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Studying links between COVID-19 and cardiovascular disease in Bosnia and Herzegovina

Bojan Stanetic, medical professional performing procedure on patient
Bojan Stanetic
Interventional cardiologist, University Clinical Centre of the Republic of Srpsk, Bosnia and Herzegovina

In May 2020, WHF issued a call for a global study on the link between COVID-19 and cardiovascular disease. Led by WHF’s President and our science committee, this study aims to better describe cardiovascular outcomes and identify risk factors associated with poor prognosis in patients with COVID-19. WHF has received interest from 40 countries wishing to participate in the study and two countries — Bosnia and Herzegovina and Sudan—started recruiting patients already. Interventional cardiologist Bojan Stanetic is leading the WHF study in his hospital, the University Clinical Centre of the Republic of Srpska, Bosnia and Herzegovina. He spoke to us about the current situation in his country, his patients with COVID-19, and what he hopes to achieve with the study.

WHF: Bosnia and Herzegovina hasn’t been amongst the hardest hit countries in Europe. What is your take on the situation in your country?

Bojan Stanetic: Thanks to the appropriate reaction of the authorities, which included prompt restriction of movement and a large number of tested individuals, an exponential growth is prevented. In Republic of Srpska, until today, out of 33,594 tested, we have 1,810 cases of COVID-19 confirmed with around 30-50 new infections per day. Unfortunately, 119 have lost their lives to the pandemic.

WHF: You are working at the University Clinical Centre of Banja Luka, the capital of Republic of Srpska, a self-governed entity in Bosnia and Herzegovina. What is the situation in your hospital and how many patients do you currently have with COVID-19?

BS: We have around 50 patients hospitalised currently. The vast majority of them are in stable respiratory condition, but still we have patients on ventilators. What is interesting to know is that we were one of the first to use a treatment for rheumatic arthritis (Tocilizumab) which is inhibitor of interleukin-6. We were able to observe positive results for our COVID-19 patients.

WHF: Tell us about patient N1 of the global study, who you registered with his consent. What is his story?

BS: He is 41 years old and has a mild form of the virus. He has hypertension but is otherwise in a healthy condition. In general, patients are willing to participate in the study mainly due to the fact they know the issues we have with COVID-19. The cardiovascular outcomes appear to be very important to our patients.

WHF: Globally, we are seeing and reporting on a worrying decline in visits by heart patients who would usually seek routine care or need to access emergency services for non-COVID related issues. Is this trend also seen in your hospital?

BS: Absolutely! Before COVID-19 we had two to three patients a day who were coming with heart attack symptoms. Now, we have had one case in the last three days. This is a big worry we have; it means that people are staying at home with serious heart problems. In April and May, the STEMI cases were down by an estimated 50-70%. It really raises a concern that patients with cardiovascular complaints or concerns may not be presenting to the emergency department because they are afraid of the hospital, they are afraid of COVID-19. Please help us spread the message – if you have chest pain or other symptoms of a heart attack, come to the hospital immediately! We want to save lives.

The Human Side of the Pandemic