Since early 2020, when the coronavirus pandemic emerged in the U.S., physicians have been taking a crash course in the complex disease and how best to treat it—and more information is on the way. The AHA established a $2.5 million rapid research fund to better understand COVID-19 and its interaction with cardiovascular diseases. William A. Gray, MD an interventional cardiologist at Lankenau Heart Institute, part of Main Line Health and the president of the AHA Southeast chapter for Pennsylvania, has more than three decades of experience treating a range of heart issues. Here, he shares what we know so far about COVID-19 and heart disease.
Heart disease survivors may have a greater risk of coronavirus complications.
While heart disease patients are not at greater risk for contracting COVID-19, they may be at greater risk for complications from the disease. “It depends on which part of heart disease they had,” says Dr. Gray. “As long as your heart pump is working reasonably well, uncomplicated events—like a small heart attack or minor stroke that they recovered from—in and of itself, is probably not going to put you at significant risk.”
What could increase the risk of complications include the same factors that lead to having a heart attack or stroke, like hypertension, diabetes, heart failure, and significant valvular heart disease Maintaining a healthy weight can help reduce the risk of heart disease, and improve the chance to have a good outcome if you do contract coronavirus. “Obesity is a significant marker of worse outcomes, and with obesity typically comes hypertension and diabetes,” he adds.
COVID-19 patients may be at greater risk for future heart complications.
Even without a prior history of heart disease, coronavirus survivors may want to pay extra attention to their heart health. COVID-19 starts as a respiratory disease, entering the body through the respiratory system, but it becomes a systemic disease, and can affect multiple organs, including the heart. “Many of the complications we see in COVID aren’t directly related to the pneumonia you get, but related to the secondary effects, including blood clotting and myocarditis, or inflammation of the heart muscle, which can cause heart failure,” says Dr. Gray. According to Dr. Gray, sometimes the myocarditis is so severe that it causes significant acute illness for a patient.
We don’t yet know the long-term effects of COVID-19.
In a crucial point, Dr. Gray also notes that the long-term impact of COVID-19’s cardiac manifestations are not yet fully understood. “In a recent study, MRI scans were used to measure the hearts of COVID patients three months after recovery,” he explains. “It turns out, there’s still inflammation. We don’t know what the long-term effects of that are going to be. We hope that it’s just a minor thing, but it’s too early to say just yet.”
Women and people of color can be more susceptible to COVID-19.
While there are no significant biases in terms of who contracts the disease, there are factors that make women and people of color more vulnerable, or more susceptible to negative coronavirus outcomes. Last fall, the Bureau of Labor Statistics monthly jobs report showed that roughly 2.2 million women had left the labor force between February and October, indicating that women are more likely to be primary caregivers. As a result, they’re more likely to be exposed if there’s somebody sick in the home. And while people of color aren’t more likely to contract COVID, statistically, they’ve been shown to have worse outcomes. According to Dr. Gray, “the disparity is not that certain racial or ethnic cohorts are getting COVID more frequently than others, but that there was preexisting inequality and disparities in access to health care.”
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