When the SARS-CoV-2 virus, or COVID-19, was first identified, it was associated as a respiratory disease due to symptoms that impacted the lungs. Scientists and doctors have since discovered the virus causes complications to other organs of the body, including the heart. While research is ongoing to understand the long-term effects of COVID-19, cardiologists are learning more about the effects on the cardiovascular system.
There is evidence of both direct and indirect heart damage that occurs in response to the body's immune system in cases of severe infection.
"Oftentimes, the body has an overwhelming immune response," says Kevin Shah, MD, a cardiologist at Ï㽶ÊÓƵ of Utah Health. "That is partially responsible for not only heart damage itself but also damage to blood vessels and the cardiovascular system."
Patients who are infected with COVID-19 have a hyper-immune response as the body tries to fight off the virus. As a result, the heart can be damaged, becoming weak and predisposed to fluid in the lungs, which can make it harder for a patient to recover from lung illness.
Health care professionals at U of U Health have recognized this in severe COVID-19 cases. It's more common among patients who are older adults and have known risk factors of heart disease. These patients tend to be at higher risk for complications, including arrhythmias, heart failure, heart damage, heart injury, and strokes. People who develop these severe symptoms are being hospitalized and sometimes need ventilator support in the intensive care unit.
Another risk factor is obesity, especially in younger people. "Younger patients who do not have any cardiovascular risk factors that are obese tend to be at higher risk of having cardiac complications from COVID-19," Shah says. Oftentimes, these patients find out in the hospital they have high cholesterol, diabetes, hypertension, or coronary artery disease. According to Shah, these risk factors can ultimately increase their risk of heart damage from the viral infection.
It's unknown at this time whether COVID-19 will cause long-term damage to the lungs or the heart. Research is underway to better understand the virus, but information is continuously evolving. Shah points to that found, of patients admitted to the hospital for severe COVID-19, many had some degree of heart muscle inflammation seen on cardiac MRI after they recovered from the virus.
"The challenge is we don't know if that phenomenon occurs with other viruses," Shah says. "We haven't paid close enough attention to other viral illnesses as we have to COVID-19."
Shah believes cardiologists will learn over time how much the virus may or may not be responsible for future cases of heart failure or cardiomyopathies.
The most important thing you can do to protect yourself from COVID-19 is to get vaccinated, wear a mask, regularly wash your hands, and to stay home when sick. Shah says it's even more important for those who have loved ones that are higher risk for cardiovascular complications. "It's important for those individuals to do their best and stay safe because this virus is going to be in front of us moving forward."