Health & Wellbeing

Study detects heart damage in majority of recovered COVID-19 patients

Study detects heart damage in ...
New research affirms we are only just now learning of the long-term health consequences of COVID-19 in recovered patients
New research affirms we are only just now learning of the long-term health consequences of COVID-19 in recovered patients
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New research affirms we are only just now learning of the long-term health consequences of COVID-19 in recovered patients
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New research affirms we are only just now learning of the long-term health consequences of COVID-19 in recovered patients

A pair of newly published studies in the journal JAMA Cardiology highlight the potential for long-term heart complications in recovered COVID-19 patients. The research suggests the virus can directly damage cardiovascular muscles with ongoing inflammation detectable months after recovery, even in patients originally suffering a mild form of the disease.

While much attention has been focused on the volume of deaths caused by COVID-19, now that we are six months into this global pandemic researchers are beginning to see signs of chronic health problems in recovered patients. Only now are clinicians starting to get a glimpse at the potential persistent health consequences of this new virus, and two new studies offer insights into the cardiovascular impact of COVID-19.

Back in March it was quickly apparent that patients with underlying cardiovascular disease were more likely to suffer a fatal outcome from COVID-19. However, it was unclear whether the virus was directly damaging myocardial cells, or whether there was longer-term cardiovascular damage following recovery.

The first new study investigated 100 recovered COVID-19 patients (median age of 49 years old), an average of 71 days after initial diagnosis. Using cardiac magnetic resonance imaging (CMR) the study detected cardiovascular abnormalities in 78 percent of the recovered patients. Signs of myocardial inflammation were detected in 60 percent of the subjects. These abnormal results were compared to a healthy age-matched control group, and independent of any cardiovascular disease diagnosed before the patients presented with COVID-19.

Most notably, only 33 percent of the cohort studied required hospitalization during the course of their COVID-19 infection. This suggests a degree of cardiovascular damage seems to result from the disease regardless of the severity of the acute illness or the presence of any pre-existing conditions.

“Our findings demonstrate that participants with a relative paucity of preexisting cardiovascular condition and with mostly home-based recovery had frequent cardiac inflammatory involvement, which was similar to the hospitalized subgroup with regards to severity and extent,” the researchers write in the study.

The study notes that it is possible these abnormal CMR findings were present prior to COVID-19 infection, however, it is also likely that the viral infection amplified any pre-existing cardiovascular damage. It is also unclear whether these post-COVID-19 cardiovascular effects are permanent or have long-term health consequences.

The second new study looked closely at heart tissue gathered during autopsies of 39 COVID-19 patients. The average age of the patients was 85, and the most commonly listed cause of death was pneumonia.

Traces of SARS-CoV-2, the virus that causes COVID-19, were found in heart tissue of more than 60 percent of the subjects. Sixteen of the subjects were found to have clinically significant levels of viral load in their heart tissue at the time of death.

Again, there is no evidence at this stage that the viral presence in heart tissue means the disease has any long-term negative cardiovascular effects. But, the two studies combined do suggest this new virus certainly has an effect on the heart.

John Swartzberg, an infectious disease expert from UC Berkeley, says it is becoming increasingly clear COVID-19 is more than just a respiratory disease, and its long-term complications are yet to be seen.

“There is evidence now that the virus can directly attack heart muscle cells, and there’s also evidence that the cytokine storm that the virus triggers in the body not only damages the lungs, but can damage the heart,” says Swartzberg, who did not work on either of these new studies. “We don’t know what the long-term effects of that may be, but it could be that we will have a population of people who survive COVID-19 only to go on and have chronic cardiac problems.”

In a commentary accompanying the publication of the new studies, deputy editor of JAMA Cardiology Clyde Yancy and section editor Gregg Fonarow call for urgent ongoing research to better understand the cardiovascular complications associated with COVID-19, as preparations may be necessary for what could be another dimension to this pandemic crisis.

“We wish not to generate additional anxiety but rather to incite other investigators to carefully examine existing and prospectively collect new data in other populations to confirm or refute these findings,” write Yancy and Fonarow. “… if this high rate of risk is confirmed, the pathologic basis for progressive left ventricular dysfunction is validated, and especially if longitudinal assessment reveals new-onset heart failure in the recovery phase of COVID-19, then the crisis of COVID-19 will not abate but will instead shift to a new de novo incidence of heart failure and other chronic cardiovascular complications.”

