22/03/2020
A Preventative Cardiologist Perspective on COVID-19 - Dr Jason Kaplan MBBS FRACP FACC
We are living in unprecedented times, and each day brings new challenges in the medical management of this pandemic. We are lucky in Australia to have experts guide us to help best handle this, and we are learning from other countries that are more advanced in COVID-19 affecting them than we are.
This is an edited portion of the abstract from a fast-tracked review in the Journal of the American College of Cardiology ( JACC) dated March 2020.
DOI: https://doi.org/10.1016/j.jacc.2020.03.031
The coronavirus disease-2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus -2 that has significant implications for the care of patients with heart disease.
First, those with COVID-19 and pre-existing cardiovascular disease (CVD) have an increased risk of severe illness and death. This is especially true for those over 80 years old.
The cardiovascular conditions that may put people at risk are those with heart failure, those on immune suppressive medication and those with untreated severe heart valve disease. Those patients that have co-existing diabetes, high blood pressure and chronic kidney disease are also at risk.
Second, the infection has been associated with multiple direct and indirect cardiovascular complications, including acute heart muscle injury, inflammation of the cardiac muscle, arrhythmias and blood clots.
Third, therapies under investigation for COVID-19 may have cardiovascular side effects.
Fourth, the response to COVID-19 can compromise the rapid assessment of non-COVID-19 patients with heart problems.
Finally, the provision of cardiac care may place health care workers in a position of vulnerability as they become hosts or carriers of virus transmission.
I have a few pieces of advice to people during this time, and mostly this is from a general medical perspective.
Get your medical information from reputable sources such as academic medical institutions, the Centre for Disease Control, the NIH (https://www.nih.gov/health-information/coronavirus), Australian and State health Departments and experts in the media. MedTwitter # is a resource many of us are using to keep up with the latest developments.
An example of this is from the Cleveland Clinic:-
https://health.clevelandclinic.org/faqs-what-you-should-kn…/
Practice social distancing, excellent hygiene and if you are at risk, make sure you do your best to isolate physically from the general population as much as possible (but stay in touch with loved ones however you can). A lot of medical appointments can be done via telehealth.
If you do have concerning symptoms such as severe cough, shortness of breath or fever, make sure you seek medical treatment early, and if you are concerned that you might have contracted the virus follow local testing protocols.
Do your best to take care of your immune system, by managing stress (which many of us are experiencing), getting adequate sleep, exercising (many fitness providers are moving classes online) and eating a healthy plant-based diet. While the temptation is to resort to "comfort food " at times like this, there is plenty of fresh produce available.
I would also suggest that people connect with their usual preventative health care practitioners, as they will have some advice about supplements that may be helpful.
Despite what you may read online, there is no one magic vitamin or supplement or a specific food guaranteed to boost your immune system and protect you from COVID 19. We are using extra vitamin C, D, A, zinc, garlic and an immune defence formula from a reputable manufacturer.
There has been some concern about whether to stop certain types of blood pressure medications. Namely, the angiotensin receptor antagonists. However, many cardiac societies around the world are suggesting to continue these if they have been prescribed to you and ask your physician for individual advice about your situation.
I would also encourage people to use this time when many of us will not be at our usual workplaces and have some more time to ourselves and with our families to re-calibrate their health and lifestyle and at the end of this time come out stronger, healthier and more resilient than before.
I wish you to be safe, be well, be healthy, and I look forward to connecting with you in the future. During this time, I will do my best to post about some of the latest updates in cardiovascular medicine, nutrition and lifestyle that I hope will be of use.
