How COVID-19 Can Affect Heart Health

Three years into the COVID-19 pandemic, doctors and researchers can point to several ways in which cardiac health and the coronavirus are connected.

Feb. 22, 2022 5   min read

Finding the best ways to protect our health when it comes to COVID-19 is a big part of many people’s lives. This is especially true for people who may have health conditions that put them at an increased risk of hospitalization or death if they are sickened by the virus.

Uzma Iqbal, MD, is a cardiologist with Rochester Regional Health and explains the ways in which heart patients may be affected by COVID-19.

Risk factors for patients

As the world enters a fourth year of living with COVID-19, scientists and doctors continue to look at the latest information about the virus to determine how it is affecting us – and who it is affecting.

So far, research shows the virus affects different people in different ways based on their health history.

Several risk factors may contribute to a COVID-positive individual becoming sicker:

  • Age
  • High blood pressure
  • Diabetes
  • Obesity

“All of these risk factors that place certain patients at greater risk of having a more severe case of COVID-19 are the same risk factors that increase their risk of heart disease or congestive heart failure,” Dr. Iqbal said.

Vaccinated vs. unvaccinated heart patients

After more than two years of COVID-19 vaccines being widely available to the public, data overwhelmingly shows that the vaccines are extremely effective in preventing severe illness and has shown significant reductions in the number of hospitalizations and deaths.

For most vaccinated heart patients who experience a breakthrough infection, symptoms are mild and the recovery is a quicker process. For unvaccinated heart patients, the disease is more severe and the prognosis is much worse.

A study published in the British Medical Journal analyzed health data for 30 million people in the U.K. and found the risk of hospitalization or death due to hemorrhage and stroke was substantially higher for unvaccinated individuals compared to vaccinated individuals.

The American Heart Association encourages patients to talk with their primary care provider about getting vaccinated against COVID-19, saying in a statement they recommend “people who have medical conditions consult with their health care professionals before seeking vaccination. In addition, the Association reiterates the importance of handwashing, social distancing and wearing masks as vaccinations continue, particularly for people at high risk of infection and/or severe COVID-19.”

Post-COVID heart issues

Patients who were sickened by COVID-19 have developed heart-related issues, both in the short term and the long term. If a patient has some of the risk factors mentioned above, they are 3 times more likely to have heart attacks and strokes following a COVID-19 infection, according to a study published in The Lancet.

New data released by the American Heart Association shows 928,741 people died of heart disease in 2020 – the highest number of heart disease-related deaths since 2003. The most significant increases in deaths were among Asian, Black, and Hispanic individuals. By comparison, 874,613 people died of heart disease in 2019.

“If you are having chest pain or significant shortness of breath a short time after you have recovered from COVID-19, you are still at risk,” Dr. Iqbal said. “You should immediately contact your primary care provider and let them evaluate you.”

Other patients will start to show symptoms 2-3 months after they have recovered from COVID-19, including:

  • Chest pain
  • Shortness of breath
  • Heart palpitations
  • Increased heart rates
  • Fatigue

Approximately 40 percent of patients who are hospitalized from these symptoms after a COVID infection have gone through testing which shows they may be developing some heart-related conditions, according to Dr. Iqbal. Many of those tests show elevated levels of troponin – a protein in the heart muscle that is only released into the blood when heart muscles are damaged.

When the COVID-19 virus enters the body, it attaches to the ACE-2 receptors on an individual’s blood cells. Those receptors are on the heart muscle and blood vessels, as well as in the lungs. While higher levels of troponin could be related to heart inflammation, research is still being done about how significant that damage indicated by higher troponin levels is and how long it could last.

Heart inflammation and COVID-19 vaccination

In the U.S., there are four COVID-19 vaccines being administered: Pfizer-BioNTech, Moderna, Janssen (Johnson & Johnson), and Novavax. There have been a small number of instances of myocarditis reported by some patients who received doses of the Pfizer or Moderna vaccines. Myocarditis is a condition that occurs when the heart muscle becomes inflamed.

There were fewer than 200 myocarditis cases reported out of 211 million people who have been fully vaccinated in the U.S.; most of these cases were males under the age of 30. Most of those cases were very mild and most people recovered from those cases fairly quickly.

If an individual is unvaccinated, risks for developing myocarditis and pericarditis are much higher, especially if they contract COVID-19. The benefits of vaccination far outweigh the risks. A study in the U.K. published in the medical journal Nature looked at millions of vaccinated and unvaccinated individuals and found those who had a COVID-19 infection were significantly more likely to develop heart inflammation compared to vaccinated individuals.

Seeking treatment at hospitals

If a patient is having a heart attack or stroke, they should go to a hospital without hesitation. The hospitals are still the safest place for patients to be wherever they may be.

Time and being close to a place of treatment are of essence when it comes to heart attacks and stroke. Toward the beginning of the pandemic, patients experienced heart failure that could have been prevented if they had showed up earlier at a hospital.

“Don’t write off any of these symptoms that could signify a heart attack or stroke at home,” Dr. Iqbal said. “If you are having chest pain or any other symptom suggestive of a stroke, the best thing to do is call 911. We are here to take care of emergencies.”

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