COVID-19 is creating a new generation of cardiac patients. With heart disease already the leading cause of deaths globally, this epidemic within a pandemic — a crisis within a crisis — creates a cardiology conundrum.
In all my years involved in healthcare, this is the most massive medical mystery I’ve encountered. The way patients are triaged, diagnosed, treated and monitored will forever change because of COVID-19. Perhaps nowhere has that been more evident than in the field of cardiology.
Still in its infancy, the virus has layers upon layers of complexities, which have resulted in sometimes contrary observations and evidence about the impact it has on the heart.
In the early days, using ECG and ultrasound, clinicians in China reported signs of myocarditis and heart disease associated with COVID-19 patients. That data helped explain the spike in out-of-hospital cardiac arrests in the hard-hit northern region of Italy where Professor Luigi Badano, director of the cardiovascular imaging unit at Istituto Auxologico Italiano, IRCCS, and professor of cardiology at the University of Milano-Bicocca, uses strain imaging on ultrasound to understand the function of the right ventricle in predicting the prognosis of those patients who will survive the virus.
Currently, the United States surpasses 5 million recorded COVID-19 cases and record numbers of hospitalizations. New studies reinforce the earlier evidence suggesting that COVID-19 patients may have long term heart damage, while another study published by the American Heart Association (AHA) indicates suspected damage to the heart may not be myocarditis, but rather a unique pattern of cell death in scattered individual heart muscle cells.
These observational studies, albeit small, are eye-opening and underscore the need for more research with larger sample sizes that will help draw solid conclusions to guide effective therapies and treatments. But the practice of medicine takes time, which is in short supply.
Hospitals have worked diligently to reassure patients that it’s not only safe, but important to seek medical care during the pandemic. But, out of fear of contagion, many patients delay care. As a med tech company with more than 40 years of experience in cardiology, we anticipate this delay puts patients with pre-existing cardiac conditions at even a greater risk of long-term harm, and additional burden on cardiologists as they manage care with new constraints. At the same time, technology is opening the door for patient care to exist beyond the walls of the hospital, to manage patients on site and provide their caregivers with up-to-date information on their well-being.
When it comes to treating COVID-19 patients, clinicians globally are already using our technologies such as ECG to perform rapid first line diagnostic tests to identify cardiac emergencies and improve triage, and AI enabled ultrasound like a handheld device for automated, fast and objective ejection fraction measurement and a point-of-care ultrasound system that, in seconds, automates critical information needed by ER and ICU doctors to determine if the heart is pumping enough blood through the primary arteries to the organs. As we look to the future, we will bring new technologies and solutions to the market that improve efficiency, productivity and clinical outcomes to meet the demands of this new world.
While these are puzzling times, the medical field continues to practice patience and perseverance — even as a rapidly spreading virus creates urgency on several fronts. What we don’t know now won’t stop us from figuring it out. Let’s fix what we can, learn as we go and continue forging ahead, wherever it may lead us.
Editor's note: Anders Wold is president and CEO, clinical care solutions, at GE Healthcare. He is celebrating 22 years at GE Healthcare and nearly four decades working in healthcare, with most of his focus in cardiovascular ultrasound.
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