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Long-term cardiovascular consequences of COVID-19 are possible, according to two studies out this week.

The German studies, published Tuesday in the peer-reviewed journal JAMA Cardiology, found heart abnormalities in COVID-19 patients months after they had recovered from the virus

https://jamanetwork.com/journals/jamacardiology/fullarticle/2768916

Heart MRI’s of patients recovered after COVID-19. (JAMA Cardiology)

78 out of 100 patients studied showed heart impacts from COVID-19. 

Study Raises ‘Significant Concerns,’ Says UCSF Fresno Heart Doctor

“The results from the Valentina Puntmann and her colleagues online on July 27th in JAMA Cardiology raises some very significant concerns about the long term effect on the heart,” said UCSF Fresno cardiologist Richard G. Kiel, M.D., in a statement to GV Wire℠.

Kiel also said, “These findings are concerning as these conditions often are the precursor to a patient developing congestive heart failure,  a condition in which the heart cannot pump enough blood to supply the body’s demand.  It’s important to consider that the patients included in this study all recovered from their infection, often at home.  We also do not know if these findings in the heart will continue to persist and cause chronic disease, or if they will return to normal with time, do we see similar findings in patients with milder courses of the disease.”

“Patients who have had severe cases of COVID-19 infections should be aware of the symptoms of heart failure and discuss with their physician if they should occur. These symptoms include excessive fatigue; shortness of breath, especially if it occurs while laying flat; waking up with the feeling of being suffocated; racing heartbeats, or worsening leg swelling.  The earlier that these symptoms can be treated, the better the chance of restoring heart function.”

Portrait of UCSF Fresno cardiologist Richard G. Kiel, MD

“Patients who have had severe cases of COVID-19 infections should be aware of the symptoms of heart failure and discuss with their physician if they should occur. These symptoms include excessive fatigue; shortness of breath, especially if it occurs while laying flat; waking up with the feeling of being suffocated; racing heartbeats, or worsening leg swelling.”  — Dr. Richard G. Kiel, UCSF Fresno

Saint Agnes Interventional Cardiologist, COVID-19 Can ‘Directly Infect the Heart’

In a statement to GV Wire℠ Saint Agnes Medical Center cardiologist Dr. Alfred Valles writes, “Some studies have shown that the virus has affinity for proteins found in the heart called angiotensin receptors and this may contribute to localized heart Infection and inflammation that may be detectable using Cardiac MRI.”

Valles believes it’s still too early to tell if inflammation brought on by COVID-19 will be associated with any long term implications. He also wants to put some perspective on the numbers.

“Although COVID-19 is important and 153,000 Americans have died thus far, it pales in comparison to deaths attributable to cardiovascular disease. One person dies every 37 seconds in the United States from cardiovascular disease,” says Valles.

Key Points

Researchers set out to answer this question: What are the cardiovascular effects in patients who recently recovered from COVID-19?

A group of 100 adult patients was chosen.

Cardiac MRIs showed cardiac involvement in 78 patients and ongoing myocardial inflammation in 60 patients. The Mayo Clinic describes myocardial inflammation as something that can affect your heart muscle and your heart’s electrical system.

“When this came to our attention, we were struck,” Dr. Clyde Yancy, chief cardiologist at Northwestern Memorial Hospital and an editor at JAMA Cardiology, told USA Today.

The authors of the study say these findings indicate the need for the ongoing investigation of the long-term cardiovascular consequences of COVID-19.

“Although COVID-19 is important and 153,000 Americans have died thus far, it pales in comparison to deaths attributable to cardiovascular disease. One person dies every 37 seconds in the United States from cardiovascular disease.”Dr. Alfred Valles, Saint Agnes Hospital cardiologist

The findings would have been virtually impossible to pinpoint without this study, as the majority of patients didn’t exhibit any symptoms. Moreover, the specific abnormalities detected by the MRI wouldn’t have been seen on an echocardiogram.

Design, Setting, and Participants

The 100 patients were identified from the University Hospital Frankfurt COVID-19 Registry between April and June 2020.

All participants were considered eligible after a minimum of two weeks from the original diagnosis if they had a resolution of respiratory symptoms and negative results on a swab test at the end of the isolation period.

Long-Term Health Effects

The authors conclude by stating, “The long-term health effects of these findings cannot yet be determined. … Most imaging findings point toward ongoing perimyocarditis (acute inflammation) after COVID-19 infection.”

Study Limitations

The study isn’t intended for use in pediatric patients 18 years and younger.

They also do not represent patients during acute COVID-19 infection or those who are completely asymptomatic with COVID-19.

(USA Today contributed to this story.)

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