The novel coronavirus, previously thought to primarily attack and affects the lungs, could have a potentially devastating effect on the nervous system, brain, kidneys and heart, according to new research.
A recent paper by Dr. William Brady, a professor of emergency medicine at the University of Virginia School of Medicine, and other colleagues around the country examined early reports and studies of cardiovascular complications brought on by the novel coronavirus.
“Unfortunately, with COVID, it seems to attack the heart as much as it attacks other systems,” Brady said.
Heart failure is a particular concern in patients with COVID-19. One study discussed in the paper found that almost a quarter of COVID-19 patients – 24% – were suffering acute heart failure when they were first diagnosed with the coronavirus.
Other viruses, such as influenza, sometimes cause heart conditions, but “the rate of issues was much lower,” Brady said.
The novel coronavirus, though, seems to directly attack the heart, as well as causing intense immune responses that can weaken the heart. Severe inflammation throughout the body increases the risk that fatty plaque built up in the blood vessels will rupture, leading to heart attacks and stroke.
Patients with myocarditis, or inflammation of the heart muscle, are coming to the emergency room much more frequently than doctors are used to, Brady said, which has also forced teams to rethink how they deal with cardiac issues during a pandemic.
Myocarditis can sometimes seem to be a heart attack, but each have different treatments and interventions, and if a patient appears to be COVID-19 positive, the nurses and doctors must take extra precautions and be patient while they sort out treatment in an environment where speed is crucial, Brady said.
“Care is even more individualized than it was before,” he said.
Of the patients with heart failure, nearly half were not known to have high blood pressure or cardiovascular disease. Another study reviewed, though, found that of 44,672 patients with COVID-19, a history of cardiovascular disease was associated with a nearly five-fold increase in the case fatality rate when compared with patients without that history, or a fatality rate of 10.5% versus 2.3%.
The authors also briefly mention how potential COVID-19 treatments may interact with blood pressure and heart attack medications; both hydroxychloroquine, which has largely been discarded by researchers as a possible treatment, and remdesivir, which has shown promise in early trials and is authorized by the FDA, can affect heart rhythm. Hydroxychloroquine can cause heart damage and worsen cardiomyopathy.
However, while COVID-19 appears to cause or exacerbate heart conditions, fewer people seem to be visiting hospitals for help with those conditions, according to a population study published Tuesday.
Because heart conditions can become serious with even an apparently mild case of COVID-19, Brady emphasized the importance of visiting a doctor in case of a cardiac emergency or pain.
“I want people to know we are open for business and are providing appropriate care, and if you have an emergency, you should come in,” he said.