How COVID-19 Increases the Risk for Patients with Heart Disease?
COVID-19, resulted from the novel coronavirus (a.k.a. SARS-CoV-2), has been in the headlines of newspapers for weeks. It is notorious for resulting in pulmonary complications, that is, viral pneumonia.
Recent studies also find that it might result in cardiovascular complications, especially for those already with comorbid conditions.
One major risk factor for causing mortality, in addition to advanced age and male gender, is the presence of comorbidities, including hypertension, diabetes mellitus, cardiovascular disease, respiratory disease, and cancer. Although the definite pathogenic mechanism is still under investigation, some clinical observational findings might illuminate this chain reaction.
COVID-19, A Systemic Infection
Generally speaking, coronavirus, like other infections, introduces inflammatory responses from the immune system. Inflammation is a response of the immune system, summoning its troops to attack invaders. When inflammation happens, raised heart rate and increased power of cardiac contraction, work together at an accelerated speed for transporting troops and their supplies (such as oxygen and nutrients). That response is typically mediated by cytokines and sympathetic stimulation. The risk of arrhythmia will thus increase.
Meanwhile, since the workload of the heart increases, the oxygen demand of heart muscle cells increases as well. If that demand couldn’t be matched by sufficient supply, atherosclerosis can result in narrowed blood vessels, ischemia of cardiac cells might occur, and then even cellular death might happen, which results in myocardial infarction.
COVID-19 Can Affect Your Heart Directly
Moreover, several case reports related to COVID-19 suggested a mechanism of the virus directly invading heart cells, a phenomenon called myocarditis. Myocarditis is identified by microscopically examining the damaged cardiac cells, which are surrounded by inflammatory cells. With damaged cardiac cells, the power of cardiac contraction attenuates, and the supply of oxygen and nutrients decreases, which further threatens the heart cells. In addition, electrophysiology of the diseased heart cells will be disturbed, which results in the raise of arrhythmia risk.
No matter the mechanism, the common result is heart cell injury, followed by circulatory failure. One cohort study, conducted at the epicenter of the virus, found that cardiac injury occurred during hospitalization in 19.7% of confirmed Covid-19 cases among a study group of 416 consecutively admitted patients. Along with other clinical reports, cardiac monitoring is regarded as essential in the treatment of COVID-19, especially those in critical situations.
Understanding how your heart and health can be affected is important, but there is no need to panic. Prevention done correctly can be more effective than a cure; increasing preventative measures is critical as we face COVID-19.
Your lifestyle can make a big difference. Controlling cardiac risk factors such as smoking, hypertension, diabetes mellitus, and hyperlipidemia, is a must to protect your heart. Increasing your endurance and improving your cardio performance, via regular exercise, will further strengthen your heart. Through these actions, you are building your health capital to combat future threats against your heart health.
Aristotle once said: “We are what we repeatedly do. Excellence, then, is not an act, but a habit.” Let’s take the opportunity and transform this unprecedented crisis into a stepping stone towards building a brighter and healthier future.