Most of the headlines concerning coronavirus are focused on lung injuries and acute respiratory distress, but damage to the cardiovascular system is emerging as a long-term consequence of the virus.
A number of those who are infected develop heart-related symptoms – sometimes, seemingly out of the clear blue. Other times, an existing cardiac problem worsens, sometimes severely, after a person becomes sick with COVID-19.
Statistics from early reports at the pandemic’s epicenter, Wuhan, China, related that among 41 patients, twelve percent had signs of cardiovascular damage. Bloodwork revealed elevated levels of cardiac troponin, a protein that is released in the blood when heart muscle tissue is damaged. Abnormalities on electrocardiograms and heart ultrasounds were also reported.
A later study looked at 416 patients and found that 19% showed evidence of heart damage. And those who did were more likely to die; about half of those with heart damage died versus 4.5% of those who did not have heart damage.
Doctors have long known that any significant medical event, from illness to surgery, can create serious stress on the body that leads to heart damage. The pneumonia caused by COVID-19 can cause widespread inflammation in the entire body. Inflammation is known to destabilize plaque in arteries, leading to heart attacks. Inflammation itself can case myocarditis, an inflammation of the heart muscle.
People with preexisting heart disease are generally at greater risk for severe complications from COVID-19, as they are for complications from the influenza virus. And heart attacks are often brought on by respiratory infections, including the flu.
The grim progress of COVID-19 is that as result of oxygen levels being lowered because the lungs cannot function, the heart does not receive enough oxygen at the same time that fever and inflammation accelerate the heart rate and increases metabolic demands on many organs, including the heart.
COVID-19 is not the first virus to attack heart muscle – Coxsackie B virus does this as well. There are reported incidences when patients are brought to the ER displaying heart attack symptoms. Patients are sent straight to the cardiac catherization lab to clear a suspected blockage, only to find that the patient was not having a cardiac blockage but had suffered cardiac damage from COVID-19.
Understanding how the virus impacts the heart will help doctors determine which treatments are needed to protect their patients. It is likely that in the long run, many COVID-19 patients will have their lives altered, with a cardiac condition that requires further treatment.
Over the future 6-12 months, we expect to see an increase in claims for long-term disability, and many will be the result of complications from COVID-19. We also expect to see more from the science community providing insight into these potential connections.