The impact of novel coronavirus COVID‐19 on noncommunicable disease patients and health systems: a review

Coronavirus disease 2019 (COVID‐19) is an ongoing global pandemic affecting all levels of health systems. This includes the care of patients with noncommunicable diseases (NCDs) who bear a disproportionate burden of both COVID‐19 itself and the public health measures enacted to combat it. In this review, we summarize major COVID‐19‐related considerations for NCD patients and their care providers, focusing on cardiovascular, pulmonary, renal, haematologic, oncologic, traumatic, obstetric/gynaecologic, operative, psychiatric, rheumatologic/immunologic, neurologic, gastrointestinal, ophthalmologic and endocrine disorders. Additionally, we offer a general framework for categorizing the pandemic’s disruptions by disease‐specific factors, direct health system factors and indirect health system factors. We also provide references to major NCD medical specialty professional society statements and guidelines on COVID‐19. COVID‐19 and its control policies have already resulted in major disruptions to the screening, treatment and surveillance of NCD patients. In addition, it differentially impacts those with pre‐existing NCDs and may lead to de novo NCD sequelae. Likely, there will be long‐term effects from this pandemic that will continue to affect practitioners and patients in this field for years to come.

[1]  Shaima Hussain Alnajjad,et al.  Implications for COVID-19 , 2022, International journal of health sciences.

[2]  T. Tabuchi,et al.  Coronavirus Disease , 2021, Encyclopedia of the UN Sustainable Development Goals.

[3]  Jing Cheng,et al.  Association Between Youth Smoking, Electronic Cigarette Use, and COVID-19 , 2020, Journal of Adolescent Health.

[4]  R. Fiocca,et al.  Lung fibrosis: an undervalued finding in COVID-19 pathological series , 2020, The Lancet Infectious Diseases.

[5]  P. Kirchhof,et al.  Association of Cardiac Infection With SARS-CoV-2 in Confirmed COVID-19 Autopsy Cases. , 2020, JAMA cardiology.

[6]  Eike Nagel,et al.  Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19) , 2020, JAMA cardiology.

[7]  S. Gilboa,et al.  Characteristics of Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status — United States, January 22–June 7, 2020 , 2020, MMWR. Morbidity and mortality weekly report.

[8]  P. Matthews,et al.  Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study , 2020, The Lancet Psychiatry.

[9]  Kipp W. Johnson,et al.  Prevalence and Impact of Myocardial Injury in Patients Hospitalized With COVID-19 Infection , 2020, Journal of the American College of Cardiology.

[10]  M. Shishehbor,et al.  Impact of COVID‐19 pandemic on ST‐elevation myocardial infarction in a non‐COVID‐19 epicenter , 2020, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[11]  Jason M. Nagata,et al.  Screen Time for Children and Adolescents During the Coronavirus Disease 2019 Pandemic , 2020, Obesity.

[12]  E. Klang,et al.  Severe Obesity as an Independent Risk Factor for COVID‐19 Mortality in Hospitalized Patients Younger than 50 , 2020, Obesity.

[13]  S. Shulman.  Pediatric COVID-associated Multi-system Inflammatory Syndrome (PMIS). , 2020, Journal of the Pediatric Infectious Diseases Society.

[14]  Scott D. Solomon,et al.  Fewer Hospitalizations for Acute Cardiovascular Conditions During the COVID-19 Pandemic , 2020, Journal of the American College of Cardiology.

[15]  D. Kansagara,et al.  Risks and Impact of Angiotensin-Converting Enzyme Inhibitors or Angiotensin-Receptor Blockers on SARS-CoV-2 Infection in Adults , 2020, Annals of Internal Medicine.

[16]  P. Spagnolo,et al.  Pulmonary fibrosis secondary to COVID-19: a call to arms? , 2020, The Lancet Respiratory Medicine.

[17]  B. Bozkurt,et al.  Joint HFSA/ACC/AHA Statement Addresses Concerns Re: Using RAAS Antagonists in COVID-19 , 2020, Journal of Cardiac Failure.

[18]  L. Argaud,et al.  Assessment of QT Intervals in a Case Series of Patients With Coronavirus Disease 2019 (COVID-19) Infection Treated With Hydroxychloroquine Alone or in Combination With Azithromycin in an Intensive Care Unit. , 2020, JAMA cardiology.

[19]  P. Zimetbaum,et al.  Risk of QT Interval Prolongation Associated With Use of Hydroxychloroquine With or Without Concomitant Azithromycin Among Hospitalized Patients Testing Positive for Coronavirus Disease 2019 (COVID-19). , 2020, JAMA cardiology.

[20]  J. Connors,et al.  COVID-19 and its implications for thrombosis and anticoagulation , 2020, Blood.

[21]  Eun Ji Kim,et al.  Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. , 2020, JAMA.

