Cardiovascular conditions and COVID-19

Cardiovascular conditions and COVID-19

Last updated 1 Jun 2020

Authors: Dr Jacqui Bollmann, Consultant Occupational Physician

Dr Tony Williams, Consultant Occupational Physician, Working Fit Ltd

 

Cardiovascular conditions

 

 

Vulnerability

 

 

References

 

Angina

That restricts your daily life

Frequent use of GTN

Add 3 years Provisional figure, may be higher
Angina

Well controlled

Increased
Atrial fibrillation Increased or low https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/coronavirus-and-your-health

insufficient evidence at present to stratify risk

Brugada syndrome

Long QT syndrome

Increased

May need extra ECG monitoring

Avoid very high pyrexia

https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/coronavirus-and-your-health
Cardiomyopathy

With breathlessness

Limits daily life

Associated with problems with heart function

Add 9 years Provisional figure, may be higher
Cardiomyopathy

Well controlled with treatment

Increased
Cardiovascular disease

general

Add 3 years

 

Provisional figure, may be higher

OR 3.42 quoted for severe disease JORDAN, R. E., et al. 2020. Covid-19: risk factors for severe disease and death. Bmj, 368, m1198.

Congenital heart disease

With lung disease

pulmonary hypertension

heart failure

complex (Fontan, single ventricle, cyanosis etc.)

Add 9 years Provisional figure, may be higher
Coronary heart disease

Any past history of

MI

Stent

Bypass surgery

Add 3 years Provision figure, may be higher
Diabetes

And any heart condition

Add the appropriate age for diabetes relevant to control level
Endocarditis https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/coronavirus-and-your-health

there is no evidence COVID-19 causes endocarditis

Heart failure

 

Add 9 years Provisional figure, may be higher
Heart transplant Very high

(shield)

 

Add 16 years

https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/coronavirus-and-your-health

https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19

Heart valve disease

Severe

Symptoms including breathlessness

Awaiting valve surgery

Add 9 years Provisional figure, may be higher
Heart valve

Asymptomatic murmur

Low
Hypertension No additional added age No evidence for hypertension as a separate vulnerability factor
Myocarditis, in past Low There is no evidence a past history of myocarditis would place patients at increased risk.
Myopericarditis

Completed all treatment (NSAIDs/Colchicine)

No complications

At least three months from diagnosis

As per pericarditis below
Kidney disease

CKD 3, 4 and 5, in addition to heart disease

Add another 6 years
Pacemaker Depends on underlying pathology https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/coronavirus-and-your-health

Pacemaker itself does not increase risk

Pericarditis, Acute

Symptomatic

High or increased depending on symptoms, complications and treatment https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2015/10/30/12/01/2015-esc-guidelines-for-the-diagnosis-and-management-of-pericardial-diseases

 

https://www.hse.ie/eng/health/az/p/pericarditis/treating-pericarditis.html

 

https://www.uptodate.com/contents/recurrent-pericarditis?topicRef=15800&source=see_link

Pericarditis, Acute

Benign course with response to treatment and

  • Completed all treatment ( NSAID, 3/12 colchicine).
  • Returned to strenuous activity
  • Uncomplicated (no tamponade, effusion)
  • At least three months from diagnosis
Low https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2015/10/30/12/01/2015-esc-guidelines-for-the-diagnosis-and-management-of-pericardial-diseases

 

https://www.hse.ie/eng/health/az/p/pericarditis/treating-pericarditis.html

 

https://www.uptodate.com/contents/recurrent-pericarditis?topicRef=15800&source=see_link

Pericarditis caused by:

Tuberculosis

Rheumatoid arthritis, SLE

Radiotherapy

Renal failure

Hypothyroidism

Cancer

Myocardial infarction

Trauma: post-surgery/RTA

medication

Will depend on underlying cause and complications

 

Likely to be high for majority

https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2015/10/30/12/01/2015-esc-guidelines-for-the-diagnosis-and-management-of-pericardial-diseases

 

https://www.hse.ie/eng/health/az/p/pericarditis/treating-pericarditis.html

 

https://www.uptodate.com/contents/recurrent-pericarditis?topicRef=15800&source=see_link

Pericarditis, recurrent Low to increased as per acute depending on recurrent episode Consider treatment that the individual has been on in cases of refractory symptoms, as this may include prednisolone and immune therapy
Pregnant

With significant heart disease

Very high, shield https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/coronavirus-and-your-health

https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19

Respiratory disease

And any heart disease

Add relevant age factor
Smoking with any heart disease No additional age added No evidence that smoking is a separate vulnerability factor
Stroke

With any heart condition

Add 9 years https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/coronavirus-and-your-health
Surgery

Open heart surgery in last three months

Very high https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/coronavirus-and-your-health
Vascular dementia

With any heart condition

Add 9 years https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/coronavirus-and-your-health

RELATED CONTENT

Vulnerability levels

Very high (Red)

Risk of severe illness or death if contracts COVID-19. Read more

High (Orange)

Likely to need hospitalisation if contracts COVID-19, with protracted illness and heavy NHS burden. Read more

Increased/Moderate (Yellow)

Increased risk compared with healthy individual but should recover.

Low/Standard (Green)

No greater risk than healthy individual.