مقاله انگلیسی چالش ها و نوآوری ها در مراقبت از بیماران نارسایی قلبی پیشرفته در طول COVID-19
Abstract
Introduction
Mitigating the fear in seeking medical care
Managing patients on the heart transplant waiting list
Ensuring appropriate care delivery and optimization of GDMT
Surveillance testing and elective procedures in heart transplant and LVAD patients
Ensuring staf and physicians’ safety and preventing burnout
Conclusion
References
Abstract
The COVID-19 pandemic underscored our healthcare system’s unpreparedness to manage an unprecedented pandemic. Heart failure (HF) physicians from 14 diferent academic and private practice centers share their systems’ challenges and innovations to care for patients with HF, heart transplantation, and patients on LVAD support during the COVID-19 pandemic. We discuss measures implemented to alleviate the fear in seeking care, ensure continued optimization of guideline directed medical therapy (GDMT), manage the heart transplant waiting list, continue essential outpatient monitoring of anticoagulation in LVAD patients and surveillance testing post-heart transplant, and prevent physician burnout. This collaborative work can build a foundation for better preparation in the face of future challenges.
Introduction
Since first reported in Wuhan, China, SARS-CoV2 has infected more than 75.8 million people with an estimated 1.68 million deaths worldwide to date [1]. In the United States (U.S.), the COVID-19 outbreak has caused major disruptions to the healthcare system, highlighting our lack of preparedness to manage a pandemic of this magnitude. In response to these challenges, providers and hospital systems have been forced to rapidly develop innovations focused on all areas of systems-based healthcare. In this report, physicians from 14 diferent academic and private practice models across the U.S. (4 West Coast, 8 East Coast, and 2 Midwest) share examples of centers’ challenges and innovations highlighting approaches to (1) mitigate fear in seeking medical care, (2) ensure appropriate care delivery and optimization of guideline directed medical therapy, (3) balance risks and benefts in managing care for pre- and post-transplant patients, (4) pursue surveillance testing in heart transplant and LVAD patients, and (5) protect physicians and staf from burnout, depression, and anxiety. Our work may not be necessarily refective of all the U.S. centers’ experience in caring for patients with advanced heart failure during the COVID-19 pandemic.