How does COVID-19 affect the heart?
A string of studies and anecdotal evidence suggests that some COVID-19 patients develop heart problems and a few of them die of cardiac arrest.
COVID-19 has been understood as a pulmonary disease so far; more serious cases progress to pneumonia and ARDS (acute respiratory distress syndrome) causing significant respiratory issues, and death in some cases.
However, a string of studies and anecdotal evidence from the frontline is suggesting that some COVID-19 patients develop heart problems and a few of them die of cardiac arrest. The central question though is if heart problems are a byproduct of the disease or if the virus directly infects the heart muscle. The inquiries on the matter are still in the preliminary stages, so our knowledge is based more on well-educated guesses rather than hard evidence.
What do the studies say so far?
A study published by JAMA looked at 416 hospitalized patients in China. Of these, 19% (or 82 patients) showed signs of heart damage. Significantly, those with cardiac issues had a mortality rate of 51% compared to 4.5% of those who didn’t.
The researchers added that those who had pre-existing heart conditions were more likely to develop cardiac problems, but some with no prior history also developed them. Surprisingly, it was this sub-group that suffered a higher fatality rate.
Does the virus directly attack heart cells?
The JAMA study discussed cases wherein there were only cardiac symptoms; none of the classic respiratory symptoms was present.
On the other hand, widespread inflammation can cause cardiac issues as well. For example, plaque in the arteries can become unstable and lead to heart attacks. Severe pneumonia may also eventually cause the heart to stop, which is then the proximate cause of death. A severe infection, like COVID-19 , can strain the body and push heart tissue to dangerous limits.
Some researchers have pointed out that the receptors present in the lungs which the virus latches onto are also present in the heart. It is, therefore, a possibility that there could be direct damage to the heart.
Why do some people have cardiac symptoms while others don’t? That is a difficult question to answer for researchers right now but genes likely play a role, as does the concept of ‘viral load’. Since all of this is taking place during an emergency, it is difficult to design experiments. With time, however, we will have a clearer understanding.
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