According to a recent report in JAMA Cardiology, persons with advanced heart failure and those receiving heart transplants may be at greater risk for poor outcomes, including death, should they contract COVID-19.
Of the 28 patients studied, 80 percent who became ill with the virus were hospitalized. Roughly a third of those admitted and a quarter of the total died from the disease. The study concluded that clinical distancing of these patients could prove beneficial.
Mary Norine Walsh, MD, MACC, medical director of heart failure and transplantation at Ascension St. Vincent Heart Center in Indianapolis and past president of the American College of Cardiology, spoke to Healio - Cardiology Today about the study and a related paper published in The Journal of Heart and Lung Transplantation by her team.
Before the COVID-19 pandemic, patients with advanced heart failure and cardiac transplant underwent care at Ascension St. Vincent Hospital Indianapolis, the main facility where heart transplantation was performed, according to the paper by Dr. Walsh and colleagues.
“Our primary transplant hospital anticipated a surge of patients with COVID-19 infection, many of whom might require medical ICU support,” Dr. Walsh said.
Because of demand, Ascension St. Vincent Hospital was redesigned to care for patients with COVID-19. Ascension St. Vincent Heart Center decided to protect its heart failure and transplant patients from infection by safely moving them from Ascension St. Vincent Hospital to a smaller cardiac specialty hospital just over five miles away, which had no known patients with COVID-19.
“In the planning for this surge, it was clear that our transplant patients would likely be at less risk at our system’s cardiac specialty hospital,” Dr. Walsh said.
“The patients who were moved were all stable at the time of ambulance transfer,” Dr. Walsh told Healio. “All were accompanied by experienced transplant and heart failure ICU professionals.”
She said the plan also involved transferring staff to the specialty hospital.
“In addition to the advanced heart failure and transplant cardiologists and nurse practitioners who shifted to our campus, critical care transplant nursing staff were reassigned to the cardiac specialty hospital in order to provide seamless care to our patients,” she said. “The PharmD and physical therapy staff who work with our patients shifted as well.”
Using a single-bed concept, the specialty hospital enabled patients to remain in their room throughout the course of their hospital stay, receiving the entire spectrum of care – perioperative and intensive care, hemodynamic monitoring, and complete device and cardiac management – in a single setting, according to the paper by Dr. Walsh and colleagues. That in turn minimized their potential exposure to COVID-19.
“It is important to underscore the point that all decisions were patient-centric,” Dr. Walsh added. “Protection of a vulnerable population was and continues to be the goal.”