2022 AHA/ACC Key Data Elements and Definitions for Cardiovascular and Noncardiovascular Complications of COVID-19



## Preamble
The American College of Cardiology (ACC) and the American Heart Association (AHA) support their members' goal to improve the prevention and treatment of cardiovascular diseases (CVDs) through professional education, research, the development of guidelines and standards, and by fostering policy that supports optimal patient care and outcomes. The ACC and AHA also recognize the importance of using clinical data standards for patient management, assessment of outcomes, and conduct of research, as well as the importance of defining the processes and outcomes of clinical care, whether in randomized trials, observational studies, registries, or quality improvement initiatives.
Clinical data standards aim to identify, define, and standardize data elements relevant to clinical topics in cardiovascular medicine, with the primary goal of assisting data collection and use by providing a corpus of data elements and definitions applicable to various conditions. Broad agreement on common vocabulary and definitions is needed to pool or compare data from the electronic health records (EHRs), clinical registries, administrative datasets, and other databases and to assess whether these data are applicable to clinical practice and research endeavors. The clinical data standards can, therefore, serve as a guide to develop administrative data sets, and complementary administrative or quality assurance elements can evolve from these core clinical concepts and elements. Thus, rather than forcing the clinical data standards to harmonize with existing administrative codes, such as ICD-10-CM or CPT codes, we envision the For example, a longitudinal clinic database may contain these elements because access is restricted to the patient's health care team.
In clinical care, health care providers communicate with each other through a common vocabulary. In an analogous manner, the integrity of clinical research depends on firm adherence to prespecified procedures for patient enrollment and follow-up; these procedures are guaranteed through careful attention to definitions enumerated in the study design and case report forms.
Harmonizing data elements and definitions across studies facilitates comparisons and enables the conduct of pooled analyses and meta-analyses, thus deepening our understanding of individual study results.
The recent development of quality performance measurement initiatives, particularly those for which the comparison of health care providers and institutions is an implicit or explicit aim, has further raised awareness about the importance of clinical data standards. Indeed, a wide audience, including nonmedical professionals such as payers, regulators, and consumers, may draw conclusions about care and outcomes from these comparisons.
To understand and compare care patterns and outcomes, the data elements that characterize them must be clearly defined, consistently used, and properly interpreted. Different diagnostic terminologies are being used for overlapping conditions such as "myocardial injury," "myocarditis," "type II myocardial infarction," "stress cardiomyopathy," or "inflammatory cardiomyopathy."
These data standards will help standardize definitions and set the framework to capture and better understand how COVID-19 impacts cardiovascular health. This document is intended for use by researchers, registry developers, and clinicians and is proposed as a framework for ICD-10 code development of COVID-19-related cardiovascular conditions. Specifically, COVID-19 cardiovascular data standards are of great importance to patients, providers, investigators, scientists, administrators, public health officials, policy makers, and payers. The ACC/AHA Writing analysis or meta-analysis is anticipated n Public health policy, health insurance coverage, and legislation development n Health system administrators for estimation of necessary resources such as protective personal equipment (PPE), testing, space and staffing needs, isolation, sanitation, or quarantine requirements n Alternative models of health care such as telemedicine, virtual visits, and point-of-care diagnostic platforms.
The data element tables are also included as an Excel file in the Online Data Supplement.

## Special considerations
In this document, data elements were not differentiated for specific encounters, such as for inpatients versus outpatients, dates of encounter, number of encounters, baseline or repeated data elements. Databases can be built and customized according to users' needs to capture such information. The intent of this writing committee was not to provide recommendations regarding COVID-19 treatment, and the writing committee recommends that readers follow prevailing COVID-19 management guidelines.

## Abbreviations

# Methodology

## Writing committee composition
The Task Force selected the members of this writing committee. The writing committee consisted of 15 individuals with domain expertise in cardiomyopathy, infectious disease, CVD, myocarditis, cardiovascular registries, outcomes assessment, medical informatics, health information management, and health care services research and delivery.

## Relationships with industry and other entities
The Task Force made every effort to avoid actual or potential conflicts of interest because of personal, professional, or business interests or relationships of any member of the writing committee. Specifically, all members of the writing committee were required to disclose all such relationships that could be perceived as real or potential conflicts of interest in writing. The included documentation was updated when any changes occurred.
Authors' and peer reviewers' relationships with industry and other entities pertinent to this data standards document are disclosed in Appendixes 1 and 2, respectively. In addition, for complete transparency, the disclosure information of each writing committee member-including relationships not pertinent to this document-is available in a Supplemental Appendix. The work of the writing committee was supported exclusively by the AHA and ACC without commercial support. Writing committee members volunteered their time for this effort. Meetings of the writing committee were confidential and attended only by committee members and staff.

