What Does the Coronavirus Do to the Heart?

How COVID-19 Affects the Heart



When people talk about COVID-19, they often focus on the effects the disease has on a person's lungs. Respiratory symptoms, such as a cough and difficulty breathing, are among the most common symptoms of an infection with the coronavirus.



As the pandemic continues, more light is being shone on the other ways the virus affects the body. In addition to impacting the lungs and upper airways of many patients, coronavirus also affects the cardiovascular system. Additionally, people with existing heart issues are more likely to have severe cases of COVID-19 than people without pre-existing conditions.



Learn more about what COVID-19 means for the health of your heart and what you can do to keep yourself healthy.



Changes to the Heart Due to COVID-19



One of the ways that SARS-CoV-2, the coronavirus that causes COVID-19, can affect the heart is by causing inflammation. Myocarditis is inflammation of the heart muscle that can occur due to damage from the virus itself or as a result of the immune response. When the heart is inflamed, it is weakened and less able to pump blood through the body.



Myocarditis can cause symptoms, such as chest pain or an abnormal heart rhythm. It can also be asymptomatic.



It's not yet clear how prevalent inflammation in the heart is due to COVID-19. About 25% of patients hospitalized with the virus had cardiovascular complications1. A very small study that autopsied 39 COVID-19 patients found heart damage in patients who weren't previously diagnosed with heart problems while ill with COVID. Another small study, of 100 patients, found ongoing inflammation in 60% of people after recovery from the illness1.



Other Ways COVID-19 Can Affect Heart Health



COVID-19 can also affect heart health indirectly. Some people are delaying treatments they need to stay healthy or save their lives out of concerns about the virus. Just over 40% of people reported delaying treatments (as of June 2020) because of the pandemic2. Among the people most likely to put off getting treatments or care were people who had pre-existing conditions, such as heart disease.



Delaying or avoiding care can increase mortality and can make conditions more difficult to treat. If you have a pre-existing condition, such as cardiovascular disease, talk to your family physician about what you can do to continue to get the treatment and care you need, as safely as possible.



The pandemic itself might be contributing to heart issues for many people, due to increased stress levels. Stress cardiomyopathy is a condition that mimics a heart attack without blood clots or changes in blood flow.



The symptoms of stress cardiomyopathy, such as chest pain, often occur after a person has had a challenging or stressful experience, such as losing a loved one. One study suggested that incidences of stress cardiomyopathy increased to 7.8% of patients with acute coronary syndrome. In pre-pandemic times, incidences of stress cardiomyopathy were around 1.5% of patients3.



What People With Heart Conditions Need to Know About COVID-19



People with certain medical conditions need to be particularly cautious about COVID-19. Having heart failure, high blood pressure, and other forms of cardiovascular disease increases the risk of developing a severe case of COVID-19. It's important to understand that having cardiovascular disease doesn't increase the risk of developing COVID-19. It increases the risk of developing severe symptoms from the illness and possibly needing hospitalization.



How to Protect Your Heart Health During the Pandemic



What can you do to protect the health of your heart, during the pandemic and after? The best course of protection is to do what you can to avoid exposure to the virus that causes COVID-19. For now, that means wearing a mask when you are around others, keeping six feet between yourself and others, and limiting the time you spend in public or crowded areas.



Vaccines against COVID-19 are now available and are being distributed to people based on eligibility. Depending on the type of work you do, your age, and whether you have pre-existing conditions, such as cardiovascular disease, you might soon be eligible for a vaccine, if you aren't already.



In the meantime, continue to take good care of your health. See a physician for care for any conditions you have or if you have new medical concerns. Talking to a psychiatrist or therapist can be helpful if you're feeling more stressed or depressed than usual as are a result of the pandemic.



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Sources:  

1. What COVID-19 is Doing to the Heart, Even After Recovery, American Heart Association, https://www.heart.org/en/news/2020/09/03/what-covid-19-is-doing-to-the-heart-even-after-recovery

2. Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020, Centers for Disease Control and Prevention, https://www.cdc.gov/mmwr/volumes/69/wr/mm6936a4.htm

3. Incidence of Stress Cardiomyopathy During the Coronavirus Disease 2019 Pandemic, JAMA, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7348683/

4. People With Certain Medical Conditions, CDC, https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html#heart-conditions

5. What do heart patients need to know about COVID-19 now? American Heart Association, https://www.heart.org/en/news/2020/08/10/what-do-heart-patients-need-to-know-about-covid-19-now

6. COVID-19 and the Heart: What We Have Learned, Harvard Health Publishing, https://www.health.harvard.edu/blog/covid-19-and-the-heart-what-have-we-learned-2021010621603





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