Question NW3090 to the Minister of Health
05 January 2021 - NW3090
Ismail, Ms H to ask the Minister of Health
(1)Whether he will furnish Ms H Ismail with a full and detailed report of the number of patients in each province who passed away due to heart attacks while they were recovering from COVID-19; if not, what is the position in this regard; if so, what are the relevant details; (2) whether it was due to a possible intake and/or the amount of medication that was administered; if not, what is the position in this regard; if so, what are the relevant details; (3) whether any similarity traits have been identified; if not, what is the position in this regard; if so, what are the relevant details?
Reply:
1. DATCOV data provides us with Case Fatality Ratio among Covid-19 admissions with chronic cardiac disease, by province, South Africa, 5 March-28 November 2020, n=2097
|
Province |
Died |
Total admissions |
CFR (%) |
|
Eastern Cape |
132 |
294 |
44,9 |
|
Free State |
64 |
208 |
30,8 |
|
Gauteng |
175 |
531 |
33,0 |
|
Kwazulu-Natal |
169 |
482 |
35,1 |
|
Limpopo |
8 |
32 |
25,0 |
|
Mpumalanga |
15 |
37 |
40,5 |
|
North West |
27 |
94 |
28,7 |
|
Northern Cape |
26 |
67 |
38,8 |
|
Western Cape |
113 |
352 |
32,1 |
|
SOUTH AFRICA |
729 |
2097 |
34,8 |
*Note*: The surveillance platform does not include fields on myocardial infarction (heart attacks) as a complication of CovidD-19.
2. Assessment of cause of heart attack, and association of medication as a contributing factor would need to be done on a per patient basis. Many clinical considerations around the patient’s condition, history, and medication management would need to be considered. It is thus difficult to comment broadly on this issue.
South Africa has an adverse drug reporting process, whereby medication associated adverse effects are reported to a central point and important trends are captured to inform future use of products.
Cardiotoxicity is the occurrence of heart electrophysiology dysfunction or muscle damage. The heart becomes weaker and is not as efficient in pumping and circulating blood. Certain medications can cause cardiotoxicity. On the question of whether there was a specific medication administered, that she is concerned about, the Honourable Member is requested to supply this detail for us to investigate.
The Clinical Management Guidelines, version 5, August 2020 outlines the management of Covid-19, as well as, medications that can be used. These can be accessed at: http://www.health.gov.za/index.php/component/phocadownload/category/628. Management of Covid-19 is generally supportive, however key medications used in hospitalised Covid-19 patients with specific indications are: dexamethasone or heparin, which are not associated with known Cardiotoxicity.
As part of the overall management of the patient, the clinicians and team balance risk and benefits of all treatments used to ensure the patient, based on their clinical state, has the best expected outcome.
3. A detailed of assessment of individual patients will be needed to assess any drug causality, and any similarity of traits.
END.