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The pandemic of the novel coronavirus infection (COVID-19), caused by SARS‑CoV‑2, has become a challenge to healthcare systems in all countries of the world. Patients with comorbidity are the most vulnerable group with the high risk of adverse outcomes. The problem of managing these patients in context of a pandemic requires a comprehensive approach aimed both at the optimal management in self-isolated patients not visiting medical facilities, and management of comorbidities in patients with COVID-19. The presented consensus covers these two aspects of managing patients with cardiovascular disease, diabetes, chronic obstructive pulmonary disease, gastrointestinal disease, and also pay attention to the multiple organ complications of COVID-19.

The article contains Russian expert consensus statement on the diagnosis and treatment of fulminant myocarditis (FM), prepared by the National Society for the Study of Lipidology and Associated Metabolic Diseases, the Society of Internal, Sports and Preventive Medicine based on the clinical guidelines of the Russian Society of Cardiology, results of China Clinical Study (NCT03268642), Expert Guidelines of Russian Clinical and Research Center of Gerontology, Chinese Society of Geriatrics, Cardiology Branch of Beijing Medical Association. Pathogenesis, diagnosis and treatment of myocardial injury and FM in patients infected with SARS-CoV-2 in the context of the COVID-19 pandemic are discussed. Clinical features and diagnostic criteria of FM, as well as and comprehensive therapy for myocardial injury and FM are presented. The proposed protocol for the management of patients with myocardial injury in patients infected with SARS-CoV-2 was adapted with the clinical experience of Chinese experts. The protocol for anticoagulant and antiplatelet therapy was proposed by the Moscow State University Medical Center.

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Atrial fibrillation (AF) is the most common heart rhythm disorder requiring treatment and is associated with an increased rate of hospitalization and death. When choosing the tactics of restoring and maintaining sinus rhythm in most patients with AF paroxysm without pronounced organic heart damage, the drug of choice is propafenone, which has a high level of safety and efficacy. The use of the drug within the framework of a «pill in a pocket» by the patient himself, intravenously in a day hospital of an outpatient medical institution or by an ambulance team allows stopping AF paroxysm in most patients at the prehospital stage. Propafenone is also the drug of choice for inpatient sinus rhythm restoration and for long-term antiarrhythmic therapy in a wide range of patients with AF.