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Changing Trends of Mean Pulmonary Artery Pressure Reading During Covid-19 Pandemic Stay at Home Orders

INTRODUCTION: Heart failure patients with difficult to manage volume status and recurrent heart failure exacerbation benefit from CardioMems(TM) placement. This helps in remote monitoring of pulmonary artery (PA) pressure and diuretic dosing can be changed on the basis of these readings preventing h...

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Detalles Bibliográficos
Autores principales: Rai, Devesh, Tahir, Muhammad Waqas, Chowdhury, Medhat, Kharsa, Adnan, Pandela, Satish, Saddique, Irfan, Feitell, Scott
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Published by Elsevier Inc. 2020
Materias:
200
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7527173/
http://dx.doi.org/10.1016/j.cardfail.2020.09.211
Descripción
Sumario:INTRODUCTION: Heart failure patients with difficult to manage volume status and recurrent heart failure exacerbation benefit from CardioMems(TM) placement. This helps in remote monitoring of pulmonary artery (PA) pressure and diuretic dosing can be changed on the basis of these readings preventing hospitalizations. During the COVID-19 pandemic, a stay-at-home order was issued by the state government, which may have led to heart failure deterioration secondary to poor follow up and change in dietary habits. HYPOTHESIS: We aim to evaluate changes in the mean PA pressure during stay-at-home order during COVID-19 pandemic as patients are not seen in clinic and there are presumed changes in dietary habits. METHODS: We identified 26 patients with a history of CardioMems(TM) implant using our heart failure clinic database. We extracted their daily available PA pressure reading before the COVID-19 pandemic and during pandemic. RESULTS: The characteristics of the patients are described in Table 1. 26 cases with were identified with sufficient CardioMems(TM) readings. Average age was 69.7 years with 38.5% females. There were 54% patients with systolic heart failure. Number of COVID-19 cases rose to almost 700 in 1 month. With regression analysis, we observed a trend towards increase in the mean PA pressure readings during the pandemic (R(2) = 0.09, P-value<0.05). The patients also developed symptoms of heart failure exacerbation and were managed remotely with the changes in their medications (57% of cases). The trend of the change in the mean PA pressure readings during pandemic is presumably attributed to decreased activity and dietary changes as patients are staying at home and possibly consuming more canned food. However, none of these patients were hospitalized for heart failure exacerbation suggesting patients being scared of coming to the hospital because of the risk of transmission of COVID-19. CONCLUSIONS: There is an increase in the mean PA pressure during pandemic compared to that of before pandemic likely because of lack of proper food resources and restriction on exercise activity.