Covid-19 can affect your heart

A visit to any of the high streets in the city gives you the impression that the pandemic is over and there’s no need for social distancing. If stories of patients losing their lives because they couldn’t get a hospital bed or ambulance in time aren’t enough, two papers published recently in The Journal of the American Medical Association (JAMA) on strong evidence of Covid-19 causing damage to the heart should be a wake-up call.

While the recovery and mortality rates are encouraging and present a picture of this pandemic not being as deadly as initially thought, the learning over time is saying otherwise. The effect of the virus does not stop with the pass-through asymptomatic or mild/moderate infection that most of the victims recover from quickly. It is now becoming increasingly clear that it attacks almost every vital organ of the body, not just the lungs, and leaves a lasting impact that manifests in different ways over time.

While as much as 80% of those infected by Covid-19 can suffer from permanent debilitating and even potentially fatal heart conditions according to the JAMA papers, inflammation and tissue damage are seen in all vital organs.

There are some critical facts that you need to understand. Covid-19 attacks you in three ways. First, it is a systemic disease. It means it attacks the tissues of every single organ in the body – from the brain to the heart to the kidneys. It is not localised to only the lungs as believed in the initial days of the pandemic. Second, it causes severe inflammation, leading the body’s immune system to overwork and over-express itself. The cytokine storm, as this condition is known as, can be fatal. Third, it causes micro blood clots in all the vital organs.

These clots in the cardiac microcirculation lead to a heart attack. Around 14 per cent of Covid-19 cases come to the hospital with a heart attack. This is an acute form of the disease.

Two papers presented in JAMA by two different teams of researchers showed worrying results. One team conducted autopsies on Covid-19 victims. It revealed that in 80% of the cases, there was evidence of the virus replicating in the tissues of the heart. This showed that the heart is affected by the infection. The other team studied the hearts of those who had recovered fully from the infection 70 days earlier. The study showed that even though the patients had been Covid-19 negative for over two months, their hearts were still inflamed. This means that even though there was no virus replication, the body’s immune system’s response has continued for over two months. This is very worrying because if this inflammation persists for a longer time, it will weaken the tissues, leading to heart failure.

The alarming fact here is that a majority of those studied were younger – around 50 years of age, and with only mild or moderate symptoms. Most of these patients did not require hospitalisation. This study indicates that a large number of those who have recovered from the infection – asymptomatic, mild, moderate or severe – are potentially heading towards heart involvement.

What can you do to protect your heart? Absolutely nothing. This is, therefore, a time to be extraordinarily careful. The infection has entered the community.

Avoid every visit or outdoor activity that you can. This is a dangerous virus, and it is showing no signs of weakening. With the lockdowns lifted, the cases are spiking. Those who oppose lockdowns citing economic concerns articulate the view that it is time to consider this another strain of flu and get on with life as usual. Nothing can be further from the truth. This is no common flu. It is a deadly virus that will continue to devastate lives and economies long after the vaccine comes and the pandemic is gone. The only option for you now is the age-old saying – prevention is better than cure. Stay indoors as far as possible, eat healthily and never leave home without a mask. That’s the only way to beat Covid-19.

(The writer is an interventional cardiologist)