ABC | Volume 114, Nº5, May 2020

Review Article Costa et al. The heart and COVID-19 Arq Bras Cardiol. 2020; 114(5):805-816 with the Brazilian Ministry of Health, recognized the possibility and ethical character of telemedicine regarding teleguidance, teleconsultation, and telemonitoring. 67 General recommendations • Intensify the care and preventivemeasures against the novel coronavirus infection in the population with CVD. • Patients with CVD should be managed according to current guidelines, ensuring the best treatment available for chronic illnesses. • It is essential that patients withCVDmaintain strict adherence to proper diet, regular sleep and physical activity, avoiding tobacco and alcohol consumption. • It is important to update vaccines. This includes the pneumococcal vaccine, because of the increased risk of bacterial infection secondary to SARS-CoV-2, and the influenza vaccine, indicated for patients with CVD. • Outpatient appointments as well as elective tests and procedures should be postponed if clinical discretion determines they are not essential and if not performing themneither increases the risk of events nor hinders the clinical management of an underlying CVD. Telemedicine should be used to help patient’s follow-up. • The number of healthcare professionals taking part in ward rounds for patients should be reduced, and online discussion should be implemented. Conclusions COVID-19 is potentially severe and has a high spread rate. Current data available are mainly derived from retrospective studies and should be cautiously interpreted. However, current evidence already shows the need to pay special attention to patients at risk and the importance of the proper management of cardiovascular complications, with rapid identification and implementation of adequate treatment. Author contributions Conception and design of the research: Costa IBSS, Bacal F, Oliveira GMM, Lacerda MVG, Barberato SH, Chagas ACP, Rochitte CE, Ramires JAF,Kalil Filho R, Hajjar LA; Acquisition of data and Writing of the manuscript: Costa IBSS, Bittar CS, Rizk SI, Everaldo Filho A, Queiroz KA, Machado TIV, Andrade FTA, Arévalo ANG, González TB, Almeida JP; Analysis and interpretation of the data: Costa IBSS, Bittar CS, Rizk SI, Everaldo Filho A, Queiroz KA, Machado TIV, Andrade FTA, Lopes MACQ, Arévalo ANG, González TB, Almeida JP; Critical revision of the manuscript for intellectual content: Costa IBSS, Lopes MACQ, Bacal F, Oliveira GMM, Lacerda MVG, Barberato SH, Chagas ACP, Rochitte CE, Ramires JAF,Kalil Filho R, Hajjar LA. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding There were no external funding sources for this study. Study Association This study is not associated with any thesis or dissertation work. Ethics approval and consent to participate This article does not contain any studies with human participants or animals performed by any of the authors. 1. Clerkin KJ, Fried JA, Raikhelkar J, Sayer G, Griffin JM, Masoumi A, et al. Coronavirusdisease2019(COVID-19)andcardiovasculardisease.Circulation. 2020Mar 21. [Epub ahead of print]. 2. Ganatra S HS, Hammond SP, Nohria A. The novel coronavirus disease (COVID-19) threat for patients with cardiovascular disease and cancer. JACC CardioOncology. 2020Mar. [Epub ahead of print]. 3. Mizumoto K, Kagaya K, Zarebski A, Chowell G. Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. 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