## Review of literature and existing data definitions

## Development of terminology concepts
The writing committee aggregated, reviewed, harmonized, and extended these terms to develop a controlled, semantically interoperable, machine computable terminology set that would be usable in as many contexts as Also referred to as "postacute COVID-19 syndrome" or "long COVID."
Not well characterized currently.

## Multisystem inflammatory syndrome in children (mis-c)
The occurrence of fever, laboratory evidence of inflammation, and evidence of clinically severe illness requiring hospitalization with multisystem ($2) organ involvement AND No plausible alternative diagnoses AND Positive for current or recent SARS-CoV-2 infection by RT-PCR, serology, or antigen test OR exposure to a suspected or confirmed COVID-19 case within 4 wk prior to symptom onset in an individual aged <21 y

## Covid-19 reinfection
New discrete episode of acute COVID-19 in person with a prior history of probable/ confirmed COVID-19. Other information can provide supporting but not definitive evidence for reinfection, such as culture or subgenomic mRNA analysis (to detect the presence of replication-competent virus) or serology, which could be useful to document a serological response to SARS-CoV-2. HF can be subclassified according to LVEF as HF with preserved EF (LVEF $50), HF with reduced EF (LVEF <40%), HF with mildly reduced EF (LVEF 41%-49%), or HF with improved EF (HF with a baseline LVEF #40%, a $10-point increase from baseline LVEF, and a second measurement of LVEF >40%). See Appendix 3 for the definition of a probable or confirmed acute COVID-19 case.

## Pasc ischemic cardiomyopathy
Reduced LV function with LVEF <50% in a patient with history of suspected or confirmed myocardial ischemia or ACS with confirmed acute COVID-19 and persisted beyond 4 wk after the initial diagnosis of COVID-19. Preexisting cardiovascular conditions, or those that did not develop until after COVID-19 had resolved, should not be listed here. See Appendix 3 for the definition of a probable or confirmed acute COVID-19 case.

## Pasc nonischemic cardiomyopathy
Reduced LV function with LVEF <50% without evidence of myocardial ischemia that started during probable or confirmed acute COVID-19 and persisted beyond 4 wk after the initial diagnosis of COVID-19. Preexisting cardiovascular conditions, or those that did not develop until after COVID-19 had resolved, should not be listed here. See Appendix 3 for the definition of a probable or confirmed acute COVID-19 case.

## Pasc inappropriate sinus tachycardia
Inappropriate sinus tachycardia at rest with heart rate >100 bpm that cannot be explained by any identifiable cause, including anemia, hypoxia, hypotension, or fever that started during probable or confirmed acute COVID-19 and persisted beyond 4 wk after the initial diagnosis of COVID-19. Preexisting cardiovascular conditions, or those that did not develop until after COVID-19 had resolved, should not be listed here.

## Pasc pots
PASC POTS is a clinical syndrome that started during probable or confirmed acute COVID-19 and lasts $3 mo. POTS is defined as 1) sustained heart rate increment $30 bpm within 10 min of standing or head-up tilt (for individuals who are age 12-19 y, the required heart rate increment is $40 bpm); 2) absence of orthostatic hypotension (ie, no sustained systolic blood pressure drop of $20 mm Hg); 3) frequent symptoms of orthostatic intolerance during standing, with rapid improvement on return to a supine position. Symptoms may include lightheadedness, palpitations, tremulousness, generalized weakness, blurred vision, and fatigue; 4) duration of symptoms for at least 3 mo; and 5) absence of other conditions explaining sinus tachycardia such as anorexia nervosa, primary anxiety disorders, hyperventilation, anemia, fever, pain, infection, dehydration, hyperthyroidism, pheochromocytoma, use of cardioactive drugs (eg, sympathomimetics, anticholinergics) or severe deconditioning caused by prolonged bed rest. See Appendix 3 for the definition of a probable or confirmed acute COVID-19 case.
PASC AF or atrial flutter AF or atrial flutter in a patient without prior history of atrial tachyarrhythmias that started during probable or confirmed acute COVID-19 and persisted beyond 4 wk after the initial diagnosis of COVID-19. Preexisting cardiovascular conditions, or those that did not develop until after COVID-19 had resolved, should not be listed here. implications for long-term surveillance and outcomes in survivors. Heart See Appendix 3 for the definition of a probable or confirmed acute COVID-19
case.
PASC supraventricular tachyarrhythmia other than AF or atrial flutter Supraventricular tachycardia other than AF or atrial flutter in a patient without prior history of atrial tachyarrhythmias that started during probable or confirmed acute COVID-19 and persisted beyond 4 wk after the initial diagnosis of COVID-19. Preexisting cardiovascular conditions, or those that did not develop until after COVID-19 had resolved, should not be listed here.
n Yes n No n Unknown Mitrani RD, Dabas N, Goldberger JJ. COVID-19 cardiac injury: implications for long-term surveillance and outcomes in survivors. Heart See Appendix 3 for the definition of a probable or confirmed acute COVID-19 case.

