One of the most harrowing effects of COVID-19 is severe damage to the lungs, which makes breathing hard or impossible for those who are severely affected.
However, the evidence is mounting that COVID-19 also damages the heart, damage either caused by the virus itself, from inflammation triggered by the immune system’s response to the virus or a from increased clotting in heart vessels.
There is now evidence that heart damage may persist even after the patient recovers and, in some cases, that damage may be long-lasting.
In a recent review study at the Intermountain Healthcare Heart Institute, researchers found a clear link between heart disease and COVID-19, but the long-term implications are unknown.
The study is published in the Journal of Molecular and Cellular Cardiology. One author is Kirk U. Knowlton, M.D.
In the current study, the team reviewed more than 100 published studies related to COVID-19 and its effects on the heart.
While lung disease (severe acute respiratory distress syndrome, or ARDS) has been the most consistent problem with the virus, they found that many patients also suffer strong cardiovascular damage that might also persist after they have otherwise recovered.
The researchers say there’s clear evidence that COVID-19 can cause heart disease. It does not affect all patients but affects around one in five patients admitted to the hospital with COVID-19.
When heart damage is present, patients have a greater chance of needing ventilators to support their breathing and they are at substantially higher risk of dying of COVID-19.
In addition to the acute effects, scientists still need to learn more about the long-term implications of the virus on the heart after people have otherwise recovered.
In the review of published research, the team found multiple reports of myocarditis or inflammation of the heart muscle that can damage the heart and affect the heart’s ability to pump blood.
They point out that there is considerable evidence that the COVID-19 infection can damage the heart in hospitalized patients via several mechanisms, including myocarditis.
However, less is known about the effects of the virus on the heart in patients that do not require hospitalization or in those that do not develop significant lung disease.
While children are usually spared from the most ravaging effects of COVID-19, it can trigger a Kawasaki-like disease in children, which is referred to as Multisystem Inflammatory Syndrome in Children (MIS-C).
This causes an inflammation of multiple body parts including the heart with evidence of myocarditis.
Other cardiovascular manifestations of COVID-19 include a thrombotic or clotting disorder that may manifest as deep-vein thrombosis, pulmonary embolism, stroke, and peripheral artery disease.
Also, thrombosis of small and medium-size vessels can contribute to cardiac injury.
This link between heart diseases and transmittable viruses isn’t new.
Autopsies of patients who died during the 1918 flu pandemic found heart damage, and 50% of patients who died of polio from 1942 to 1951 had myocarditis.
Heart damage has also been found in people infected with mumps, measles, and enterovirus illnesses.
What’s less understood, is what role the virus-activated immune system plays in heart damage.
The team says treating COVID-19 is about finding a balance between allowing the immune system to fight the virus, but not so hard that it hurts the heart.
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