related to myocarditis, endothelial and microvascular injury, myocardial stress in the setting of increased myocardial demand and reduced myocardial oxygenation in the setting of hypoxia, myocardial inflammation and proinflammatory cytokine surge.”
Non-CV complications of COVID-19 infection covered in the report include pneumonia, acute respiratory distress syndrome and multiorgan failure related to septic shock, cytokine storm, cardiogenic shock, obstructive shock or mixed distributive combined with cardiogenic shock.
“This document is intended for use by researchers, registry developers, and clinicians and is proposed as a framework for ICD-10 code development of COVID–19–related cardiovascular conditions,” the committee wrote. “Specifically, COVID-19 cardiovascular data standards are of great importance to patients, providers, investigators, scientists, administrators, public health officials, policy makers, and payers.”
Please see the report for full details.
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