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For Professionals: COVID-19 & cardiovascular disease

Information and resources for health care professionals.

Key takeaways

People with cardiovascular disease are more susceptible to severe complications from COVID-19, including intensive care admission and death.^1-3
People with cardiovascular disease may have a five-fold higher fatality rate compared to the general population of people with COVID-19.²
People with underlying health conditions including hypertension, cardiovascular disease, diabetes, and stroke are at a higher risk of developing serious illness from COVID-19.^3-5
COVID-19 can worsen existing cardiovascular conditions. Complications can include arrythmias, heart failure and myocardial damage.^1,3,4

Novel coronavirus disease 2019 (COVID-19) is an infectious disease caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2).⁵
The World Health Organization reports among those who develop symptoms, 80% recover from the disease without requiring hospital treatment, 15% become seriously ill and 5% become critically ill.⁵ People with existing cardiovascular disease who develop COVID-19 have a significantly increased risk of severe complications and morality.^1-3

COVID-19 and cardiovascular disease

COVID-19 can increase systemic inflammation and progress to lung injury, myocardial injury, and impaired cardiac function.^1-3
People with existing cardiovascular disease have a higher risk of acute cardiac complications, thrombosis, infection and developing severe illness from COVID-19. These people have an increased risk of hospitalisation, intensive care admission, and death.^1-3
Common cardiovascular complications in people with COVID-19 are arrythmias, thrombosis, heart failure, cardiomyopathy, myocardial damage, and acute coronary syndromes.¹

COVID-19 clinical care guidelines

The National COVID-19 Clinical Evidence Taskforce was established to develop living guidelines for clinical management and care of people with suspected or confirmed COVID-19.⁶The taskforce frequently review evidence to identify, evaluate, and synthesise emerging research to provide evidence-based recommendations, clinical flowcharts and COVID-19 guidelines.⁷

Clinical flowcharts include:

Assessment for suspected COVID-19
Management of adults with COVID-19 according to severity
Management of people with COVID-19 who are older and living with frailty and/or cognitive impairment.⁸

The Australian Living Evidence Consortium (the Consortium) convenes the National COVID-19 Clinical Evidence Taskforce. The Heart Foundation is a member of the Consortium.⁷

Access the latest evidence here

How you can support your patients with cardiovascular disease

Advise your patients with cardiovascular disease to get an influenza vaccination

People with cardiovascular disease are at increased risk of hospitalisation and death associated with influenza infection. Influenza vaccination can reduce the risk of acute myocardial infarction by between 15-45%.⁹

Advise your patients with cardiovascular disease to get vaccinated against COVID-19

Patients with cardiovascular disease are one of the priority groups for COVID-19 vaccination.^{1-3, 10}Encourage your patients to get the COVID-19 vaccination as soon as possible.

Visit the Department of Health’s website for more information, including how to become a COVID-19 vaccination provider, here.

Get your COVID-19 vaccine

Health care workers are one of the priority groups for COVID-19 vaccination, as they are at higher risk of COVID-19 exposure and transmission at work.^{2, 10}We encourage health care workers, including aged care and disability workers, to get vaccinated as soon as possible.²

Getting vaccinated will help reduce the risk of transmission to vulnerable people, such as those with cardiovascular disease and other underlying health conditions, who are at higher risk of hospitalisation and death from COVID-19.^1-3 Uptake of COVID-19 vaccines by health care workers is also likely to improve public confidence in vaccines and encourage others to get vaccinated.²

Learn more about COVID-19 and influenza vaccines, here.

Encourage patients with cardiovascular disease to maintain their physical and mental health

Encourage your patients with cardiovascular disease to maintain their current treatment plan and continue taking their prescribed medicines.

Support people to maintain their health by being physically active and following a heart-healthy diet. Meeting physical activity guidelines (150 minutes per week of moderate to vigorous exercise) is strongly associated with a reduced risk of hospitalisations, intensive care admissions and death in adults with COVID-19.¹¹

A 2020 survey in response to COVID-19 restrictions found 45% of respondents either agreed (26%) or strongly agreed (19%) that they often felt lonely.¹² Anxiety, depression, social isolation, and loneliness are associated with the development of cardiovascular disease.^13-17Early diagnosis of mental health conditions and helping people to access effective treatment improves outcomes.¹⁸

Learn more about mental health and cardiovascular disease, here.

Resources for your patient's

We have developed COVID-19 information and advice for your patients with cardiovascular disease, including how to stay physically active, follow a heart-healthy diet and the importance of seeking help in a medical emergency. Find out more, here.

Webinars

Duration: 1 hour
Recording year: 2021
Audience: GPs, GP Registrars.

Speakers: Associate Professor Erin Michos, Associate Professor Ralph Audehm, Ms Siobhan Cheeseman

Learning objectives:

Understand how the COVID-19 pandemic impacted cardiovascular health.
Describe novel strategies that are emerging in clinical practice that complement the absolute cardiovascular disease risk approach.
Explain what factors help re-classify an individual's cardiovascular disease risk, including coronary artery calcium imaging and female specific risk factors.
Understand how general practices can utilise the COVID-19 vaccine rollout as an opportunity to engage patients in discussions about cardiovascular disease.

Duration: 1 hour
Recording year: 2020
Audience: Health care professionals caring for people with cardiovascular disease.

Speakers: Associate Professor Sarah Zaman, Professor Mark Morgan, Ms Barbara Peterson and Dr Anna Samecki.

Learning objectives:

Understand the link between COVID-19 and cardiovascular disease, including the cardiac manifestations of COVID-19.
Apply guidance produced by the Cardiac Society of Australia & New Zealand relating to the management of cardiovascular disease during the COVID-19 pandemic.
Explain strategies to stay connected with cardiac patients in the community and support maintenance of their treatment and medicine plans.
Understand how to leverage MBS and medicine-related policy changes to support the management of cardiovascular disease in primary care.

