Severe COVID-19 may damage the heart

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In a new study, researchers found that some severely ill COVID-19 patients sustain heart damage.

They found that among 416 patients hospitalized for severe COVID-19 infections, almost 20% developed damage to the heart muscle. More than half of those patients died.

They warn that heart injuries appear common in COVID-19 patients, particularly those with existing heart disease or high blood pressure.

Patients who develop heart damage may face an “unexpectedly” high risk of death.

The research was conducted by a team at Wuhan University.

The ACC highlights the extra risks to patients with heart disease and tells cardiologists to be ready to assist other doctors caring for severely ill patients.

The novelty of the coronavirus means that it’s not fully clear how to best manage those hospitalized patients. Standard heart medications and devices to provide cardiac support are being used.

But the importance of prevention is more obvious than ever.

The team says people with existing heart disease—such as a past heart attack—or a history of stroke should consider themselves at “high risk” and be vigilant about protecting themselves.

For those living in a community with a COVID-19 outbreak, that means staying home as much as possible, according to the U.S. Centers for Disease Control and Prevention.

Meanwhile, all high-risk people should wash their hands often, disinfect surfaces they routinely touch and be serious about “social distance” if they do go out.

Among the unknowns, though, is whether people with high blood pressure might also fall into the high-risk category.

In the study, among the 82 patients in this study who developed a heart injury, 60% had high blood pressure. About 30% had a previous diagnosis of coronary heart disease, while almost 15% had chronic heart failure.

The team says it’s hard to tell whether high blood pressure alone—without other health issues—was a risk factor for heart injury.

Plus, there’s no information on whether patients’ high blood pressure was under control with medication or not.

Of patients who sustained heart damage, just over 51% died in the hospital, according to the study. That compared with 4.5% of those without heart injury.

The team says the immune system’s reaction to the coronavirus may damage the body’s organs. A second possibility is that in people who already have heart disease, the overall stress of the infection harms the heart muscle.

Finally, it’s possible that the new coronavirus directly invades the heart.

Researchers say the virus very effectively latches onto receptors on our body cells called ACE2.

Those receptors are found not only in the lungs but elsewhere in the body—including the heart and digestive tract.

There has been some speculation that common blood pressure drugs—ACE inhibitors and angiotensin receptor blockers—might make people more vulnerable to falling ill with COVID-19.

But that is based only on animal research suggesting that the drugs can boost the activity of ACE2 receptors.

The team stressed that no one should stop taking their prescriptions since poorly controlled high blood pressure or heart disease would be dangerous—especially now.

The lead author of the study is Dr. Bo Yang of Renmin Hospital.

The study is published in JAMA Cardiology.

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