IMR Press / RCM / Volume 22 / Issue 1 / DOI: 10.31083/j.rcm.2021.01.241
Open Access Review
Exploring the impact of the COVID-19 pandemic on provision of cardiology services: a scoping review
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1 Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, 247000 Karachi, Pakistan
2 Department of Internal Medicine, Ziauddin Medical University, 247000 Karachi, Pakistan
3 Dr NTR University of Health Sciences, 502355 Vijayawada, India
4 Department of Internal Medicine, Dow International Medical College, 247000 Karachi, Pakistan
5 Department of Internal Medicine, Staten Island University Hospital, NY 10001, USA
6 Department of Medicine, Cleveland Clinic Foundation, Cleveland, OH 44111, USA
Rev. Cardiovasc. Med. 2021, 22(1), 83–95;
Submitted: 8 November 2020 | Revised: 30 December 2020 | Accepted: 3 January 2021 | Published: 30 March 2021

The coronavirus disease-19 (COVID-19) pandemic has forced hospitals to prioritize COVID-19 patients, restrict resources, and cancel all non-urgent elective cardiac procedures. Clinical visits have only been facilitated for emergency purposes. Fewer patients have been admitted to the hospital for both ST-segment elevation myocardial infarctions (STEMI) and non-ST segment elevation myocardial infarctions (NSTEMI) and a profound decrease in heart failure services has been reported. A similar reduction in the patient presentation is seen for ischemic heart disease, decompensated heart failure, and endocarditis. Cardiovascular services, including catheterization, primary percutaneous coronary intervention (PPCI), cardiac investigations such as electrocardiograms (ECGs), exercise tolerance test (ETT), dobutamine stress test, computed tomography (CT) angiography, transesophageal echocardiography (TOE) have been reported to have declined and performed on a priority basis. The long-term implications of this decline have been discussed with major concerns of severe cardiac complications and vulnerabilities in cardiac patients. The pandemic has also had psychological impacts on patients causing them to avoid seeking medical help. This review discusses the effects of the COVID-19 pandemic on the provision of various cardiology services and aims to provide strategies to restore cardiovascular services including structural changes in the hospital to make up for the reduced staff personnel, the use of personal protective equipment in healthcare workers, and provides alternatives for high-risk cardiac imaging, cardiac interventions, and procedures. Implementation of the triage system, risk assessment scores, and telemedicine services in patients and their adaptation to the cardiovascular department have been discussed.

Coronavirus disease-19 (COVID-19)
Primary percutaneous coronary intervention
Cardiac catheterization
Fig. 1.
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