[22]  Sunil V. Rao,et al.  Management of acute myocardial infarction during the COVID‐19 pandemic , 2020, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[23]  Pibao Li,et al.  Clinical Characteristics of COVID-19 Patients With Digestive Symptoms in Hubei, China: A Descriptive, Cross-Sectional, Multicenter Study , 2020, The American journal of gastroenterology.

[24]  C. Schmidt,et al.  Reduction in ST-Segment Elevation Cardiac Catheterization Laboratory Activations in the United States During COVID-19 Pandemic , 2020, Journal of the American College of Cardiology.

[25]  Cdc Covid- Response Team.  Preliminary estimates of the prevalence of selected underlying health conditions among patients with coronavirus disease 2019 — United States, February 12–March 28, 2020 , 2020 .

[26]  Emily N. Ussery,et al.  Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients with Coronavirus Disease 2019 — United States, February 12–March 28, 2020 , 2020, MMWR. Morbidity and mortality weekly report.

[27]  Marc A Pfeffer,et al.  Renin–Angiotensin–Aldosterone System Inhibitors in Patients with Covid-19 , 2020, The New England journal of medicine.

[28]  C. Beyrer,et al.  Undocumented U.S. Immigrants and Covid-19. , 2020, The New England journal of medicine.

[29]  Roberto Maroldi,et al.  Cardiac Involvement in a Patient With Coronavirus Disease 2019 (COVID-19). , 2020, JAMA cardiology.

[30]  Lingkong Zeng,et al.  Neonatal Early-Onset Infection With SARS-CoV-2 in 33 Neonates Born to Mothers With COVID-19 in Wuhan, China. , 2020, JAMA pediatrics.

[31]  Wei Zhang,et al.  Antibodies in Infants Born to Mothers With COVID-19 Pneumonia. , 2020, JAMA.

[32]  Jian Wang,et al.  Possible Vertical Transmission of SARS-CoV-2 From an Infected Mother to Her Newborn. , 2020, JAMA.

[33]  D. Kimberlin,et al.  Can SARS-CoV-2 Infection Be Acquired In Utero?: More Definitive Evidence Is Needed. , 2020, JAMA.

[34]  Heidi Ledford.  Coronavirus shuts down trials of drugs for multiple other diseases , 2020, Nature.

[35]  W. Gong,et al.  Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. , 2020, JAMA cardiology.

[36]  G. Condorelli,et al.  Critical Organizational Issues for Cardiologists in the COVID-19 Outbreak: A Frontline Experience From Milan, Italy. , 2020, Circulation.

[37]  S. Bombardieri,et al.  COVID-19: the new challenge for rheumatologists. , 2020, Clinical and experimental rheumatology.

[38]  T. Burki.  Cancer care in the time of COVID-19 , 2020, The Lancet Oncology.

[39]  J. Szer,et al.  The impact of COVID-19 on the provision of donor hematopoietic stem cell products worldwide: collateral damage , 2020, Bone Marrow Transplantation.

[40]  G. FitzGerald.  Misguided drug advice for COVID-19 , 2020, Science.

[41]  D. Raoult,et al.  Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial , 2020, International Journal of Antimicrobial Agents.

[42]  D. Ost.  Bronchoscopy in the Age of COVID-19 , 2020, Journal of bronchology & interventional pulmonology.

[43]  Zhìhóng Hú,et al.  Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro , 2020, Cell Discovery.

[44]  Wu Zhong,et al.  Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro , 2020, Cell Discovery.

[45]  C. Siu,et al.  Impact of Coronavirus Disease 2019 (COVID-19) Outbreak on ST-Segment–Elevation Myocardial Infarction Care in Hong Kong, China , 2020, Circulation. Cardiovascular quality and outcomes.

[46]  S. Rasmussen,et al.  Coronavirus Disease 2019 (COVID-19) and Pregnancy , 2020, Obstetrics and gynecology.

[47]  F. Welt,et al.  Catheterization Laboratory Considerations During the Coronavirus (COVID-19) Pandemic , 2020, Journal of the American College of Cardiology.

[48]  Fenglian Ma,et al.  Coronavirus fulminant myocarditis treated with glucocorticoid and human immunoglobulin , 2020, European heart journal.

[49]  J. Willan,et al.  Care of haematology patients in a COVID‐19 epidemic , 2020, British journal of haematology.

[50]  Andrea Anderloni,et al.  Coronavirus (COVID-19) outbreak: what the department of endoscopy should know , 2020, Gastrointestinal Endoscopy.

[51]  Michael Roth,et al.  Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? , 2020, The Lancet Respiratory Medicine.

[52]  Subrata Ghosh,et al.  Implications of COVID-19 for patients with pre-existing digestive diseases , 2020, The Lancet Gastroenterology & Hepatology.

