Fighting the pandemic with collaboration at heart: Report from cardiologists in a COVID-19-dedicated Portuguese intensive care unit

• DOI: 10.1016/j.repce.2021.11.009
• Publication Date: 2021-12-15T20:45:45Z
• Authors: Pedro Ribeiro Que...; Daniel Caeiro; Marta Ponte; Cláudio Guerreiro; Marisa Silva; Sara Pipa; Ana Lúcia Rios; Diana Adrião; Raul Neto; Pedro Teixeira; Gualter Silva; Mariana Silva; Nuno Dias Ferreira; Paula Castelões; Pedro Braga
• Keywords: Adult; Male; Portugal; SARS-CoV-2; COVID-19; Middle Aged; Cuidados intensivos; Cardiologia; Oxigenação por membrana extracorporal; Intensive Care Units; 03 medical and health sciences; Cardiologists; 0302 clinical medicine; Cuidados multidisciplinares; RC666-701; Diseases of the circulatory (Cardiovascular) system; Humans; Original Article; Pandemics; Takotsubo; Aged; Retrospective Studies

The coronavirus disease 2019 (COVID-19) spread quickly around the world. Although mainly a respiratory illness, there is growing interest in non-respiratory manifestations, particularly cardiovascular ones. At our center, mobilization of cardiologists with intensive care training was needed. Our aim is to describe patients with severe COVID-19 admitted to a Portuguese intensive care unit (ICU), the cardiovascular impact of the disease and the experience of cardiologists working in a COVID-19 ICU.Data from adult patients with COVID-19 admitted to the ICU of Centro Hospitalar de Vila Nova de Gaia/Espinho between 16 March 2020 and 21 April 2020 were analyzed retrospectively.Thirty-five patients were admitted. Mean age was 62.6±6.0 years and 23 (65.7%) were male. Dyslipidemia was the most common cardiovascular risk factor (65.7%, n=23), followed by hypertension (57.1%, n=20). Mean ICU stay time was 15.9±10.0 days. Patients had high rates of mechanical ventilation (88.6%, n=31) and vasopressor support (88.6%, n=31). Low rates of new onset left systolic dysfunction were detected (8.5%, n=2). One patient required venoarterial extra-corporeal membrane oxygenation. Mortality was 25% (n=9). Acute myocardial injury and N-terminal pro-B-type natriuretic peptide (NT-proBNP) elevation was detected in 62.9% (n=22). Patients that died had higher NT-proBNP compared to those discharged alive (p<0.05). Care by cardiologists frequently changed decision making.The cardiovascular impact of COVID-19 seems relevant but is still widely unknown. Studies are needed to clarify the role of cardiac markers in COVID-19 prognosis. Multidisciplinary care most likely results in improved patient care.