COVID-19 & CARDIOLOGY UPDATES: March 17 to 26

concept image - COVID-19 cardiovascular updates march 17-26, 2020

As a response to the Coronavirus/Covid-19 outbreak, many medical associations and organizations have released statements specifically related to treatment for cardiovascular patients.

As we have little to no clinical data at this time, position statements and articles from reliable sources are especially important.

These resources provide credible and trustworthy information. Many if not most, speak to the need for more detailed research and data, to help guide us as we develop new standards of practice to ensure optimal care based on clinical practice rather than speculation.

VIDEO: What Cardiologists Need to Know About COVID-19

March 17 - DAIC
Recent ACC document on novel cornonavirus (COVID-19). Dr. Thomas Maddox, M.D., MSc, FACC and chairman of ACC (American College of Cardiology explains the statement and what cardiologist and teams caring for COVID-19 patients need to know.
Also discussed are:
Cardiovascular disease, combined comorbidities and mortality rates
Protective equipment, mitigating exposure and other considerations for CV teams

COVID-19 Hydroxychloroquine Treatment Brings Prolonged QT Arrhythmia Issues

March 24 - DAIC
Hydroxychloroquine and chloroquine are being touted as the new “medical miracles” in letters to the editor and anecdotal in-vitro/vivo studies.
When recent open-label studies showed a significant reduction in viral “carriage” in patients receiving hydroxychloroquine and azithromycin, it led to the off-label recommendation to use hydroxychloroquine for COVID-19.
Hydroxychloroquine is used to prevent or treat malaria infections and to treat auto-immune diseases such as lupus and rheumatoid arthritis when other medications have not worked or cannot be used.
It is expected that the outcomes of larger trials will take months to deliver reliable data, but what we can be confident in, is the safety profiles of these medications. Both hydroxychloroquine and chloroquine have been U.S. Food and Drug Administration (FDA) approved for lupus erythematosus, rheumatoid arthritis, and malaria.
Years of safety data show that these medications can cause cardiac ECG QT prolongation and subsequent arrhythmias, including torsade de pointes. These medications can prolong the QT correction (QTc), even when taken as recommended. So with limited treatment options how can providers proceed with treatment options?

COVID-19: Telemedicine in Cardiology & Medical Imaging

March 26 - DAIC
There has been an unprecedented expansion of telemedicine across the U.S. The most recent growth spurt was driven as more States issued "Stay at Home" orders.
Previously reimbursement of Medicare and Medicaid Services were only approved for Telehealth service in rural areas where the Centers for Medicare and Medicaid (CMS) determined there to be a shortage of doctors.
In early March of 2020, the Centers for Medicare and Medicaid (CMS) dropped the geographic requirements and allowed for Telehealth usage across the country in an effort to reduce in-person-contact, to mitigate the spread of the virus, and to protect those at high risk by allowing at-home check-ups to be provided remotely.

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About Jasdeep Dalawari MD

Experienced General and Specialist Physician with a demonstrated history of working in the medical practice industry. Skilled in Interventional, Endovascular, Vascular, and General Cardiovascular Medicine; Emergency Medicine; Healthcare Consulting, including Peer Review, Expert Witness, and Utilization Review; and Medical Education. Strong healthcare services professional with an MS focused in Health Administration from Virginia Commonwealth University.