COVID-19: not that heavy on the heart
It is widely known that severe COVID-19 can adversely affect the guts and circulatory system's future. The University of Cape Town’s (UCT) Professor Mpiko Ntsekhe shared some insights into understanding the virusʼs impact on these vitals.
Professor Ntsekhe is that the chair of the Division of Cardiology at UCT, based at Groote Schuur Hospital. During a virtual interview, he highlighted the long-term COVID-19ʼs (long COVID) effect on the guts, and therefore the picture isn't as bleak as some might imagine.
“We know that with COVID-19 the organ most severely and commonly affected [by the disease] is that the lungs. However, we also know that COVID-19 is capable of spreading throughout the body to multiple organs, including the guts,” he said.
Fortunately, this doesn't happen very frequently, and therefore the overwhelming majority of patients with severe COVID-19 won't present with evidence of serious damage to the guts .”
Niémah Davids (ND): In cases where COVID-19 does affect the guts, how does it manifest?
Miko Ntsekhe (MN): When brooding about how COVID-19 affects the guts, it’s useful to consider two groups of people: those with long-standing heart conditions (present before COVID-19) and people with healthy hearts at the time of infection.
In those patients with an established heart condition, like a history of heart attacks, coronary failure, valve disease, and a hypertensive heart condition, the danger of developing severe COVID-19 and dying from it's much above those without the heart condition . one among the explanations for this is often because an impaired circulatory system isn't ready to deal with the physiological burden and demand COVID-19 imposes on the body and on the guts.
For patients with an abnormal heart who contract COVID-19, it’s like asking them to run 10 km or more, and typically they will only deal with 1 km. It places the guts under significant additional strain.
ND: Are COVID-19-positive patients more in danger of getting heart attacks?
MN: In some cases, COVID-19 can trigger heart attacks, especially in patients who have suffered heart attacks before, and/or those with known fatty plaques (a build-up of fats, cholesterol, and other abnormal substances) in their coronary arteries.
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COVID-19 also can precipitate coronary failure in those with a history of cardiac muscle disease. it's going to also cause the guts to beat abnormally fast, slow, or irregularly in those with cardiac rhythm disorders. The overwhelming majority of patients with COVID-19 who we've taken care of at Groote Schuur Hospital’s Cardiology Unit within the past year have fallen into this category.
ND: In patients who don’t have a history of heart condition, how does COVID-19 affect the heart?
MN: During this instance, the virus can cause injury to cardiac muscle cells (myocardial injury) without damaging the guts muscle itself. Approximately 5% of hospitalized patients with severe COVID-19 present evidence of this phenomenon. Thankfully, for the bulk of patients with myocardial injury as a result of severe COVID-19, the cardiac cell injury is detectable only by sensitive blood tests, without enough damage to cause any detectable cardiovascular dysfunction.
ND: apart from myocardial injury, are there other ways COVID-19 can affect the heart?
MN: during a very rare subset of individuals, the virus can cause active inflammation and necrosis (death) of the guts muscle and cause a disorder called myocarditis. If an outsized part of the guts is suffering from myocarditis, it can cause coronary failure and in some cases permanent heart damage.
During the 2 COVID-19 infection waves within the country, we took care of fewer than a couple of patients with severe myocarditis and coronary failure as a result of the virus.
ND: What are a number of the most long-term effects on the heart?
MN: it's important to emphasize that at this stage, impairment of the guts as a result of COVID-19 infection after patients are discharged from hospital or recovered from mild or asymptomatic infection is extremely, very rare.
Having said that, a growing number of patients with long COVID and their doctors report inappropriately fast heart-rate responses to exercise, sometimes related to palpitations. Although most formal tests of the guts are normal in these patients, speculation is that COVID-19 may affect the autonomic systema nervosum, which regulates things like pulse, breathing rate, sweating, and bowel function. This remains to be proven and is that the subject of ongoing research.
ND: Have you ever started a proper study to trace COVID-19 survivors to know their challenges after recovery?
MN: Because long-term cardiac COVID-19 has been rather infrequent, we’ve not yet commenced a proper study to delve into the topic further. However, the cardiac clinic at Groote Schuur Hospital may be a referral center where patients who are concerned about cardiac COVID-19 are regularly evaluated.
“COVID-19: not that heavy on the heart” is among a series of articles dedicated to long COVID which will be published on UCT News within the coming weeks.
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