[53]  Jack Tsai,et al.  COVID-19: a potential public health problem for homeless populations , 2020, The Lancet Public Health.

[54]  Jie Zeng,et al.  How to balance acute myocardial infarction and COVID-19: the protocols from Sichuan Provincial People’s Hospital , 2020, Intensive Care Medicine.

[55]  J. Xiang,et al.  Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study , 2020, The Lancet.

[56]  G. Lippi,et al.  Cardiac troponin I in patients with coronavirus disease 2019 (COVID-19): Evidence from a meta-analysis , 2020, Progress in Cardiovascular Diseases.

[57]  Huahao Shen,et al.  Risk of COVID-19 for patients with cancer , 2020, The Lancet Oncology.

[58]  Bing Han,et al.  COVID-19: Gastrointestinal Manifestations and Potential Fecal–Oral Transmission , 2020, Gastroenterology.

[59]  Michael Lawrence Barnett,et al.  Nursing Homes Are Ground Zero for COVID-19 Pandemic. , 2020, JAMA health forum.

[60]  Shao-hua Hu,et al.  Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019 , 2020, JAMA network open.

[61]  K. Yuen,et al.  Clinical Characteristics of Coronavirus Disease 2019 in China , 2020, The New England journal of medicine.

[62]  J. Tong,et al.  Evaluation of coronavirus in tears and conjunctival secretions of patients with SARS‐CoV‐2 infection , 2020, Journal of medical virology.

[63]  J. Cheung,et al.  Staff safety during emergency airway management for COVID-19 in Hong Kong , 2020, The Lancet Respiratory Medicine.

[64]  Zunyou Wu,et al.  Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. , 2020, JAMA.

[65]  Novel Coronavirus Pneumonia Emergency Response Epidemiol Team.  [The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China]. , 2020, Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi.

[66]  Ruchong Chen,et al.  Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China , 2020, The Lancet Oncology.

[67]  Yan Zhao,et al.  Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. , 2020, JAMA.

[68]  G. Rubin,et al.  The psychological impact of quarantine and how to reduce it: rapid review of the evidence , 2020, The Lancet.

[69]  Y. Hu,et al.  Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China , 2020, The Lancet.

[70]  U. Laufs,et al.  Methamphetamine‐related cardiovascular diseases , 2020, ESC heart failure.

[71]  中国疾病预防控制中心新型冠状病毒肺炎应急响应机制流行病学组.  The Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China./ 新型冠状病毒肺炎流行病学特征分析 , 2020 .

[72]  J. Westfall,et al.  Projected Deaths of Despair from COVID-19 , 2020 .

[73]  H. Morgenstern,et al.  US Renal Data System 2019 Annual Data Report: Epidemiology of Kidney Disease in the United States. , 2019, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[74]  R. Adams,et al.  The American College of Obstetricians and Gynecologists , 2018, Obstetrics & Gynecology.

[75]  R. Zamanian,et al.  Methamphetamine and the risk of pulmonary arterial hypertension , 2018, Current opinion in pulmonary medicine.

[76]  W. H. Pearse,et al.  American College of Obstetricians and Gynecologists , 2018, Definitions.

[77]  R. Luqmani,et al.  Hydroxychloroquine retinopathy , 2017, Eye.

[78]  T. Gomes,et al.  Predictors of Opioid-Related Death During Methadone Therapy. , 2015, Journal of substance abuse treatment.

[79]  A. Reeves,et al.  Economic suicides in the Great Recession in Europe and North America , 2014, British Journal of Psychiatry.

[80]  B. Gersh,et al.  Provider Specialty and Atrial Fibrillation Treatment Strategies in United States Community Practice: Findings From the ORBIT‐AF Registry , 2013, Journal of the American Heart Association.

[81]  C. Alves,et al.  Infections in patients with diabetes mellitus: A review of pathogenesis , 2012, Indian journal of endocrinology and metabolism.

[82]  C. Fuller,et al.  Alcohol abuse/dependence symptoms among hospital employees exposed to a SARS outbreak. , 2008, Alcohol and alcoholism.

[83]  Y. Yuzawa,et al.  Aspects of immune dysfunction in end-stage renal disease. , 2008, Clinical journal of the American Society of Nephrology : CJASN.

[84]  Mark Chappell,et al.  A crucial role of angiotensin converting enzyme 2 (ACE2) in SARS coronavirus–induced lung injury , 2005, Nature Medicine.

[85]  Arthur S Slutsky,et al.  Angiotensin-converting enzyme 2 protects from severe acute lung failure , 2005, Nature.

[86]  Deepali Kumar,et al.  Severe Acute Respiratory Syndrome (SARS) in a Liver Transplant Recipient and Guidelines for Donor SARS Screening , 2003, American Journal of Transplantation.