COVID-19 (the CORONAVIRUS) and SCAD

19th March 2020 - please keep an eye on national guidelines as advice is rapidly changing

Clearly it is a worrying time for many people at the moment and our thoughts are naturally with all our patients and friends in the SCAD-survivor community. At the moment Public Health England have not been very specific about what defines ‘people with underlying health issues’ and I think we will need to keep eyes and ears open in the coming days as advice becomes more specific. So the following advice is based on what we know currently and we need to watch the advice closely in the coming days.

There is of course no specific data on SCAD and very little specifics overall on risk. From what is understood at the moment, it is the frail elderly with multiple pre-existent medical problems who are most at risk. Patients with SCAD who are young but do have a prior medical condition which is stably managed will perhaps be at very slightly higher risk than people without health conditions but that risk will still be very low. It may be slightly higher again for those with impaired heart function (say an ejection fraction of less than 50%).  The overwhelming likelihood though if you do catch the virus is that you will be poorly but ultimately just fine. So reasons to be sensibly careful.

The advice for SCAD-survivors would be to:

1: Keep taking your medications – there have been some questions about COVID-19 and ACE-inhibitors (drugs ending in –pril) and ARBs (drugs ending in –sartan). These are based on unsubstantiated theory and the advice from the experts is NOT TO STOP THESE MEDICATIONS IF YOU ARE PRESCRIBED THEM.

2: Minimise non-essential social interactions and maintain social distance – there will be a spectrum of SCAD-survivors here from those with significant heart impairment or other health issues who would fall into the category of being advised to isolate to those with normal heart function taking no medications who can safely behave in the same way as the non-SCAD population. My instinct is that for most SCAD-survivors the measures recommended for the general population are adequate. We have received questions from key-workers about whether they should continue working and we are happy to give individualised advice if that is helpful. Please use the SCAD information email (SCAD Mailbox SCAD@uhl-tr.nhs.uk)

3: Maintain good hand hygiene and minimise face-touching

If you do become unwell, isolate (as per advice), stay warm and hydrated and use paracetamol as per the packet guidelines on dose (presuming you do not take this already in other preparations) to control fever. There is a little data to suggest this is a better option than ibuprofen.

Best wishes

Dr Dave Adlam and the SCAD team