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Erschienen in:
16.04.2020 | COVID-19 | Letters to the editor
Protecting patients and healthcare personnel from COVID-19: considerations for practice and outpatient care in cardiology
Erschienen in: Herz | Ausgabe 4/2020
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Only 3 months after the first description of the new disease in Wuhan, China, at the end of December 2019, the COVID-19 pandemic has emerged as the biggest global health challenge since World War II [1]. By April 12, 2020, 1,800,791 people worldwide were infected with the novel SARS-CoV‑2 virus, and the global death toll of the life-threatening disease COVID-19 was 110,892 [2]. Healthcare professionals are at greater risk than the general population [3]. The following considerations are based on early experiences reported from Wuhan, recent recommendations of the European Association of Cardiovascular Imaging (EACVI; [4]), a subspecialty community of the European Society of Cardiology (ESC), and the author’s personal experience after four members of his medical staff were infected with SARS-CoV‑2 (Table 1).
Table 1
Take-home messages for practice and outpatient care in cardiologya
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1.
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Screen for COVID-19 symptoms by telephone and at the front desk
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2.
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Consider non-contact body temperature checks at the entrance
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3.
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Review all scheduled visits and examinations for urgency
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4.
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Postpone all visits and examinations without relevant subsequent changes in patient management
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5.
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Postpone elective invasive/interventional procedures in stable patients with chronic ischemic heart disease (this is also based on recent evidence from the ISCHEMIA trial)
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6.
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Perform transesophageal echocardiography (TEE) only if absolutely indicated. Avoid all cardiopulmonary exercise stress tests (spiroergometry, exercise ECG, exercise stress echocardiography, etc.). Pharmacological stress testing is preferable
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7.
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Provide personal protective equipment (PPE) for all medical staff members (gloves, N95 masks, gowns, caps, goggles/face shields)
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8.
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Maintain segregation and social distancing between patients and medical personnel
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9.
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Ensure meticulous hygiene and disinfection of medical equipment and rooms after every patient
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10.
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Consider a lung CT scan as a first-line testing method in patients with acute dyspnea of unknown origin and elevated body temperature
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