The COVID-19 pandemic – Many unknowns we have to face with
Maria Dorobantu, Sebastian Onciul*
Cardiology Department, Clinical Emergency Hospital, Bucharest, Romania
Cardiology Department, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
The Coronavirus Disease 2019 (COVID-19) Pandemic had a great impact on healthcare systems. Cardiology practice has been deeply changed in the past few months. In this context we have decided to dedicate this issue of our Journal to the Hypertension management in the era of COVID-19. This Editorial Foreword summarizes the current status of the Pandemic and presents the papers included in this issue of the Journal.
J Hypertens Res (2020) 6(2):33–35 [download PDF]
The ups and downs of telemedicine in treating arterial hypertension
Maria Pana, Victor Cojocaru, Stefan Sebastian Busnatu*
University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
Crises are opportunities for change, development and innovation. Faced with extensive local difficulties as insufficient hospital capacity, medical equipment and personnel, normally slow-moving healthcare systems have improvised and innovated in response to the COVID-19 pandemic. Few could have foreseen that arterial hypertension and its treatment would become a hot topic during these difficult times. Although the idea of using information communications technology (ICT) to provide remote health care services has been born for some time with the general purpose to minimize the frequently visits that patients had to do, in the fire of a pandemic we see benefits of this technology that first were unthinkable to most of us.
J Hypertens Res (2020) 6(2):36-39 [download PDF]
Treating hypertension through telemedicine in the COVID-19 era: will we ever go back to conventional consultations?
Martino F. Pengo1, Camilla Torlasco1, Grzegorz Bilo1,2, Gianfranco Parati1,2*
1 IRCCS Istituto Auxologico Italiano, Department of Cardiovascular, Neural and Metabolic Sciences, Milan, Italy
2 Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
The recent coronavirus disease 2019 (COVID-19) outbreak has shown that adopting telemedicine to obviate the need for physical meetings between patients and health providers is a sensible approach in particular when patients are asked to stay at home to prevent the spread of COVID-19 infection. Hypertension centres could continue to provide high quality health care while minimising the risk of COVID-19 exposure and integrating telemedicine in the routine evaluation and follow up of patients with high blood pressure.
J Hypertens Res (2020) 6(2):40-42 [download PDF]
The target organ damage in hypertension - the link to worse prognosis of COVID19 patients
“Carol Davila”University of Medicine and Pharmacy Bucharest,
Clinical Emergency Hospital Bucharest, Cardiology Department, Romania
From the report of the first case of COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV2) in December 2019 from Wuhan China, by June 1st 2020, 8.596.037 confirmed cases worldwide have been reported. Hypertension (HT) appears to increase the severity of COVID-19 and mortality risk both directly and indirectly. The immune system plays an important role in hypertension and hypertension-mediated organ damage. The invasion of SARS-CoV2 into the organism of a hypertensive patient, which already has a deleterious inflammatory immune response, can therefore more easily drive a quicker and exacerbated inflammatory response, leading more often, through cytokine storm, to severe ARDS forms, with worse prognosis for COVID-19 hypertensive patients.
J Hypertens Res (2020) 6(2):43-47 [download PDF]
Caring for the hypertensive patients during COVID-19 pandemic. The outpatient clinic manager perspective – reconfiguring the service during the pandemic
Emerald Medical Center, Bucharest, Romania
The administrative management of a clinic during the pandemic was not the easiest job to do, taking into account that we had to consider the patient’s needs, the doctors’ concerns and always balancing decisions from a financial point of view, making everything sustainable for the post-pandemic period. Telemedicine was a solution for our patients, but it was implemented too fast, without much certainty for our doctors (particularly from a legal point of view – are doctors exempted from the legal responsibility for tele-prescriptions taken in a wrong manner by the patient?) and considering the fact no person can rely on telemedicine legislation after the COVID-19 pandemic (currently the legislation is only available until June or September for some medical services). Telemonitoring could be the solution for a pandemic in case of hypertensive patients, but there are too many devices that do not comply yet with the needs of medical staff and which are not able to provide results, as accurate as a traditional BP Holter monitoring. We are confident that by the end of 2020, patients with hypertension will be monitored with better, faster, cheaper and easier to use devices. Everyone learned their lessons during this pandemic, from our medical staff (who is more open to proactively reach their patients) to our patients (more attentive to their healthcare status) and the administrative departments of private clinics (to reach their full potential with as efficient as possible resources use).
J Hypertens Res (2020) 6(2):48-51 [download PDF]
ACEI/ARB therapy during COVID-19 pandemic
Alexandra Paval, Maria Dorobantu
Cardiology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
The coronavirus disease 2019 (COVID-19) epidemic was caused by an infection with a new type of coronavirus, that is responsible for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and unfortunately, continues to endanger global health. Although the clinical manifestations of COVID-19 predominate in the respiratory system, some patients may also have severe cardiovascular (CV) damage. Research conducted over the past several months have indicated that patients with cardiovascular diseases are at a higher risk of complications and mortality from SARS-CoV-2 (1). Recently, the main concern for all has been to identify a causal relationship between the use of RAAS (renin–angiotensin-aldosterone system) inhibitors (angiotensin converting enzyme inhibitors -ACEIs, and angiotensin II receptor blockers- ARBs) in patients infected with COVID-19 and the course of this infection. It had also been speculated that these agents could increase the susceptibility to contracting COVID-19. Although much research has been done over the past two months, the use of angiotensin converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) remains an open topic of major interest to clinicians treating COVID-19 in patients with cardiovascular disease. After a detailed analysis of the data, recent studies have revealed a theoretical benefit of ACEIs / ARBs in patients infected with SARS-CoV-2, but we opine that there is not yet strong enough evidence to support a correlation. What is well known so far is that the withdrawal of these drugs from the scheme of patients with chronic cardiovascular disease could be detrimental to the evolution and complications of this COVID-19 infection.
J Hypertens Res (2020) 6(2):52-58 [download PDF]