## Pasc pericarditis/ pericardial effusion
Pericarditis characterized by chest pain, electrocardiographic changes or pericardial effusion, that started during probable or confirmed acute COVID-19 and persisted beyond 4 wk after the initial diagnosis of COVID-19. Preexisting cardiovascular conditions, or those that did not develop until after COVID-19 had resolved, should not be listed here.

## Pasc cardiac structural abnormalities
Cardiac structural changes or abnormalities characterized by myocardial systolic dysfunction or myocardial edema or fibrosis on noninvasive cardiac imaging that started during probable or confirmed acute COVID-19 and persisted beyond 4 wk after the initial diagnosis of COVID-19. Preexisting cardiovascular conditions, or those that did not develop until after COVID-19 had resolved, should not be listed here.

## Pasc deep venous thrombosis
Formation of $1 blood clots or thrombi in large veins of the body, diagnosed with Doppler ultrasound, occurring most frequently in lower extremities or upper extremities that started during probable or confirmed acute COVID-19 and persisted beyond 4 wk after the initial diagnosis of COVID-19. Preexisting cardiovascular conditions, or those that did not develop until after COVID-19 had resolved, should not be listed here. See Appendix 3 for the definition of a probable or confirmed acute COVID-19 case.

## Pasc pulmonary thromboembolic disease
Intravascular migration of a venous thrombus or embolus to the pulmonary arterial circulation, microvascular thrombosis in the pulmonary capillaries, or pulmonary artery thrombus in situ diagnosed by a positive pulmonary angiogram, an unequivocally positive helical CT scan, a high-probability ventilation-perfusion scan, or autopsy that started during probable or confirmed acute COVID-19 and persisted beyond 4 wk after the initial diagnosis of COVID-19. Preexisting cardiovascular conditions, or those that did not develop until after COVID-19 had resolved, should not be listed here. See Appendix 3 for the definition of a probable or confirmed acute COVID-19 case.

## Pasc neurovascular disorder
Disorder of the nervous system related to a vascular etiology that started during probable or confirmed acute COVID-19 and persisted beyond 4 wk after the initial diagnosis of COVID-19. Preexisting cardiovascular conditions, or those that did not develop until after COVID-19 had resolved, should not be listed here. Acute MI should be verified to the extent possible by the diagnostic criteria outlined for acute MI or by autopsy findings showing recent MI or recent coronary thrombosis. Death resulting from a procedure to treat an MI (PCI, CABG), or to treat a complication resulting from MI, should also be considered death attributable to acute MI. Death resulting from an elective coronary procedure to treat myocardial ischemia (ie, chronic stable angina), or death attributable to an MI that occurs as a direct consequence of a cardiovascular investigation/procedure/operation, should be considered as a death attributable to a cardiovascular procedure.

## Sudden cardiac death
Death that occurs unexpectedly and suddenly without ROSC in a patient with probable or confirmed acute COVID-19 and not within 30 d of an acute MI. Sudden cardiac death includes the following scenarios: a. Death witnessed and occurring without new or worsening symptoms b. Death witnessed within 60 min of the onset of new or worsening cardiac symptoms, unless the symptoms suggest acute MI c. Death witnessed and attributed to an identified arrhythmia (eg, captured on an ECG recording, witnessed on a monitor, with asystole, pulseless electrical activity, ventricular tachycardia, or ventricular fibrillation, or unwitnessed but found on implantable cardioverter-defibrillator review) d. Unwitnessed death in a subject seen alive and clinically stable #24 h prior to being found dead without any evidence supporting a specific noncardiovascular cause of death (information regarding the patient's clinical status preceding death should be provided, if available)

## Death attributable to stroke
Death after a stroke that is either a direct consequence of the stroke or a complication of the stroke in a patient with probable or confirmed acute COVID-19. Acute stroke should be verified to the extent possible by the diagnostic criteria outlined for stroke. Cytokine release syndrome was also observed in patients with SARS-CoV and MERS-CoV and may also be referred to as cytokine storm syndrome. For patients with both distributive and cardiogenic shock, both should be coded.

