As cities emerge from the pandemic lockdown, leading ambulatory cardiac monitoring provider InfoBionic and other industry experts are asking how the shutdowns can potentially affect heart health. One important aspect of learning more about the novel coronavirus' implications on the body's organs is the now unrefuted understanding of its impact on the hearts of previously healthy people and those with some type of heart condition.1 "Determining the impact on heart health during COVID-19 lockdown for healthy people and preexisting heart condition patients is one major challenge," says Stuart Long, the CEO of InfoBionic. "The other is how to deal with the significant and broader influx of people requiring remote cardiac monitoring to avoid life-threatening heart-related outcomes from COVID-19."
When COVID-19 began to emerge, cardiac damage was a consistent finding indicating a broader problem. Health researchers now know that those with preexisting conditions, those with undiagnosed heart disease and a subset of previously healthy COVID-19 patients are at major risk.2 Just as more will be known about these groups through further studies in the next several months, the same can be said about the effects of the lockdown itself on these groups.
While CDC data shows that coronavirus cases dropped 44% during shelter-in-place orders, the heart health effects of that time period have yet to emerge via studies.3 What we do know is that this is sure to be a mixed bag of health outcomes when you add in the fact that heart inflammation can be life threatening, and it can happen in people who don't have any preexisting risk factors. Inflammation that leads to atrial fibrillation (AF) can come from a wide verity of health conditions. Studies show COVID-19 can attack organs like the heart and brain, as well as the respiratory system as a consequence of inflammation.4 The question of whether lockdown is and has been bad for the heart is an ongoing one. Some observational data shows that lockdown has potentially improved heart health since it has resulted in lower resting heart rates, more people exercising and adhering better to medication regimens.5
There is also an equal amount of observational and anecdotal data showing how lockdown may lead to a more sedentary life, which increases cardiovascular stress and danger for all groups.6 In cases where people have preexisting conditions like AF that are linked or directly involve cardiovascular disease, remote cardiac monitoring may be key as they return to more regular routines or continue in lockdown.
Whether its fear of infection, sedentary lockdown lifestyles, or lack of knowledge, the pandemic has profoundly impacted cardiac care and intervention. Evidence shows that ER visits decreased by 42% over four weeks in April, compared with the same period in 2019 and rebounded somewhat to 26 percent in May during the pandemic.7 The concern is that people with serious medical conditions, like CVD, are avoiding hospitals, according to CDC analysis.8
More leading healthcare voices are saying in-person cardiac care visits are now safer in specific areas of the country, though a significant portion of patients may still be hesitant to do so.9 Major North American cardiovascular societies are simultaneously issuing guidance for health professionals on safely reintroducing diagnostic tests and invasive cardiovascular procedures, with an eye to regions with lower rates of infection.10 Non-invasive heart monitors for cardiac arrhythmia detection are a crucial diagnostic tool in all vulnerable patient scenarios.
What is clear in all of this is that the pandemic has profoundly changed things societally and in terms of health and healthcare for the foreseeable future. This means that more fact-based studies and evidence are necessary to know where we are in terms of cardiovascular risk cross populations, and where we need to go in the future.
"Cardiologists need real-time full disclosure data from remote cardiac monitoring and accurate alerts for ambulatory homebound and post lockdown cardiovascular patients for quick action that could saves lives," Long says. "Solutions like the MoMe® Kardia platform have an important role to play in remote diagnosis and ongoing empirical data studies that contribute to understanding of the pandemic's long-term effects and treatment."
InfoBionic is a digital health company transforming the efficiency and economics of ambulatory remote patient monitoring processes by optimizing clinical and real-world utility for the users that need it most —physicians and their patients. The Massachusetts-based team of seasoned entrepreneurs leverages successful careers in healthcare, IT, medical devices, and mobile technology, along with specific expertise in remote monitoring and cardiology. Their first-hand experience with the complexities of traditional cardiac arrhythmia detection and monitoring processes led to design of the transformative MoMe® Kardia platform to remove the roadblocks, thus amounting to a faster and more effective process for decision-making and diagnosis. InfoBionic is the recipient of the Frost & Sullivan 2019 North American Remote Cardiac Monitoring Technology Leadership Award. For more information, visit http://www.infobionic.com.
1. Cohut M. New study warns of COVID-19 impact on cardiovascular health. Medical News Today. Published May 19, 2020. Available at medicalnewstoday.com/articles/new-study-warns-of-covid-19-impact-on-cardiovascular-health.
2. Pesheva E. COVID-19 may spark cardiac trouble in multiple ways. Harvard Gazette. Published April 14, 2020. Available at news.harvard.edu/gazette/story/2020/04/covid-19s-consequences-for-the-heart/.
3. Coronavirus cases plummet by 44% due to shelter-in-place orders, according to this study drawing on CDC data. MarketWatch. Published May 5, 2020. Available at marketwatch.com/story/coronavirus-cases-drop-by-up-to-44-due-to-shelter-in-place-orders-study-drawing-on-cdc-data-shows-2020-05-04.
4. These are the ways doctors think coronavirus can attack the body. World Economic Forum. Published May 1, 2020. Available at weforum.org/agenda/2020/05/covid-19-lungs-heart-blood-brain/.
5. Coronavirus doctor's diary: Is lockdown good for your heart? BBC News. Published May 5, 2020. Available at bbc.com/news/health-52535044.
6. O'Riordan M. COVID-19 Lockdown Inactivity May Spell Trouble for CVD Prevention. TCTMD. Published April 24, 2020. Available at tctmd.com/news/covid-19-lockdown-inactivity-may-spell-trouble-cvd-prevention.
7. Abelson R. E.R. Visits Drop Sharply During Pandemic. New York Times. Published June 3, 2020. Available at nytimes.com/2020/06/03/health/hospitals-coronavirus.html.
8. Hartnett KP, et al. Impact of the COVID-19 Pandemic on Emergency Department Visits — United States, January 1, 2019–May 30, 2020. CDC. Published June 3, 2020. Available at cdc.gov/mmwr/volumes/69/wr/mm6923e1.htm.
9. Life after lockdown should start with this healthy to-do list. American Heart Association. Published June 3, 2020. Available at heart.org/en/news/2020/06/03/life-after-lockdown-should-start-with-this-healthy-to-do-list.
10. Safe Reintroduction of Cardiovascular Services during the COVID-19 Pandemic: Guidance from North American Society Leadership. The Annals of Thoracic Surgery. Published April 27, 2020. Available at annalsthoracicsurgery.org/article/S0003-4975(20)30688-3/pdf.