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Fear of Coronavirus Disease 2019—An Emerging Cardiac Risk

Educational Objective
To understand how fear during COVID-19 is an emerging cardiac risk
1 Credit CME

We are in the midst of the coronavirus disease 2019 (COVID-19) pandemic and, as many clinicians across the globe, we are seeing firsthand the pain and death caused by COVID-19. While there are more than 300 clinical trials currently under way for this illness, there are as yet no specific therapies broadly accepted to decrease mortality. In response to dire predictions and a lack of effective treatments, authorities across the world continue to recommend a series of aggressive mitigation strategies to slow the spread of COVID-19. While early fears of widespread death and overwhelmed hospitals have played an important role in sounding the alarm about this pandemic and motivated important social distancing measures, these fears are also causing substantial harm. In this Viewpoint, using cardiac disease as an example, we explore the hazards associated both with the pandemic and initial response. We argue that clinicians’ ability to modulate fear—a sensitive but nonspecific response to threats—will be a major determinant of the magnitude of the pandemic’s effects.

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Article Information

Corresponding Author: Marvin A. Konstam, MD, Cardiovascular Center, Tufts Medical Center, Tufts University School of Medicine, 800 Washington St, PO Box 108, Boston, MA 02111 (mkonstam@tuftsmedicalcenter.org).

Published Online: July 22, 2020. doi:10.1001/jamacardio.2020.2890

Correction: This article was corrected on August 12, 2020, to fix an error in the text. The phrase “there are no specific therapies that are known to decrease mortality” should instead have said “there are as yet no specific therapies broadly accepted to decrease mortality.” The error has been corrected.

Conflict of Interest Disclosures: Dr Wessler reported support from the National Institutes of Health (grants K23AG055667 and R03AG056447) during the conduct of the study. Dr Kent reported support from the National Institutes of Health (grant UL1TR002544) and the Patient-Centered Outcomes Research Institute (grant ME-1606-35555). No other disclosures were reported.

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AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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