## Acute kidney injury with renal replacement therapy
Abrupt reduction in kidney function in a patient with probable or confirmed COVID-19, measured by urine output and renal biomarkers requiring any renal replacement therapy Only for patients who were not previously on chronic renal replacement therapy for end-stage kidney disease Acute liver injury with fulminant failure Acute liver injury manifested by abnormalities in liver enzymes in a patient with probable or confirmed COVID-19. A minority of patients experience severe liver injury that can result in hepatic failure, defined as rapid loss of liver function during acute COVID-19, which is associated with coagulopathy or encephalopathy, and often multiorgan failure. Coagulopathy may occur in acute COVID-19 in the absence of disseminated intravascular coagulation.

## Rhabdomyolysis
Destruction or degeneration of muscle tissue accompanied by the release of breakdown products from muscle cells into the bloodstream (eg, creatine kinase, aldolase) that may lead to acute kidney injury in a patient with probable or confirmed COVID-19 The presumed mechanism is cerebral hypoperfusion. There should not be clinical features of other nonsyncopal causes of loss of consciousness, such as septic shock, seizure, antecedent head trauma, or apparent loss of consciousness (ie, pseudosyncope).

## Presyncope
The symptoms before syncope. These symptoms could include extreme lightheadedness; visual sensations, such as "tunnel vision" or "graying out"; and variable degrees of altered consciousness without complete loss of consciousness. Presyncope could progress to syncope, or it could abort without syncope. The presumed mechanism is cerebral hypoperfusion. There should not be clinical features of other nonsyncopal causes of loss of consciousness, such as septic shock, seizure, antecedent head trauma, or apparent loss of consciousness (ie, pseudosyncope).

## Presyncope
The symptoms before syncope. These symptoms could include extreme lightheadedness, visual sensations, such as "tunnel vision" or "graying out," and variable degrees of altered consciousness without complete loss of consciousness. Presyncope could progress to syncope, or it could abort without syncope.

## Rhythm
Presence of: n Sinus rhythm: an electrocardiographic finding of a cardiac rhythm that originates in the sinoatrial node n AF: an arrhythmia characterized by uncoordinated atrial myocardium attributable to multiple reentry circuits with consequent deterioration of atrial mechanical function. Instead of intermittently contracting, the atria quiver continuously in a chaotic pattern, causing a totally irregular often tachycardic ventricular rate n Atrial flutter: a disorder characterized by an electrocardiographic finding of an organized, regular atrial rhythm with atrial rate of 240-340 bpm. Multiple P waves typically appear in the inferior leads in a sawtooth-like pattern between the QRS complexes. n Ventricular arrhythmia: a disorder characterized by an electrocardiographic finding of an atypical cardiac rhythm resulting from a pathological process in the cardiac ventricles n Supraventricular tachycardia: a disorder characterized by an electrocardiographic finding of a tachycardia that does not originate in the ventricles or His Purkinje system n Paced rhythm: an electrocardiographic finding that the cardiac rhythm is initiated by an electrical impulse from a mechanical cardiac pacemaker n Other NCI Pulmonary infiltrates Imaging-defined opacification and consolidation of lungs suggesting injury and substance denser than air, such as pus, blood, or protein, within the parenchyma of the lungs during acute COVID-19
Pulmonary vascular redistribution Distension of the pulmonary veins, particularly in the upper lung fields during acute COVID-19
Pulmonary congestion Imaging findings consistent with increased intravascular blood volume in the lungs during acute COVID-19 NCI PAPi Pulse pressure across pulmonary artery divided by RA (calculated systolic pulmonary arterial pressurediastolic pulmonary pressure)/right atrial pressure) n Numeric

## Mean pulmonary capillary wedge pressure
The pressure measured by wedging a pulmonary catheter with an inflated balloon into a small pulmonary arterial branch n Numeric, mm Hg NCI Thesaurus Code: C129955 63 May be recorded with or without V-wave.

