IJCS | Volume 33, Nº3, May / June 2020

DOI: https://doi.org/10.36660/ijcs.20200080 The COVID- 19 pandemi c , c aus ed by t he betacoronavirus SARS-CoV-2, has rapidly spread worldwide from the city of Wuhan, China. Since its beginning, it has affectedmore than 2,700,000 individuals and caused almost 185,000 deaths in 185 countries, compounding the difficulties in medical healthcare worldwide. By April 23, 2020, Brazil had registered almost 47,000 confirmed cases and 3,000 deaths. 1 COVID-19 aggravates the inequalities and uncertainties of science in general. This is no different when it comes to the heart. Unlike other epidemics caused by respiratory viruses, COVID-19 affects the heart, not only because most confirmed cases and deaths involve individuals with hypertension, heart failure, arrhythmias and coronary artery disease, but also because the disease is associated with a higher number of cardiac complications, such as myocardial injury, cardiogenic shock, Takotsubo syndrome, pulmonary embolism, myocarditis and arrhythmia. 2 Apart from inflammation, endothelial activation, oxidation of low-density lipoproteins, platelet activation and tissue factor expression caused by respiratory virus epidemics, such as severe acute respiratory syndrome (SARS) and Middle-East respiratory syndrome (MERS), poor COVID-19 prognosis is compounded by the deleterious effect of the association of treatment drugs (chloroquine/ azithromycin) that can cause malignant arrhythmias in patients with heart disease. 3 The challenges concerning COVID-19 are huge, because it tests us all - patients, healthcare personnel, health systems and the general population. In light of this, the importance of the safety of healthcare workers has never been so emphasized. 2 Working in a hospital during a pandemic of a highly contagious disease, suchasCOVID-19, reminds healthcare workers of the need to reinforce all safety measures inside a cardiac catheterization laboratory (CCL). That is because, in addition to the cardiovascular alterations due to COVID-19, patients with cardiovascular diseases, such as acute myocardial infarction and advanced structural diseases, continue to require interventional procedures. Therefore, the safety measures for healthcare professionals and patients become even more important during the COVID-19 pandemic. Some of the safety issues that might affect both patients and healthcare personnel are as follows: ionizing radiation, equipment, and contact with chemical and biological agents. All health professionals in contact with patients should follow the local and national guidelines for infection control and use of personal protective equipment (PPE), which should be available and on hand for all staff members. In addition, strict adherence to all safety rules required for a catheterization procedure indication should be encouraged; moreover, all urgent cases should be prioritized, and all routine cases postponed if this carries no loss to either prognosis or the patients’ quality of life. 4 The Brazilian Society of Interventional Cardiology (SBHCI) has published a position statement on some general measures to tackle COVID-19: limitation of social exposure; adoption of stricter personal hygiene habits; home confinement of individuals with the mild 288 VIEWPOINT International Journal of Cardiovascular Sciences. 2020; 33(3):288-294 Mailing Address: Gláucia Maria Moraes de Oliveira Universidade Federal do Rio de Janeiro – R. Prof. Rodolpho P. Rocco, 255 – Prédio do HU 8º andar – sala 6, UFRJ. Postal Code: 21941-913, Cidade Universitária, RJ – Brazil. E-mail: glauciam@cardiol.br, glauciamoraesoliveira@gmail.com Covid-19 and Safety in the Cath Lab: Where We Are and Where We Are Headed Giordana ZeferinoMariano, 1 V iviana Guzzo Lemke , 2 M aria Sanali Moura Paiva, 3 G láucia Maria Moraes de Oliveira 4 Hospital São João Batista, 1 Criciúma, SC – Brazil Hospital das Nações, Curitiba, 2 PR – Brazil Universidade Federal do Rio Grande do Norte (UFRN), 3 Natal, RN – Brazil Universidade Federal do Rio de Janeiro (UFRJ), 4 Rio de Janeiro, RJ – Brazil Manuscript received April 23, 2020; revised manuscript April 25, 2020; accepted April 26, 2020. Coronavirus; COVID-19; Pandemics; Pathological Conditions, Signs andSymptoms; Fever; Cough; Dyspnea; Fatigue; Diarrhea; Chest Pain; Mental Confusion; Myalgia, Cardiovascular Diseases/complications; Safety. Keywords