Heart Disease Emerging as a Post Covid Complication

Covid-19 is a respiratory virus that can damage the heart and blood vessels of many of its survivors. And while some damage may heal on its own, people who’ve had Covid are at increased risk for heart damage, according to a large-scale study published in Nature Medicine.

What’s surprising is that this long-term damage is not only affecting older adults with typical risk factors for Covid complications such as diabetes or obesity, but also people younger than 65 without those risk factors. Moreover, many people in the study who developed cardiac damage after Covid weren’t hospitalized when they had Covid symptoms. 

“Covid-19 is a dangerous virus that can lead to many complications, particularly if you are older, obese or have diabetes, chronic obstructive pulmonary disease or a heart condition,” says Bernard Kaminetsky, MD, medical director, MDVIP. “But it can also affect younger, healthier people in ways we’re still trying to understand.”

Patients were found at higher risk for a range of cardiovascular maladies including:

• Heart attacks
• Heartbeat irregularities
• Strokes
• Heart inflammation
• Cardiac arrest

Long-Term Study Looks at the Cardiovascular Effects of Covid

Researchers at Washington University in St. Louis used the U.S. Department of Veterans Affairs national healthcare databases to extract data on more than 11 million U.S. veterans. The veterans were divided into three groups. The first group of 153,760 veterans survived the first 30 days of a Covid-19 infection. A second group created – a control group referred to as the “contemporary” cohort, consisted of 5,637,647 enrolled in the Veterans Health Administration (VHA) system who don’t have a history of Covid-19. The third group – also a control group, labeled “historical” cohort comprised of 5,859,411 non-Covid-19 infected VHA users during 2017. 

All three groups were followed in longitudinally to help researchers gauge risk for and damage to the heart 12 months after a Covid infection and whether the setting of care such as a non-hospital, hospital floor or hospital intensive care unit made a difference in heart health.

Researchers found the risk of 20 different cardiovascular issues were significantly higher among veterans who had Covid-19 one year prior. Even veterans who were not hospitalized as result of Covid-19 had a much higher risk for heart attacks, heartbeat irregularities, strokes, heart inflammation and cardiac arrest when compared to people who were never infected with Covid-19.  

“This is the first long-term study to look at the cardiovascular affects of Covid. And while I believe the study should be replicated before considering the results as Gospel, I also believe it should be taken seriously at this point,” says Kaminetsky. “If you survived a case of Covid-19, work closely with your doctor on maintaining your heart health.”

Researchers aren’t sure what is triggering the heart and vascular problems. But they think it may be related to Long Covid – a group of symptoms that persist after recovering from Covid-19 and include fatigue, weakness, loss of smell, palpitations, dizziness, chest pain, shortness of breath and brain fog. And many primary care physicians and cardiologists have reported irregular and/or fast heartbeat, heart inflammation, broken heart syndrome and changes in heart rate when laying down or upright, leading to dizziness and fainting (also known as postural orthostatic tachycardia syndrome or POTS).

It's hard to predict who will struggle with long Covid. It can affect either gender – although it seems to affect more women than men. You can be any age; in fact, many long haulers are healthy, young adults ranging in age between 20 to 40 years old. Not even the severity of your Covid case is predictive, as if you’ll be saddled with long-term Covid after recovering from a mild or very serious case.  

Why Covid Might be Linked to Heart Damage

There are several theories as to why Covid is linked with heart disease. First, many people had preexisting conditions like obesity and diabetes, that put that at risk for heart disease and a bout Covid-19 triggered heart disease. Another problem is that people skipped routine care during the pandemic. It’s possible to have developed a heart condition while staying home that was diagnosed after getting hit with Covid. It might also be related to heart inflammation.  

Inflammation is physiological response to an infection or injury. When it affects the heart, it can manifest as pericarditis (inflammation of the sac-like tissue that surrounds the heart), myocarditis (inflammation of the heart muscle) and/or endocarditis (inflammation of the inner lining of the heart’s chambers and valves). As of now, only pericarditis and myocarditis have been linked to Covid-19. 

Mild heart inflammation often resolves on its own within a few months. More serious cases may require treatment such as medication or a procedure.  

“Heart inflammation can develop if the immune system produces too much inflammation while fighting the virus or because of the virus attacking the heart,” Kaminetsky says. “Covid-related heart inflammation seems to affect all ages. Even if the heart inflammation doesn’t produce symptoms, it can still lead to serious complications.” 

Persistent heart inflammation can be life threatening. It can cause fluid and pressure around the heart, thickening/scarring of the heart lining, irregular heartbeat, heart failure, heart attack, stroke and sudden cardiac death.

Physicians began reporting a rise in persistent heart inflammation at the beginning of the Covid-19 pandemic. A couple of small studies -- one conducted by German researchers and the other conducted by American researchers and focused on college athletes – support the uptick. 

When to Talk to Your Doctor if Experience these Symptoms

If you’ve had Covid-19, pay attention to early warning signs of a heart condition. Talk to your doctor if you begin experiencing:

• Changes to your normal heartbeat
• Intermittent chest pain
• Lightheadedness, dizziness and/or fainting, particularly if this wasn’t a problem before Covid-19
• Feeling more fatigued 
• Ankle swelling
• Weight gain
• Shortness of breath, particularly if this wasn’t a problem before Covid-19

Don’t have a doctor? Consider joining an MDVIP-affiliated practice. MDVIP-affiliated doctors have time to really work with you and develop a wellness plan that can focus on heart health. Find a physician near you and begin your partnership in health »