## Cardiac output
The total volume of blood pumped by the heart over a set period of time, conventionally 1 min; it is calculated as heart rate times stroke volume and is additionally dependent on preload and afterload for functional output.
n Numeric, L/min NCI Thesaurus Code: C119246 63

## Cardiac index
The measure of an individual's cardiac output as divided by their body surface area). This calculation is a useful function to determine an individual's cardiac performance in relation to their body size, providing an overview of global cardiovascular function.
n Numeric, L/min/m 2 NCI Thesaurus Code: C119245 63

## Transpulmonary gradient
Difference between mean pulmonary artery pressure and mean pulmonary capillary wedge pressure n Numeric, mm Hg

## Pulmonary vascular resistance
Pulmonary vascular resistance is calculated as (mean PA pressure minus mean pulmonary capillary wedge pressure) divided by cardiac output. Norepinephrine Norepinephrine is a sympathomimetic drug that increases blood pressure and enhances ventricular contractility.

## Epinephrine
Epinephrine is a sympathomimetic drug that increases blood pressure and enhances ventricular contractility.

## Dopamine
Dopamine is a sympathomimetic drug that increases blood pressure and enhances ventricular contractility.

## Vasopressin
Vasopressin is a vasoactive hormone used synergistically with another sympathomimetic drug (typically norepinephrine) to increase and maintain peripheral vascular tone in patients with distributive shock.

## Phenylephrine
Phenylephrine is a sympathomimetic drug whose primary activity results from stimulation of the alpha receptors of the vasculature, resulting in vasoconstriction while producing comparatively mild direct cardiac effects.

## Other
None IV inotropic agent IV positive inotropic agents are a group of medicines that stimulate and increase the force of contraction of the heart muscle.

## Milrinone
Milrinone is a phosphodiesterase 3 inhibitor that works to increase the heart's contractility, decrease pulmonary vascular resistance, and as a systemic vasodilator.

## Dobutamine
Dobutamine is a direct-acting inotropic agent whose primary activity results from stimulation of the b receptors of the heart while producing comparatively mild chronotropic, hypertensive, arrhythmogenic, and vasodilative effects.
Other None COVID-19-specific intermediate-or full-dose anticoagulation (heparin, lowmolecular-weight heparin, DOAC, warfarin)
Intermediate-or full-dose anticoagulation used to prevent VTE complications attributable to SARS-CoV-2 specifically and not because of documented VTE or another noninfectious indication. Note that this excludes the low-dose prophylactic anticoagulation often given to inpatients for VTE prophylaxis (see below). Note that "low-dose" anticoagulation is specifically excluded from this element (see below).

## Full dose standard treatment dose
Intermediate dose Intermediate dose is defined here as a dosing strategy targeting levels of anticoagulation less than standard treatment doses but greater than standard VTE prophylaxis doses.

## Unknown
A proper value is applicable but not known. Heparin is an indirect thrombin inhibitor composed of a mixture of heterogeneous mucopolysaccharides with a molecular weight of 5-30 kDa.

## Anticoagulation for vte prophylaxis
Low-molecularweight heparin
Low-molecular-weight heparin compounds are fractions of heparin that primarily act by inhibiting the activated clotting factor X. Examples include enoxaparin and dalteparin.

## Fondaparinux
Fondaparinux is a synthetic anticoagulant based on the pentasaccharide sequence that makes up the minimal antithrombin-binding region of heparin.

## Bivalirudin
Bivalirudin is a semisynthetic derivative of hirudin and is a highly specific inhibitor of thrombin.
Other Unknown A proper value is applicable but not known.

