Article Text

Download PDFPDF

Management principles in patients with COVID-19: perspectives from a growing global experience with emphasis on cardiovascular surveillance
  1. Gruschen R Veldtman1,
  2. Mario Pirisi2,
  3. Enrico Storti3,
  4. Asad Roomi4,
  5. Fadl Elmula M Fadl-Elmula5,
  6. Olga Vriz6,
  7. Sabahat Bokhari7,
  8. Naser Ammash8,
  9. Yezan Salam9,
  10. Guang Zong Liu10,
  11. Stefano Spinelli11,
  12. Greta Barbieri11 and
  13. Shahrukh Hashmi12
  1. 1Adolescent and Adult Congenital Heart Disease Program, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
  2. 2Department of Translational Medicine, Università del Piemonte Orientale, Novara, Novara, Italy
  3. 3Department of Critical Care, Maggiore Hospital, Lodi, Lodi, Italy
  4. 4Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Riyadh, Saudi Arabia
  5. 5Cardiology, Heart Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Riyadh, Saudi Arabia
  6. 6Cardiology, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
  7. 7Cardiology, Columbia University, New York, New York, USA
  8. 8Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
  9. 9College of Medicine, Alfaisal University, Riyadh, Riyadh Province, Saudi Arabia
  10. 10Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, Harbin, China
  11. 11Emergency Medicine Unit, Pisa University Hospital, Pisa, Toscana, Italy
  12. 12Clinical Trials Unit, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
  1. Correspondence to Dr Gruschen R Veldtman; gruschen{at}


The COVID-19, due to SARS-CoV-2, has uncovered many real-world issues when it comes to healthcare management and has led to a widespread mortality. Observations thus far from the reports of COVID-19 have indicated that certain risk groups for example, those with pre-existing cardiovascular (CV) disease, hypertension, diabetes, chronic kidney disease and tobacco use are prone to disease development and specifically development of severe disease and possible fatality. It is increasingly evident that many CV conditions occur frequently. These include myopericarditis, acute coronary syndromes, thrombosis, arrhythmias, hypertension and heart failure. Many professional organisations and societies related to cardiology have produced guidelines or recommendations on most of the above-mentioned aspects. Given these rapid developments, the aims of this review manuscript were to summarise and integrate recent publications with newly developed guidelines and with the first-hand experience of frontline physicians and to yield a pragmatic insight and approach to CV complications of COVID-19. We emphasise on a strategic tier-based approach for initial assessment and management of COVID-19, and then delve into focused areas within CV domains, and additionally highlighting the role of point-of-care ultrasound especially lung ultrasound, echocardiography and electrocardiography, in the management of these patients. We hope this paper will serve as a useful tool in the CV management of COVID-19 for clinicians practicing in both developing and developed countries.

  • coronary artery disease
  • myocarditis
  • anticoagulation

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

Statistics from


  • Twitter @ysalam1

  • GRV and ES contributed equally.

  • Contributors All authors have contributed to the manuscript with respect to its content, but specifically in the overall design, layout and broad messages contained in it. The physicians also agreed on the treatment approaches contained in the manuscript.

  • Competing interests SH has received honoraria from Pfizer, Novartis, Janssen and Mallinckrodt. SH has received travel grants from Gilead, Merck and Sanofi.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement As this is a review article, no datasets are available apart from the published literature.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.