Over the past several months, nearly every corner of the world has felt the terrible effects of the novel coronavirus. With each day that passes, medical professionals around the world continue to piece together the mystery that this virus has posed. Although primarily associated with respiratory issues, Covid-19 can wreak havoc throughout the body, including the heart and vascular system. From the onset of the outbreak of this virus, “medical experts have recognized that older adults and people with existing medical conditions, including heart disease, are at higher risk from the new coronavirus.”[1] This has raised considerable concern, as tens of millions of adults in the United States live with heart disease.
The Coronavirus & Heart Health
Covid-19 has been categorized as a respiratory disease, but as cases increase worldwide, other impacts and aspects of this virus have presented themselves. The lungs of patients facing the coronavirus typically cannot operate to their full potential, which can be incredibly taxing on the heart as it overworks itself to pump oxygen-rich blood throughout the body. For individuals with heart disease, this additional strain on the heart can be particularly dangerous. “Patients with pre-existing cardiovascular diseases suffer the highest mortality rate of all COVID patients… and in some cases, COVID causes acute heart failure, myocarditis, shock and thromboembolism, and the drugs being used to treat the virus can compound cardiac issues by causing arrhythmias.”[2] In particular, for those with underlying conditions such as coronary heart disease, high blood pressure, diabetes, or who have previously experienced a stroke, Covid-19 can be extremely detrimental. Not only are such individuals more likely to contract this virus, but in the event that they do become ill, their symptoms are more likely to be severe. And though those with heart disease spanning all ages are considered to be high-risk for Covid-19, older adults with heart disease are in even greater jeopardy.
Cardiac Repercussions of Covid-19
In many cases, patients with underlying conditions like cardiovascular disease, specifically coronary disease and heart failure, have found their conditions to become disrupted after getting infected with Covid-19. For example, according to the American College of Cardiology2:
- As much as 50% of hospitalized coronavirus patients also have a chronic medical condition.
- 40% of individuals who have contracted Covid-19 also have either a cardiovascular or cerebrovascular disease.
- 16.7% of coronavirus patients have developed arrhythmia.
- 8.7% of coronavirus patients have developed shock, while 3.6% developed acute kidney injury.
- 7.2% of individuals who have become infected with Covid-19 have developed acute cardiac injury.
- Some coronavirus patients have developed myocarditis.
- Comorbid patients have higher mortality rates in comparison to the general population: cardiovascular disease (10.5%), diabetes (7.3%), chronic respiratory disease (6.3%), hypertension (6%), and cancer (5.6%).
Cytokine Release Syndrome
Numerous more severe cases of the coronavirus have been linked to cytokine release syndrome, which is a drastic immune reaction that causes the body to release an excess of cytokines into the body much too rapidly. This has the potential to result in the failure of various organs. Covid-19 cases that have encountered a slew of complications are thought to be associated with cytokine release syndrome, perhaps having brought on organ failure, as well as shock and ischemic strokes.
Ischemic and Hemorrhagic Strokes
Covid-19 has been found to result in both ischemic and hemorrhagic strokes in a multitude of recent studies. In one particular study in Italy, out of 725 consecutive hospitalized coronavirus patients, 15% — 108 individuals — experienced acute neurological symptoms which necessitated neuroimaging. An altered mental state (59%) and ischemic stroke (31%) were the two most common neurological symptoms that presented themselves in this study. Furthermore, six patients (6%) suffered intracranial hemorrhage and two patients endured cerebral venous thrombosis.
QT-Prolongation and Arrhythmias
Myocarditis brought on by Covid-19, coupled with the most common drugs being used on the frontlines to treat infected patients, can result in fatal arrhythmias. Hydroxychloroquine, chloroquine and azithromycin are all drugs that were used excessively from March through May to treat patients who had the coronavirus, and they can all lead to QT-prolongation. Unfortunately, when used to treat this virus, it can result in a deadly irregularity in heart rhythm. And so, if patients with underlying cardiac problems are prescribed one such drug in effort to combat this disease, critically dangerous arrhythmias may result.
Protecting Your Heart from Covid-19
Probably as a result of fear of contracting the novel coronavirus, hospitals have seen significantly fewer cases of ST-elevation myocardial infarction, or STEMI. However, it is imperative that individuals stay alert and keep an eye out for signs of heart health issues. The coronavirus has not eliminated cardiac issues, so patients should not ignore signs and symptoms of such events. Warning signs of cardiovascular health issues might include:
- Chest pain/discomfort
- Trouble breathing
- Chills
- Muscle pain
- Headaches
- Weakness
- Confusion
- Loss of taste and/or smell
- Diarrhea
Individuals are also encouraged to maintain heart-healthy diets and consistent exercise regimens. Although we are amidst uncertain times, this virus will not plague the planet forever. And when it is over, strong hearts will be what see each individual through to the rest of their lives.
Let Avicenna Cardiology Diagnose Your Heart Health
Although the United States currently faces unprecedented times and the world is battling a global pandemic, heart health remains the most critical aspect of personal health. Every individual is encouraged to participate in social distancing, steer clear of crowds, and stay home when possible.
Patients with underlying cardiac conditions who become infected with COVID-19 must seek out proper cardiac care. Moreover, individuals looking to improve upon their cardiac health during this should do so with assistance from a trusted and skilled medical professional. With an immense wealth of knowledge on the multitude of approaches to cardiac care, Dr. Beheshtian is an interventional cardiologist who has treated thousands of patients, in New York and elsewhere. She is extremely well-informed and experienced regarding treatment paths for various types of cases, mild or complex.
Please feel free to contact Avicenna Cardiology’s office with any questions. Schedule a telehealth appointment or come in soon to see Dr. Beheshtian, who will work with you to create a care plan.