## Renal replacement therapy
Use of renal replacement therapy during hospitalization for COVID-19 in a patient without end-stage renal disease prior to such hospitalization. These therapies may include CRRT, prolonged intermittent renal replacement therapy, IHD, or other forms of renal replacement therapy.
[fig] n: Ipatiet ad outpatiet cliical programs Cliical registries Basic ad traslatioal research programs Cliical research, particularly where evetual pooled [/fig]
[fig] A: substantial body of literature was reviewed for this manuscript. The primary sources of information were the "Infectious Diseases Society of merica Guidelines on the Treatment and Management of Patients with COVID-19" 2 , NIH COVID-19 Treatment Guidelines, 3 data definitions from the U.S. Centers of Disease Control and Prevention (CDC), and previous Task Force publications. This information was augmented by multiple peer-reviewed references listed in the tables under the column "Mapping/ Source of Definition." [/fig]
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J Am Geriatr Soc. 2010;58:2329-2336. 153. Sudore RL, Lum HD, You JJ, et al. Defining advance care planning for adults: a consensus definition from a multidisciplinary Delphi panel. J Pain Symptom Manage. 2017;53:821-832. KEY WORDS ACC/AHA Clinical Data Standards, cardiogenic shock, cardiovascular diseases, coronavirus infections, COVID-19, extracorporeal membrane oxygenation, medical informatics, myocarditis, SARS-CoV-2 APPENDIX 1. AUTHOR RELATIONSHIPS WITH INDUSTRY AND OTHER ENTITIES (RELEVANT)-2022 AHA/ACC KEY DATA ELEMENTS AND DEFINITIONS FOR CARDIOVASCULAR AND NONCARDIOVASCULAR COMPLICATIONS OF COVID-19 Prathit A. Kulkarni Baylor College of Medicine-Assistant Professor, Infectious Diseases; Michael E. DeBakey VA Medical Center-Assistant Chief of Medicine Erin D. Michos Johns Hopkins University School of Medicine-Associate Professor of Medicine and Epidemiology; Director, Women's Cardiovascular Health; and Associate Director, Preventive Cardiology This table represents the relationships of committee members with industry and other entities that were determined to be relevant to this document. These relationships were reviewed and updated in conjunction with all meetings and/or conference calls of the writing committee during the document development process. The table does not necessarily reflect relationships with industry at the time of publication. A person is deemed to have a significant interest in a business if the interest represents ownership of $5% of the voting stock or share of the business entity, or ownership of $$5,000 of the fair market value of the business entity; or if funds received by the person from the business entity exceed 5% of the person's gross income for the previous year. Relationships that exist with no financial benefit are also included for the purpose of transparency. Relationships in this table are modest unless otherwise noted. According to the ACC/AHA, a person has a relevant relationship IF: a) the relationship or interest relates to the same or similar subject matter, intellectual property or asset, topic, or issue addressed in the document; or b) the company/entity (with whom the relationship exists) makes a drug, drug class, or device addressed in the document or makes a competing drug or device addressed in the document; or c) the person or a member of the person's household, has a reasonable potential for financial, professional or other personal gain or loss as a result of the issues/content addressed in the document. *Significant relationship. Kathleen LaPoint is an ACC/AHA joint staff member and acts as the Clinical Healthcare Data Manager for the "2022 AHA/ACC Key Data Elements and Definitions for Cardiovascular and Noncardiovascular Complications of COVID-19." No relevant relationships to report. Not included/counted in the RWI balance for this committee. ACC indicates American College of Cardiology; AHA, American Heart Association; COVID-19, coronavirus disease-2019; UT, University of Texas; and VA, Veterans Affairs. University of Pennsylvania-Professor of Medicine, Vice Chair of Medicine for Informatics, and Section Chief, Advanced Heart Failure and Cardiac Transplant St. Charles Health System-Chief of Cardiology, and Director, Structural Cardiology This table represents all relationships of committee members with industry and other entities that were reported at the time of peer review, including those not deemed to be relevant to this document at the time this document was under review. The table does not necessarily reflect relationships with industry at the time of publication. A person is deemed to have a significant interest in a business if the interest represents ownership of $5% of the voting stock or share of the business entity, or ownership of $$5,000 of the fair market value of the business entity; or if funds received by the person from the business entity exceed 5% of the person's gross income for the previous year. Relationships that exist with no financial benefit are also included for the purpose of transparency. Relationships in this table are modest unless otherwise noted. Please refer to https://www.acc.org/guidelines/about-guidelines-and-clinical-documents/relationships-with-industry-policy for definitions of disclosure categories or additional information about the ACC/AHA Disclosure Policy for Writing Committees. *Significant relationship. No financial benefit. This disclosure was entered under the Clinical Trial Enroller category in the ACC's disclosure system. To appear in this category, the individual acknowledges that there is no direct or institutional relationship with the trial sponsor as defined in the (ACCF or ACC/AHA) Disclosure Policy for Writing Committees.Being in close contact, as defined by the CDC, with a person with a probable or confirmed acute COVID-19 case while the person was in the presumptive infectious period [/table]