Aqib Mushtaq
SARS-CoV-2, the virus that causes Covid-19, was initially thought to primarily impact the lungs — SARS stands for “severe acute respiratory syndrome.” Now we know there is barely a part of the body this infection spares. And emerging data show that some of the virus’s most potent damage is inflicted on the heart. An intriguing new study from Germany offers a glimpse into how SARS-CoV-2 affects the heart. Researchers studied 100 individuals, with a median age of just 49, who had recovered from Covid-19. Most were asymptomatic or had mild symptoms. An average of two months after they received the diagnosis, the researchers performed M.R.I. scans of their hearts and made some alarming discoveries: Nearly 80 percent had persistent abnormalities and 60 percent had evidence of myocarditis. The degree of myocarditis was not explained by the severity of the initial illness. Though the study has some flaws, and the generalizability and significance of its findings not fully known, it makes clear that in young patients who had seemingly overcome SARS-CoV-2 it’s fairly common for the heart to be affected. We may be seeing only the beginning of the damage. Researchers are still figuring out how SARS-CoV-2 causes myocarditis — whether it’s through the virus directly injuring the heart or whether it’s from the virulent immune reaction that it stimulates. It’s possible that part of the success of immunosuppressant medications such as the steroid dexamethasone in treating sick Covid-19 patients comes from their preventing inflammatory damage to the heart. Such steroids are commonly used to treat cases of myocarditis. Despite treatment, more severe forms of Covid-19-associated myocarditis can lead to permanent damage of the heart — which, in turn, can lead to heart failure.But myocarditis is not the only way Covid-19 can cause more people to die of heart disease. When I analyzed data from the Centers for Disease Control and Prevention, I found that since February nearly 25,000 more Americans have died of heart disease compared with the same period in previous years. Some of these deaths could be put down to Covid-19, but the majority are likely to be because patients deferred care for their hearts. That could lead to a wave of untreated heart disease in the wake of the pandemic.
The only way to prevent more people dying of heart disease, both from damage caused by the virus as well as from deferred care of heart disease, is to control the pandemic.
Since the beginning of the pandemic, it’s been clear that people with heart disease or related conditions such as diabetes or high blood pressure are at increased risk for severe Covid-19 illness. Hospitals and clinics should work overtime both to ensure they are safe for patients and to bolster telemedicine services so that patients can be cared for without having to leave their homes. Doctors and researchers should no longer think of Covid-19 as a disease of the lungs but as one that can affect any part of the body, especially the heart. The only way to prevent more people dying of heart disease, both from damage caused by the virus as well as from deferred care of heart disease, is to control the pandemic.
(The writer is a medical student by profession and writes frequently for “Kashmir Horizon”. Views are his own) [email protected]
