A new and unnerving addition to Covid-19 symptoms was recently brought to light: despite the fact that it is considered an illness of the lungs, many patients who are infected with the novel coronavirus experience cardiac issues. The findings suggest that 1 in 5 patients show signs of heart injury, regardless of whether or not they had respiratory symptoms. Many of these patients had underlying cardiovascular issues prior to contracting Covid-19 but they do not outnumber the patients who were otherwise healthy, yet developed heart problems including blood vessel injuries, blood clots, arrhythmia, strokes, and heart attacks.
These numbers have baffled physicians and health experts, but it seems a new study that was published in the journal Frontiers in Cardiovascular Medicine has some of the answers. The main reasons that coronavirus leads to heart conditions are the widespread inflammation the infection causes, the possibility that the virus directly infects and injures the cardiovascular system, and the overall stress the infection puts on preexisting heart conditions.
It is important to note that like many other coronavirus related studies, more research is needed to draw concrete conclusions, and verify exactly how the coronavirus affects heart function, and which patients with COVID-19 are most at risk for running into heart troubles.
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1. Inflammation
Inflammation is one of the key reasons why some patients experience Covid-19 so harshly. The virus is known for causing a very high level of inflammation due to a phenomenon called “cytokine storm,” in which the body produces too big of a response against an intruder.
Inflammation and a fever accelerate the heart’s rate, making it work much harder to pump blood throughout the body, and subsequently, lead the heart itself to inflammation and failure. According to a statement from Shuyang Zhang, a cardiology professor at Peking Union Medical College Hospital in Beijing, the more intense the inflammatory response a patient has the more likely they are to develop heart issues.
2. Direct Injury of the Heart
There is a risk that the coronavirus attacks cells in the cardiovascular system itself, through a receptor called ACE2. “Once inside the heart cell, damage to the cellular machinery directly from the virus and the human immune cell response leads to cell dysfunction and cellular death,” explained Dr. Jack Wolfson, a cardiologist and a fellow of the American College of Cardiology.
A similar process was observed in the early 2000s in patients infected with SARS, a disease caused by a different coronavirus.
3. Underlying Heart Issues
People with preexisting heart disease are at a greater risk for severe cardiovascular and respiratory complications from COVID-19. Research has shown that heart attack can actually be prompted by respiratory infections like the flu.
Moreover, people with previously undiagnosed heart disease may experience previously silent symptoms that are unmasked by the viral infection.
4. Certain Medications
Some medications used to treat the infection may increase one’s risk to develop heart problems - for example, nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin and ibuprofen, and some antiviral drugs.
NSAIDs can increase a person’s blood pressure while anti-inflammatory medication might “impact the immune system and the heart muscle in many different ways, some of which could lead to lethal heart rhythms in the short term or worsen heart recovery in the long term,” as explained by Dr. Wolfson.
As you can see, the underlying causes of cardiac symptoms in COVID-19 patients can happen in several ways, and most likely, the increased number of coronavirus patients with heart damage is due to a combination of all these causes. Hopefully, more and more clinicians will take the possibility of heart issues as a result of a COVID-19 infection into account and minimize the risk of serious complications.
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