COVID-19 symptoms worse in patients with underlying heart disease — Expert

In the current wave of COVID-19, it is possible that symptoms of cardiovascular diseases be wrongly assumed to be those of COVID-19 as patients may be confused in differentiating the clinical signs of both.

To further enlighten the public about these, a consultant cardiologist and Chairperson of Medical and Dental Consultants of Nigeria, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Dr Tamaraemumoemi Emmanuella Okoro, was in the spotlight and responded to questions from Tribune Online. Highlights of the questions and responses from Dr Okoro are as captured below:

How would you describe the relationship between COVID-19 clinical signs and those of cardiovascular diseases?

The clinical signs of COVID-19 include fever, cough, difficulty in breathing, sore throat, running nose, loss of smell, nausea, diarrhoea and extreme fatigue. Some of the symptoms closely resemble those of patients with cardiovascular disease, such as heart failure, and therefore, there could be a misdiagnosis. For example, patients with heart disease could also present with difficulty in breathing, extreme fatigue, cough and even nausea.

Also, COVID-19 symptoms are worse in patients who already have heart disease. It’s important to see a doctor so he or she can differentiate your symptoms and make the right diagnosis, so you can get the right treatment for your symptoms.

Some patients are afraid of coming to the hospital during this pandemic for fear of contracting COVID-19. As the chairperson of medical and dental consultants, are there measures put in place in your hospital to make sure Covid patients attending CV clinics are not at risk of Covid?

No one should fear coming to the hospital because measures have been put in place to prevent the transmission of COVID-19 from one patient to another or even from hospital staff to patients. The hospital has taken great measures to put precautions in place to keep everyone safe. As the chairperson of the Medical and Dental Consultants Association of the only teaching hospital here in Bayelsa State, I can assure you that my colleagues and I, together with the doctors in residency training, are all working with the hospital management to make sure our patients get the best care during this pandemic.

In specific terms, can you mention any measures put in place and its effectiveness, if any?

Several protocols are in place for effective triaging in the clinics and emergency rooms during this COVID-19 pandemic. For example, as a Cardiologist, I proposed and developed a protocol for effective triaging of patients presenting to the cardiology clinic. The protocol was well vetted by other experts and was used in our facility.

It has been effective in preventing cross-contamination between patients. I am aware that the protocol has received widespread application beyond our hospital due to its ease of adaptability and success recorded at our teaching hospital. Following the application of this protocol, we have had reduced mortality among our patients with heart disease while effectively isolating and treating patients with COVID-19. It has been a multidisciplinary team effort.

How would you advise patients with CVDs during this pandemic?

Patients with CVDs should be assured that we are doing everything possible to keep them safe while providing treatment for them. Patients who are hypertensive, or diabetic or have cholesterol issues or are on management for heart failure, stroke, or ischemic heart disease, popularly known as “heart attacks” should not be afraid to come for a check-up in the hospital. They should continue on their prescribed medications and maintain good hygienic practices of hand washing or use of sanitisers and maintenance of 6-feet safe distance. If they have symptoms of cough or difficulty in breathing, they should not assume the diagnosis; instead, they should come to the hospital and see their doctor.

No doubt you and your colleagues are exposed to health risks more than ever during this period. Any advice for your colleagues?

I would advise my colleagues to stay strong and stay safe. We are learning more about the virus every day, and we will get through this pandemic by the grace of God. We should practice what we preach to patients and use our face masks properly, wash our hands frequently and maintain a safe distance where possible.

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