COVID-19, the new coronavirus also known as SARS-CoV-2 was first reported in Wuhan, China in December, 2019. At the time of this article, there have been over 20 million cases and over 700,000 deaths worldwide. In the United States, over 5.5 million people have been infected with COVID-19, resulting in over 170,000 deaths.
Although the COVID-19 virus often targets the lungs, many patients have multiple organs affected, including the heart. While many of these patients have underlying heart disease such as coronary artery disease, heart failure or risk factors such as diabetes or high blood pressure, there is increasing evidence that previously healthy patients are developing heart complications, such as heart attacks and arrhythmias as well as blood clots, blood vessel damage and strokes.
The coronavirus has been linked to damage of healthy heart muscle directly by activating the body’s immune response. This can lead to inflammation of the heart muscle, a condition known as myocarditis. A recent German study looked at the cardiac MRIs of 100 people who had recovered from COVID-19 and compared them to heart images of similar patients who were not infected with the virus. More than two months after recovery from the viral infection, there was evidence of persistent heart issues in 78% of infected patients; 60% had ongoing heart inflammation, and 76% had evidence of a cardiac injury typically seen after a heart attack. Most of these patients were previously healthy, with two thirds having recovered from the infection outside the hospital, suggesting they had a relatively mild infection. Ongoing follow-up will be needed to determine if the heart damage in these patients is temporary or permanent.
It is important to follow the Centers for Disease Control’s recommendations that advise individuals to avoid crowds, physically distance in public while wearing face masks, and practice good personal hygiene. People with underlying heart disease should continue to follow their physicians’ recommendations and take their prescribed medications. Additionally, they should continue with a healthy diet and exercise plan while not smoking.
Individuals without known heart disease who contract COVID-19 should follow up with their primary care physician and be aware of symptoms such as chest pain, shortness of breath, increasing fatigue and palpitations that may signal COVID-19-related heart issues. If these symptoms develop, further medical testing may be recommended by your personal physician. Follow the advice of your doctor and specialists.
Puntmann VO, Carerj ML, Wieters I, et al. Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19). JAMA Cardiol. Published online July 27, 2020. doi:10.1001/jamacardio.2020.3557