Corona is a major health problem that is not differentiating poor vs rich, hot vs cold climate, west vs east countries.
The predominant symptoms of Corona are fever, cough, cold, breathlessness and/or loose stools. Most of these symptoms are connected to respiratory system. But scientists identified Corona patients had higher chances of complications and death if they had underlying heart diseases. So Corona is a disease of lungs and heart.
In this article we understand the heart related complications of Corona.
What is Corona?
Covid 19 virus is an RNA virus belonging to the family Corona virus. Corona virus disease 2019 (COVID-19) is a respiratory tract illness which started as an outbreak in December 2019 in Wuhan,Hubei province and has spread rapidly throughout China and now is a pandemic.
How does it spread?
It spreads from person to person by large droplet infection (large droplet are infective upto a distance of 3 feet) or from contact with any contaminated surface and when we touch our face with contaminated hands.
How does Corona act in the body?
Corona virus acts through ACE2 receptors which are present not only in lungs but also in heart. In patients with heart diseases, these ACE2 receptors secretion is increased, hence more symptoms.
How does Corona commonly present?
Corona virus commonly act on lungs and present as fever, cough and shortness of breath. This happens during the initial phase of illness.These symptoms appear anywhere between 0-14 days after exposure to infection. The most important feature being they may not exhibit any disease features during this period. Respiratory tract
infection is common and severe in people with underlying heart diseases.
What are the risk factors for severe COVID infection?
• Age> 60yrs
• Coronary artery disease
• High Blood Presure
• Pre exisiting lung problems
• Heart Failure
• Renal Failure
• Reduced immunity status as seen in Cancer, Transplant patients
How does Corona effects heart?
The disease can affect the heart either immediately or over long time.
Immediate effects of COVID 19 on heart are damage to heart muscle either due to direct infection by the virus (myocarditis) or due to the harmful chemical substances released in response to virus by the body (myocardial injury). In addition due to the acute stress on the heart it can lead to heart failure, irregular heart beat or heart attack. People with previous heart diseases are more prone to develop damage to heart but can even happen in those without heart disease.
Over long term patients develop hypertension, irregular heart beat, high lipid levels, diabetes and heart failure.
People can identify heart involvement when they have chest pain, palpitations or breathlessness.
How can we identify heart damage?
People with these symptoms need to undergo some mandatory investigations like ECG, Echo, biomarkers like high sensitive troponin (hsCTrop), CK MB, and NT pro BNP. Chest X ray and Lung ultrasound are needed to rule out cardiac involvement.
Are there any medicines for COVID 19?
In the absence of any proven medicines Covid 19 patients are presently being treated with anti viral drugs( already being used for HIV infection). But these medicines can lead to harmful heart effects.
Can drugs used for treating COVID 19 be harmful?
In 90% of these patients on anti virals, there are again chances of cardiac insufficiency, arrythmias and other cardiac disorders.Hence careful cardiac monitoring is needed in these patients.
Can we prevent damage to heart?
Cardiac patients must practice social distancing – avoiding public places and gathering and stay put at home.
It is seen that vaccination with Influenza vaccine to all cardiac patients decreases the risk of death by 18% in all cardiac patients infected with COVID 19. Hence vaccination in cardiac patients is essential.
• COVID 19 not only a disease of lungs but also of heart
• COVID 19 is a disease of lungs primarily presenting with fever, cough and breathlessness
• Symptoms like chest pain and palpitations may be seen if heart is affected
• Tests for heart function need to be done to diagnose cardiac disease at the earliest
• Early initiation of drugs to treat cardiac problems is needed to prevent death
• Anti viral drugs can potentially injure the heart so need meticulous monitoring.
• Influenza vaccine to cardiac patients is helpful in preventing severe COVID 19 infection.
(Disclaimer: Dr C Raghu, Cardiologist Director, Aster Prime Hospital. Views expressed are a personal opinion.)