How COVID-19 Affects the Heart

Female senior getting her heart checked out during COVID-19.

Every day we learn more about the short- and long-term effects of COVID-19 on the heart. Although much is still unknown, we do know the coronavirus affects the cardiovascular system in a variety of ways. This is why if you have had COVID-19, it’s important to follow-up with your primary care provider for careful monitoring.

Early Research Provides a Clue

The first indication that COVID-19 infection affects the heart came in early reports showing the virus entered cells using the same receptors (known as the renin-angiotensin-aldosterone system) that regulate the body’s blood pressure and levels of water and salt.

From there, we began to see the effects in patients.

COVID-19 and Heart Disease

COVID-19 infection can affect the heart in several ways, including inflammation of the heart muscle (myocarditis) and inflammation of the sac around the heart (pericarditis). Myocarditis can cause the heart to be weak which can lead to the syndrome of heart failure. Shortness of breath, fatigue, and swelling in the legs and abdomen are some of the signs of heart failure. It is worth noting that many other viruses can cause these same conditions.  

COVID-19 can also predispose people to form blood clots, especially in the legs. These clots can sometimes travel to the lungs causing a pulmonary embolism, or blockage of one of the pulmonary arteries in the lungs, causing breathing and blood pressure issues.

Who is Most Likely to Experience Heart Injury?

COVID-19 patients who were hospitalized, as well as patients who were not hospitalized, have both experienced heart damage. Heart injury has been found in approximately 25 percent of hospitalized patients. Roughly two-thirds of patients who die from COVID-19 have evidence of heart damage.

A recent study published in the Journal of the American Medical Association looked at the cardiac MRIs of 100 patients diagnosed with COVID-19 in the prior two to three months. Researchers found evidence of heart damage in more than 78 percent of these patients, most of whom had not been hospitalized with COVID-19.

It appears that COVID-19 can cause damage to the heart regardless of a person's age. Another recent study that looked at MRIs of competitive college athletes with an average age of 19 showed nearly half who had been diagnosed with COVID-19 showed signs of myocarditis. It is still unknown if this inflammation of the heart will improve with time or whether it will cause long-lasting heart damage.

Follow Up with Your Primary Care Provider

If you or a loved one has been diagnosed with COVID-19 it is important to keep routine follow-up appointments with your primary care provider or cardiologist. It is also reasonable to request a one-time EKG or heart ultrasound (echocardiogram) to ensure COVID-19 has not affected your heart.

Unfortunately, many patients have deferred their health-care needs during the pandemic. This has led to a sharp rise in hospital admissions for chronic conditions, like heart disease, that have gone unmanaged. Know that you physician's office takes all necessary precautions to prevent the spread of infection. Routine follow-up remains essential to good health.

The Good News About Vaccines

The good news is several vaccines have already been emergently approved by the FDA several others are coming down the proverbial “pipeline.” If we all remain vigilant over the course the next several months by wearing masks, maintaining social distance, and washing hands frequently, hopefully the worst of this pandemic will soon be behind us.

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Robert James Donovan, Jr., MD

Robert James Donovan, Jr., MD, is a cardiologist with The Heart Group of Lancaster General Health. Dr. Donovan is a graduate of the Pennsylvania State University College of Medicine, and served his residency at Virginia Commonwealth University and fellowships at Penn State Milton S. Hershey Medical Center and the University of Virginia Health System. He is board certified in both cardiovascular disease and internal medicine.

Call: 717-544-8300

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