Key Strategies for Clinical Management and Improvement of Healthcare Services for Cardiovascular Disease and Diabetes Patients in the Coronavirus (COVID-19) Settings: Recommendations From the REPROGRAM Consortium
Key Strategies for Clinical Management and Improvement of Healthcare Services for Cardiovascular Disease and Diabetes Patients in the Coronavirus (COVID-19) Settings: Recommendations From the REPROGRAM Consortium
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DOI：
10.3389/fcvm.2020.00112
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发表时间：
2020-06-16
影响因子：
3.6
通讯作者：
Walker, Antony H.
中科院分区：
文献类型：
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作者：
Bhaskar, Sonu;Rastogi, Aarushi;Walker, Antony H.
心血管疾病和糖尿病患者因COVID-19感染和死亡的风险可能更高。考虑到这些疾病导致残疾的社会和经济成本，必须观察这些患者临床管理的具体考虑因素。此外，围绕大流行应对措施的卫生服务重组进一步加剧了这一特定亚组患者在获得有限、治疗依从性、急性医疗需求和心理健康方面日益严重的危机。来自各个机构的现有建议和指南已经解决了一些压力点;然而，对于患有多种合并症（如肥胖）的vipatient，存在变化和限制。本文将综合评估心血管疾病、糖尿病、肥胖和COVID-19之间的关联，其对卫生系统的影响，以及卫生系统如何最好地应对当前的挑战和未来的需求。我们预计，在这种流行病的背景下，心血管疾病和糖尿病患者需要有针对性的战略，以确保对这一群体的伤害不会转化为对社会和经济的巨大成本。最后，我们提出了在COVID-19环境下心血管疾病和糖尿病患者的分诊和管理方案，以最大限度地减少对患者、卫生系统和医护人员的伤害。
Patients with cardiovascular disease and diabetes are at potentially higher risk of infection and fatality due to COVID-19. Given the social and economic costs associated with disability due to these conditions, it is imperative that specific considerations for clinical management of these patients be observed. Moreover, the reorganization of health services around the pandemic response further exacerbates the growing crisis around limited access, treatment compliance, acute medical needs, and mental health of patients in this specific subgroup. Existing recommendations and guidelines emanating from respective bodies have addressed some of the pressure points; however, there are variations and limitationsvis a vispatient with multiple comorbidities such as obesity. This article will pull together a comprehensive assessment of the association of cardiovascular disease, diabetes, obesity and COVID-19, its impact on the health systems and how best health systems can respond to mitigate current challenges and future needs. We anticipate that in the context of this pandemic, the cardiovascular disease and diabetes patients need a targeted strategy to ensure the harm to this group does not translate to huge costs to society and to the economy. Finally, we propose a triage and management protocol for patients with cardiovascular disease and diabetes in the COVID-19 settings to minimize harm to patients, health systems and healthcare workers alike.