Back to top
Live:
Coronavirus Updates

HealthDay Reports: Severe COVID-19 May Hurt the Heart

As the medical complications attributed to the ongoing COVID-19 crisis continue to emerge, HealthDay reporter Amy Norton examines what effect the disease may have on heart health.

Read the full story below.

By Amy Norton
HealthDay Reporter

THURSDAY, March 26, 2020 (HealthDay News) -- The new coronavirus may be a respiratory bug, but it's becoming clear that some severely ill patients sustain heart damage. And it may substantially raise their risk of death, doctors in China are reporting.

They found that among 416 patients hospitalized for severe COVID-19 infections, almost 20% developed damage to the heart muscle. More than half of those patients died.

Doctors in China have already warned that heart injuries appear common in COVID-19 patients, particularly those with existing heart disease or high blood pressure. A recent, smaller study found that 12% of hospitalized patients had the complication.

These latest findings, from a team led by Dr. Bo Yang of Renmin Hospital of Wuhan University, and published March 25 in JAMA Cardiology, add a concerning layer: Patients who develop heart damage may face an "unexpectedly" high risk of death.

Much remains to be learned. For one, the findings come from a single hospital in Wuhan, where the outbreak began. U.S. experts said it's not known whether the grim outlook will hold true at other hospitals worldwide.

"We certainly hope not," said Dr. Thomas Maddox, head of the Science and Quality Committee of the American College of Cardiology (ACC).

The ACC has already issued clinical guidance to cardiologists. Among other things, it highlights the extra risks to patients with heart disease, and tells cardiologists to be ready to jump in to assist other doctors caring for severely ill patients.

"We're anticipating that patients with underlying cardiovascular disease will struggle," Maddox said.

The novelty of the coronavirus means that it's not fully clear how to best manage those hospitalized patients. Standard heart medications and devices to provide cardiac support are being used, according to Maddox.

"We are continuing to figure this out," he said.

But the importance of prevention is more obvious than ever. Maddox said people with existing heart disease -- such as a past heart attack -- or a history of stroke should consider themselves at "high risk" and be vigilant about protecting themselves.

For those living in a community with a COVID-19 outbreak, that means staying home as much as possible, according to the U.S. Centers for Disease Control and Prevention. Meanwhile, all high-risk people should wash their hands often, disinfect surfaces they routinely touch, and be serious about "social distance" if they do go out.

Among the unknowns, though, is whether people with high blood pressure might also fall into the high-risk category.

"This is an important question, and one on many people's minds," said Dr. Elliott Antman, former president of the American Heart Association and a senior physician at Brigham and Women's Hospital in Boston.

Of the 82 patients in this study who developed a heart injury, 60% had high blood pressure. About 30% had a previous diagnosis of coronary heart disease, while almost 15% had chronic heart failure.

Antman said it's hard to tell whether high blood pressure alone -- without other health issues -- was a risk factor for heart injury. Plus, he said, there's no information on whether patients' high blood pressure was under control with medication or not.

Of patients who sustained heart damage, just over 51% died in the hospital, according to the study. That compared with 4.5% of those without heart injury.

It's not certain, though, that the heart complication is actually what caused those deaths, Antman said. "This could all be a reflection of a very bad infection," he explained.

Why does the coronavirus wreak havoc on some patients' hearts?

Again, no one is sure, Maddox said. But he explained the leading theories.

One suspect is the immune system's reaction to the coronavirus. If it veers out of control, in what's called a "cytokine storm," it can damage the body's organs. A second possibility is that in people who already have heart disease, the overall stress of the infection harms the heart muscle.

Finally, it's possible that the new coronavirus directly invades the heart, Maddox said. Researchers say the virus very effectively latches onto receptors on our body cells called ACE2. Those receptors are found not only in the lungs, but elsewhere in the body -- including the heart and digestive tract, he explained.

There has been some speculation that common blood pressure drugs -- ACE inhibitors and angiotensin receptor blockers -- might make people more vulnerable to falling ill with COVID-19. But that is based only on animal research suggesting that the drugs can boost the activity of ACE2 receptors.

Maddox and Antman stressed that no one should stop taking their prescriptions, since poorly controlled high blood pressure or heart disease would be dangerous -- especially now.

More information

People at high risk of severe COVID-19 illness can get advice from the U.S. Centers for Disease Control and Prevention.

SOURCES: Thomas Maddox, M.D., M.Sc., chairman, Science and Quality Committee, American College of Cardiology, Washington, D.C., and professor of medicine, Washington University School of Medicine in St. Louis; Elliott Antman, M.D., former president, American Heart Association, Dallas, senior physician, Brigham and Women's Hospital, Boston, and associate dean for translational medicine, Harvard Medical School, Boston; JAMA Cardiology, online, March 25, 2020

Last Updated: Mar 26, 2020

Copyright © 2020 HealthDay. All rights reserved.