The CMR study and the autopsy study were published in the journal JAMA Cardiology.

11 comments
guzmanchinky
From what I understand severe flu can do damage to the heart as well? What we really need to focus all our efforts on are universal virus vaccines, the common cold, etc. Once we crack that the human race will be so much better off...
Karmudjun
It makes perfect sense clinically - we are seeing Kawasaki syndrome in some of the infected youth. Kawasaki has been viewed as a "rare & unknown etiology" inflammatory process that some children are genetically susceptible to - but caused by a type of common cold virus? I've seen cardiomyopathy in young healthy people after "nothing other than a cold or two", clearly this SARS-CoV2 has recombined many individual harmful RNA sequences that worked on bats and pangolins to spread or sustain the the infection - with all this in one (now human) virus, we need a vaccine soon - or we will prove Darwin right for all the wrong reasons! Once selected out by SARS-CoV2, what will happen to our species? Less diversity - and with a 'more refined genome', will it select out for more autoimmune or chronic disease or will it prove a positive refining of the genome eliminating susceptibility to neurologic or psychiatric issues?
tangential
I wonder how many people had that had minor or undiagnosed cases were included in the study, since that is the majority of cases?
Nobody
More fear mongering. My coworker got a heart infection from having his teeth cleaned and some plaque shoved below the gum line. He got a heart transplant but died anyway. In another couple months I expect to be reading about gut bacteria causing heart failure. It now seems to be connected to everything else. The old saying that "death begins in the colon" must be true.
Spud Murphy
My partner and I both got sick in March of what we though was covid, but didn't get tested at the time (we stayed isolated instead) as testing here was disorganised and had to be done at a clinic - you don't go to a clinic full of people with a potentially dangerous infectious disease if you aren't sure you have it yourself. We did get tested recently now that they have drive-through testing, result was negative, but it's been over 4 months since we first got sick, and antibody testing still isn't available, so we really can't be sure we had covid, but we were exposed to overseas visitors and a definitely sick person a few days before.

Anyway, we have both had symptoms on and off since March, and recently had ECGs due to shortness of breath. The result - we both now have heart conditions we didn't have (or weren't aware of) before. The chances of 2 people in the same household coming down with similar heart conditions at the same time without an external cause? Practically zero.

So, looks like we are just seeing the beginning of the true result of this disease, anyone still thinking this is a scam or being exaggerated is a complete idiot.
Rusty Harris
This Chinese virus just gets better and better. :(
nehopsa
nobody, this is NOT "fear mongering". If you already had covid-19 yourself, you most likely will have heart condition also, possibly for the rest of your life. If you are a young person this will make a significant difference with everything going on in your life. For the worse. For an elderly person this adds to everything else. If you are lucky so far it is good to know WHY you do not want to get covid at all costs. Having compromised health is not worth it at any price. This is reality.

Face masks help, in particular with EVERYBODY wearing it, responsible people who protect YOU, religious, often and thorough, hand washing and I would consider also air filtration/uv lamp. Even compete head gear for particularly risky places. WHO had been forced to admit, only recently, that the virus remains air borne. It is in aerosols up to 3 hours. That is not just heavy particles that clear fast. That means even ordinary talk gets virus in the air - shouting, singing and coughing is much worse. WHO did their best to suppress this aerosol air borne information as long as they could. Very significant info for your protection.
sidmehta
@nehopsa Be careful with UV light to kill the virus. Most UV is bad for humans and only a certain part of the UVA light spectrum seems to be OK. I say "seems" because sometimes it takes decades to understand damage, so we don't know for sure.
DL Atlas
These studies - and this article - are MUCH too premature to be used. The test groups are TOO SMALL to show real results!
Altairtech
The fear of the virus and its potential side effects, is by itself, another comorbidity that will contribute to complications in the case of an infection. However, small doses of HCQ as a prophylaxis would remove this fear, and protect against infection. But this is too simple for the pharmatico-industrial complex.