COVID-19 was initially thought to be a respiratory disease. However, further research and progression of the pandemic revealed that the virus not only affects the lungs but also other vital organs such as the heart, kidneys, and brain. While the exact mechanism of how the COVID-19 virus affects the heart is not clear, a recent study has shown that SARS-CoV-2 (the virus that causes COVID-19) can damage the heart muscle and tissues permanently, increasing the risk of heart failure.

How does the COVID-19 virus affect the heart?

Studies have shown that SARS-CoV-2 damages the heart muscle by attaching itself to the ACE2 (angiotensin-converting enzyme 2) receptors present in the blood vessels of the heart. The novel coronavirus can damage the heart in several ways:

• The myocytes (heart muscle cells) of a COVID-positive patient get damaged due to the increased release of cytokines and other inflammatory cells in response to the SARS-CoV-2 infection.
• In COVID-19 patients, there is an increased cardiac demand due to the viral infection and lack of oxygen to the heart tissues, which puts excess pressure on the heart.
• In patients with COVID-associated pneumonia or ARDS (acute respiratory distress syndrome), the heart experiences hypoxia (lack of oxygen to the tissues) that damages the heart muscle.

What does new research on heart damage and Coronavirus reveal?

The new study published in the Journal of the American College of Cardiology: Basic to Translational Science on 26th February 2021, focused on determining the interaction between heart tissues and the COVID-19 virus. In this study, scientists from the Washington University School of Medicine engineered heart muscle in their laboratory using stem cells and exposed them to the SARS-CoV-2 virus in a safe setting. 

The results of the study showed that:

• The infection caused by the COVID virus not only damages the cells of the heart muscle but also destroys the muscle fibres that help the heart muscle contract.
• The death of heart muscle cells and fibres can be seen even in the absence of inflammation.
• The immune cells present in COVID-19 patients with heart damage (macrophages, monocytes and dendritic cells) can result in long-term consequences. 

To validate their findings, scientists studied the heart tissues of four COVID-positive patients with heart injury (post-death). The results were the same. 

With this study, scientists concluded that the COVID-19 virus infects the heart muscle which can result in heart failure. They further stated that even young people with very mild symptoms of COVID-19 can develop heart issues.

Previous research also discovered heart damage in COVID-19 patients

Several studies conducted in the past, have concluded that myocarditis is one of the major side effects in COVID-infected people. Myocarditis is the term used for the inflammation of the heart muscle, which weakens and enlarges the heart. The scarring (formation of fibres) of the heart makes it difficult for the heart to function normally and can result in heart failure. 

Some of the studies determining the link between heart and COVID-19 include:  

• Research published in the Journal of Thoracic Imaging, including 199 COVID-positive patients from 34 different studies, found that around 40% of the total patients developed myocarditis.
• Another study published in the journal JAMA Cardiology in September 2020 found that 26 young athletic patients with coronavirus disease developed myocarditis, indicating that heart disease is not limited to just older adults.
• In September 2020, the American Heart Association reported that around 40% of all COVID-related deaths occurred due to cardiovascular complications.

How can one prevent heart damage from Coronavirus?

Currently, there is no specific way to prevent the effect of the virus on the heart. However, some measures can keep one safe and these include:  

• Maintaining social distance, washing hands and wearing a mask to stop the spread of the disease.
• People already taking medications for any heart problems must not discontinue their medications without consulting their doctor.
• Practising some moderate-intensity exercise regularly for at least 30 minutes. One can indulge in rope skipping, stationary cycling or stair climbing which does not require going out in public. 
• Seeking medical help if one experiences COVID-symptoms (fever, dry cough, loss of taste and smell) along with chest pain, breathing issues, severe weakness, arm numbness or any other cardiac symptoms.
• Getting vaccinated when it is your turn. The government is currently rolling out COVID-19 vaccination to senior and individuals who have comorbid conditions. It is important for people who come under these categories to go ahead and take the vaccine.

Conclusion

Various studies have concluded that heart injury can also be prevalent in some COVID-19 patients who didn’t experience severe symptoms or required hospitalisation. Since there is no known way to prevent COVID-related heart damage yet, one must continue to take necessary precautions - wear masks, use sanitisers, wash hands, maintain physical distancing and get vaccinated early, to reduce the risk of infection and complications.

Talk to a cardiologist if you have any questions related to heart health.