Fausto J. Pinto in Conference - "Cardiovascular Diseases in Times of Pandemic: Direct and Indirect Effects"

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Professor Fausto J. Pinto presented the Conference "Cardiovascular Diseases in Times of Pandemic: Direct and Indirect Effects", which took place online within the scope of the 8th International Congress of Hospitals "Health 6.0: People and Technology", on 27 November.

In his speech, Fausto J. Pinto started by contextualizing, using graphics, the total number of covid-19 cases worldwide, highlighting the main characteristics and specificities of the new coronavirus, and made a summary of the first studies carried out in China that demonstrated a prevalence of comorbidities, namely cardiovascular, in patients infected with SARS Cov-2.

Paying particular attention to the impact of covid-19 on cardiovascular diseases, the Professor considered the existence of a direct and indirect impact. “On the one hand, we have what we can call direct changes, which are directly induced by the virus at the level of the cardiovascular system […] but also what we can designate as secondary involvement, the result, for example, of heart failure conditions that triggered situations that evolved to acute myocardial infarction. He analysed the actual clinical case, originating in England, of an 11-year-old child,  “in which we see for the first time the inclusion of the virus within myocardial cells, which shows that the virus can enter the myocardial cell directly and be responsible for a direct lesion in the cardiac tissue”.

Regarding the effect of the new coronavirus on the heart, Fausto J. Pinto also stated that “the greater the evidence of myocardial injury, the worse the prognosis of these patients”, adding that “there are disease severity markers that are determined by the type of myocardial aggression that was triggered”.

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The Professor also cited the Italian case, with the presentation of graphs illustrating the number of deaths from covid-19 and the relationship between mortality and the “biomarkers of myocardial injury”, also denoting that “the fact that there was concomitant heart disease had a significant impact in terms of prognosis”.

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Presenting the results of the magnetic resonances performed to high competition athletes, healthy adults, who were infected and with mild symptoms of covid-19, Fausto J. Pinto underlined that “although these individuals were asymptomatic or had mild forms of disease, in 15% of the cases there was evidence of myocardial injury”. A fact that can help explain some of the cases of sudden death seen in athletes that gave rise to an interesting debate within the medical community about the possibility of creating an algorithm “to evaluate, in particular, the high competition athletes who are infected, in order to exclude, or if we want to protect, those who, eventually, may be at risk of developing changes that can lead to sudden death”.

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In his intervention, the Professor also presented the conclusions of a meta-analysis, the result of several studies carried out by his work team, which focused on patients who were taking a specific type of medication - “angiotensin converting enzyme inhibitors”-“to try to understand whether or not there was any type of change that justified having to change this medication in this type of patients”. It was concluded, however, that "this type of medication does not interfere, either in the degree of infectiousness or in the severity of the disease that may develop in the affected individuals", he declared.

Regarding the functioning of the Cardiology Service in a pandemic context and the strategies implemented, according to guidelines of the European Society of Cardiology, Fausto J. Pinto explained that a set of criteria were established, with “international consensus”, in order to define the situations of higher and reduced priority, and respective procedures. “Criteria were also defined for not being admitted to the intensive care unit, obviously depending on the evolution of the pandemic”.

Despite the high mortality rate of covid-19, cardiovascular disease remains at the top of the list and is “the number one cause of mortality and morbidity” worldwide, with nearly 18 million victims every year. Hence the importance of discussing the “global phenomenon” that continues to concern the community of cardiologists, quoted Fausto J. Pinto, referring to the “very significant reduction during the pandemic period of hospitalised patients with acute infarction of the myocardium”.

Eradicating fear is, in the Professor's opinion, an important message to send to the population, “because in spite of everything, hospitals are ready to welcome people”, he assured. And although there is “a light” and some optimism with the reality of the vaccine getting closer, Fausto J. Pinto is peremptory: “I would say that we need at least one year to have the situation under control and, therefore, this is the time when we all have to endure\”, alluding to the importance of not letting our guard down regarding compliance with the pandemic containment measures.

Find out more and check  here Professor Fausto J. Pinto's presentation on the impacts of the systemic disease caused by SARS Cov-2 infection on cardiovascular diseases.