So far, the main emphasis of Medical research was focused on acute respiratory complications, especially in critically ill patients, since most of the patients admitted to an Intensive Care Unit (ICU) reported problems in their lungs. But there are more and more medical reports that warn how SARS-CoV-2 affects and even develops cardiovascular problems in people, especially those who have suffered the disease moderately or severely.
“The COVID infection generates an affectation at different levels in the human organism. What we have seen and learned in almost 2 years of a pandemic is that the cytokine storm generated by the body against the virus mainly affects the lungs. There is an affectation of the development of cytokine storms, which are defense mechanisms that generate an inflammatory phenomenon and lead to complications of the respiratory condition and bilateral pneumonia. But also this reaction compromises the cardiovascular part in several cases, with thrombi in the venous and arterial part, in which acute complications have been observed, such as pictures of thrombosis, myocardial inflammation, myocarditis, pericardium, complex and severe arrhythmias ”, he explained to Infobae the doctor Pablo Corral, professor of pharmacology of the medicine career of the FASTA University of Mar del Plata and member of the scientific group Latin American Clinical Studies (ECLA).
“When the virus finishes making its affect, over time we have seen complications appear at 12 weeks or 3 months that scientifically have been classified as Long Covid or prolonged Covid disease. After these 3 months, there would be a residual inflammatory phenomenon, which could generate cardiovascular events in the future of this patient. It is mainly observed in people who have experienced moderate or severe COVID. This inflammatory phenomenon would have a preponderant factor at the cardiovascular level to develop these clinical manifestations ”, added the expert.
According to Corral, “having a severe COVID adds a risk factor for the development of cardiovascular diseases. It implies the need to carry out more clinical and especially cardiological controls on a regular basis. It is key to control the risk factors that we can modify, such as eating healthy, exercising, not smoking, not drinking alcohol, having a good diet, reducing salt intake, among other recommended measures. Treatment does not vary from what is usually done in people with cardiovascular risk factors. “
“In a recent review of the magazine Circulation, it is noted that COVID-19 is divided into 3 distinctive phases. The first, also called ‘early infection’, is characterized by a great viral proliferation, with a duration of up to 5 days. Then, the second stage or ‘Pulmonary phase’, where the characteristic is the appearance of pneumonia. If there is no improvement in the patient at this stage, COVID-19 can become a severe to critical disease, with the ability to cause damage to the heart as a result of an inflammation called ‘Myocarditis’, either by direct infiltration of the virus into its walls, or indirectly by altered immunological mechanisms, which generate an inflammatory response in the myocardium.
A study recently published in JAMA, has reported that SARS CoV-2 would also be capable of producing alterations in the walls of the heart even in patients with positive COVID of mild to moderate degree, as demonstrated by German researchers, who carried out a heart resonance to 100 recovered patients, finding in 78% of them, alterations in the walls of the heart regardless of the degree of severity. Other conditions of the cardiovascular system have also been reported in patients with COVID-19, both in China, Europe or the United States, such as the appearance of cardiac arrhythmias, formation of thrombi in blood vessels, coronary insufficiency or myocardial infarctions.
Recent studies of the American Heart Association, states that among COVID-19 patients, the Negative evolution of the disease is directly related to the possibility of presenting cardiovascular disease (CVD) and myocardial injury.
The Identified pre-existing cardiovascular pathologies that expose the patient to greater risk if infected by COVID-19 are:
-Deterioration in the ejection fraction of the heart
-Coronary and valvular disease (angina, heart attack, previous angioplasty, heart surgery)
-Arrhythmogenic dysplasia of the right ventricle
-Cyanotic congenital heart disease
-Patients with Brugada Syndrome are at greater risk of developing arrhythmias due to fever and those with prolonged QT due to adverse effects of medications.
Recovered from COVID-19, on alert for their heart
As required by a recent study carried out at the University Hospital of Frankfurt (Germany), there is a high prevalence of cardiac sequelae post-coronavirus infection. The investigation, which included 100 recovered COVID-19 patients, showed cardiac involvement in 78% of them, as well as ongoing myocardial inflammation in 60%. This highlights the need for cardiovascular study and follow-up in all patients recovered, experts say.
Among the most common cardiovascular conditions are: myocarditis, pericarditis, pericardial effusion, arrhythmias, venous thromboembolism, heart failure and heart attacks (pathologies that increase the probability of triggering sudden death).
According to Pan American Health Organization (PAHO), each year more people die from cardiovascular diseases (CVD) than from any other cause; In addition, data from the World Health Organization (WHO) reveal that in 2030 almost 23.6 million people will die each year from some cardiovascular disease, mainly from heart disease and stroke. Therefore, conducting regular check-ups is of the utmost importance.