In our latest HealthDay Now interview, Dr. Anton Porsteinsson, a principal investigator for the Biogen aducanumab trial, and Dr. Ken Lin, a primary care physician, discuss the controversial new Alzheimer's drug and whether it will provide any benefit to patients, despite its highly uncertain efficacy and steep cost.

Watch the in-depth discussion above, and see our past HealthDay Nows and other videos on our YouTube channel.

HD Live! Videos

In our latest HealthDay Now, Mabel Jong spoke with Dr. Lori Pierce, president of the American Society of Clinical Oncology and a cancer radiation specialist at the University of Michigan.

Dr. Pierce shared important takeaways from the recently concluded 2021 ASCO annual meeting and discussed why equity was the chosen theme this year.

Watch the in-depth discussion above, and see our past HealthDay Nows and other videos on our YouTube channel.

In our latest HealthDay Now, Dr. Hina Talib, a pediatrician and adolescent health specialist at the Children's Hospital at Montefiore, debunks myths and common concerns parents may have about giving their children Pfizer's COVID-19 vaccine, which was recently approved for use in children and teens ages 12 and up.

HealthDay Now's Mabel Jong also speaks with Alan Santee, a high school freshman from Massachusetts, about why he didn't hesitate to get vaccinated, and Ethan Lindenberger, a 20-year-old vaccine advocate from Ohio, about his experience having a mom who is anti-vaccine and how kids and parents can approach these conversations.

Watch the in-depth discussion above, and see our past HealthDay Nows and other videos on our YouTube channel.

Watch our latest HealthDay Now to hear about the state of mental health and why many people fear returning to their social and work lives.

HealthDay's Mabel Jong spoke to Dr. Vivian Pender, president of the American Psychiatric Association, and Sherry Amatenstein, a social worker and therapist who has been dealing with these anxieties herself.

Watch the in-depth discussion above, and see our past HealthDay Nows and other videos on our YouTube channel.

Watch our latest HealthDay Now as we recap the highlights of the American Association for Cancer Research (AACR) Annual Meeting 2021.

Mabel Jong from our liveblog team speaks with Dr. Antoni Ribas, former president of the American Association for Cancer Research and professor of medicine at UCLA, and Anna Plym, PhD, a postdoctoral research fellow at Brigham and Women's Hospital.

Watch the in-depth discussion above, and see our past HealthDay Nows and other videos on our YouTube channel.

Watch our latest HealthDay Now as we dive into the latest details on multisystem inflammatory syndrome in children (MIS-C).

Mabel Jong from our liveblog team speaks with Dr. Mary Beth Son, Program Director of Boston Children's Hospital's Rheumatology Program, and Brian Padla, father of James Padla, who has MIS-C.

Watch the in-depth discussion above, and see our past HealthDay Nows and other videos on our YouTube channel.


Watch our latest HealthDay Now as we take a look at how living through the COVID-19 pandemic impacts children socially, mentally and emotionally.

One year in, this is their "new normal," but what does that mean for them? From social isolation to remote learning to a loss of structure and normalcy, we discuss how living during the pandemic has both short- and long-term effects on children.

Mabel Jong from our liveblog team speaks with:

  • Dr. Mark Reinecke, Department of Psychiatry & Behavioral Sciences, Northwestern University
  • Tracy Compton, a parent
  • Stephen Guerriero, a teacher
  • Jake Anderson, a student

Watch the in-depth discussion above, and see our past HD Lives and other videos on our YouTube channel.

Watch our latest HD Live! as we take a look at the COVID-19 pandemic and the vaccination rollout and how they've impacted people of color.

Mabel Jong from our liveblog team speaks with:

  • Tasha Clark-Amar, CEO, East Baton Rouge Council on Aging
  • Jill Ramirez, Executive Director, Latino HealthCare Forum (Austin)
  • Vickie Mays, PhD, Professor, UCLA Fielding School of Public Health

Watch the in-depth discussion above, and see our past HD Lives and other videos on our YouTube channel.

Watch our latest HD Live! as we take a look at the global COVID-19 vaccination rollout and how the United States rollout compares.

Mabel Jong from our liveblog team speaks with Dr. Ran Balicer of Clalit Health Services and Dr. Arnold Monto of University of Michigan School of Public Health.

Watch the in-depth discussion above, and see our past HD Lives and other videos on our YouTube channel.