Cardiology Letters 2020, 29(2):73-77

Health-care workers and patient focused proposal for anti-epidemic management during the COVID-19 epidemics in Slovakia

Hatala R

Klinika kardiológie a angiológie Národný ústav srdcových a cievnych chorôb a. s. a Lekárská fakulta Slovenskej zdravotníckej univerzita v Bratislave, Slovenská republika

The aim of the presented proposal is to counteract the dramatic spread of the COVID-19 disease and to target reduction of its high case fatality rate by risk stratification during the early phases of the disease. Two key factors have contributed to the catastrophic extent of the disease in several countries: - Most of the known COVID-19 hotspots were locally preceded by massive gatherings of up to several hundred-thousand people (sporting events, religious pilgrimages etc.). - Widespread, mostly subclinical infection of health care workers (HCW) in the hospitals of the hotspot regions inabled a crucial dramatic virus transmission to elderly population. Replication of the former factor for virus spread is actually stoped by measures preventing people from assembling. However, HCW represent at least 11% of the total infected population and they still suffer from suboptimal availability of protective gear. The following targeted steps are proposed: 1. Continuous periodic PCR "pooled testing" of at least all frontline and hospital based HCW (optimally all HCW) at 7-day intervals and strict immediate quarantine of all SARS-CoV-2 positive persons. 2. Early targeted clinical examination of all symptomatic COVID-19 patients together with assessment of the several biomarkers (mainly parameters of inflammation, thrombophilia, and organ damage - heart and liver) aiming at early risk stratification. Thus, this proposal represents a complementary sustainable strategy to general anti-epidemic measures it could be of help to achieve 3 crucial goals: 1. To minimize virus spread in and from health-care facilities; 2. To protect HCW; 3. To identify COVID-19 patients at high risk for adverse, frequently lethal, outcome.

Keywords: COVID-19; testing; prognosis; biomarkers

Published: February 1, 2020  Show citation