Heart Health Network Newsletter

The Heart Health Network is the Heart Foundation’s newsletter for healthcare professionals, delivered to your inbox once a month.

Further information

Australian and New Zealand COVID-19 clinical guidelines, statements, and resources

Stay up to date on the latest clinical guidelines and disease modifying treatments for COVID-19 through the National COVID-19 Clinical Evidence Taskforce, here.
Cardiovascular disease and COVID-19: Australia/New Zealand consensus statement, here.
Cardiac Society of Australia and New Zealand (CSANZ) resources on COVID-19, here.

COVID-19 vaccines

Find out more about COVID-19 vaccines in Australia, here.
Learn more about the vaccine approval process from the Therapeutic Goods Administration, here.
Read the guidance on myocarditis and pericarditis after mRNA COVID-19 vaccines jointly developed by the Australian Technical Advisory Group on Immunisation (ATAGI) and the Cardiac Society of Australia and New Zealand (CSANZ), here.

International resources

World Health Organization Coronavirus disease (COVID-19) pandemic resources, here.
Asian Pacific Society of Cardiology, here.
European Society of Cardiology COVID-19 and cardiology resources, here.
American College of Cardiology COVID-19 Hub, here.

Last reviewed: 23/08/2021

References

1.         Pellicori P, et al. COVID‐19 and its cardiovascular effects: a systematic review of prevalence studies. Cochrane Database of Systematic Reviews. 2021(3)doi.10.1002/14651858.CD013879
2.         Zaman S, et al. Cardiovascular disease and COVID-19: Australian and New Zealand consensus statement. Med J Aust. 2020;213(4):182-7doi.10.5694/mja2.50714
3.         Hessami A, et al. Cardiovascular diseases burden in COVID-19: Systematic review and meta-analysis. The American Journal of Emergency Medicine. 2020doi.10.1016/j.ajem.2020.10.022
4.         Australian Government. Advice for people at risk of coronavirus (COVID-19) Canberra, ACT: Department of Health 2021 [Available from:[https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert/advice-for-people-at-risk-of-coronavirus-covid-19]
5.         World Healh Organization. Coronavirus diease (COVID-19) Geneva, Switzerland: World Health Organisation; 2020 [Available from:[https://www.who.int/news-room/q-a-detail/coronavirus-disease-covid-19]
6.         National COVID-19 Clinical Evidence Taskforce. Australian guidelines for the clinical care of people with COVID-19: National COVID-19 Clinical Evidence Taskforce; 2021 [Available from:[https://app.magicapp.org/#/guideline/L4Q5An/section/nV2P3n]
7.         National COVID-19 Clinical Evidence Taskforce. About the Taskforce: National COVID-19 Clinical Evidence Taskforce; 2021 [Available from:[https://covid19evidence.net.au/about-the-taskforce/]
8.         National COVID-19 Clinical Evidence Taskforce. Clinical flowcharts [Available from:[https://covid19evidence.net.au/#clinical-flowcharts]
9.         MacIntyre CR, et al. Influenza vaccine as a coronary intervention for prevention of myocardial infarction. Heart. 2016;102(24):1953-6doi.10.1136/heartjnl-2016-309983
10.       Australian Technical Advisory Group on Immunisation. Preliminary advice on general principles to guide the prioritisation of target populations in a COVID-19 vaccination program in Australia 2020 [updated 13 November 2020. Available from:[https://www.health.gov.au/sites/default/files/documents/2020/11/atagi-preliminary-advice-on-general-principles-to-guide-the-prioritisation-of-target-populations-in-a-covid-19-vaccination-program-in-australia_0.pdf]
11.       Sallis R, et al. Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients. British Journal of Sports Medicine. 2021:bjsports-2021-104080doi.10.1136/bjsports-2021-104080
12.       Lim M. Australian loneliness report: A survey exploring the loneliness levels of Australians and the impact on their health and wellbeing. Melbourne, Australia: Australian Psychological Society and Swinbourne University 2018.
13.       Celano CM, et al. Anxiety Disorders and Cardiovascular Disease. Current Psychiatry Reports. 2016;18(11):101doi.10.1007/s11920-016-0739-5
14.       Glozier N, et al. Psychosocial risk factors for coronary heart disease. Med J Aust. 2013;199(3):179-80doi.10.5694/mja13.10440
15.       Hare DL, et al. Depression and cardiovascular disease: a clinical review. Eur Heart J. 2014;35(21):1365-72doi.10.1093/eurheartj/eht462
16.       Holt-Lunstad J, et al. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspect Psychol Sci. 2015;10(2):227-37doi.10.1177/1745691614568352
17.       Valtorta NK, et al. Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies. Heart. 2016;102(13):1009-16doi.10.1136/heartjnl-2015-308790
18.       BeyondBlue. What is mental health? : BeyondBlue; 2021 [Available from:[https://www.beyondblue.org.au/the-facts/what-is-mental-health]

For Professionals: COVID-19 & cardiovascular disease

Information and resources for health care professionals.

Key takeaways

COVID-19 and cardiovascular disease

COVID-19 clinical care guidelines

How you can support your patients with cardiovascular disease

Resources for your patient's

Webinars

Heart Health Network Newsletter

Further information

COVID-19 vaccines

International resources

References

More on this topic

Clinical guidelines and position statements

Clinical guidelines and position statements

Clinical guidelines and position statements

COVID-19 and cardiovascular disease

COVID-19 and cardiovascular disease

COVID-19 and cardiovascular disease

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