COVID-19 takes a toll on the heart, and not just metaphorically. A recent study looked at the hearts of 100 patients recovering from the novel coronavirus that has gripped the globe. Seventy-eight of the hundred showed signs of heart complications and 60 showed ongoing myocardial inflammation of the heart muscle.
Myocarditis can cause chest pain, fatigue and even heart attack and make physical activity dangerous, meaning the scars left by COVID-19 would set up patients for years of complications and hazards. The study’s authors warn that early diagnosis using magnetic resonance imaging (MRI) is important to treat or possibly stop the relentless course of inflammatory damage.
The German study, published in the JAMA Cardiology, is the first to select subjects randomly from a pool of coronavirus patients—this one from a registry kept by the University Hospital Frankfurt—and test them for heart damage.
Which COVID-19 patients get this type of heart problem?
The patients varied in terms of preexisting conditions, severity of illness, and time since diagnosis. Fifty-three were male and the median age was 49. Sixty-seven recovered at home and the other third were hospitalized. Of those that recovered at home, 18 were asymptomatic and 49 had minor or moderate symptoms.
None of these factors seemed to be a predictor for cardiovascular complications. The researchers used MRI to search for signs of heart conditions and myocardial inflammation and found both were common across all groupings. Despite it being a respiratory illness, the inflammation burden that COVID-19 places on the body damages the heart.
The study, led by Eike Nagel, MD, and Valentina O. Puntmann, MD, PhD, both of the University Hospital Frankfurt, was published on July 27 and was soon referenced in thousands of other pieces of academic literature. Some researchers criticized it for faulty data handling and inconsistent figures within the study. It was corrected this week and the journal said the conclusions are valid.
There are several mechanisms by which COVID-19 may attack the heart, according to a Harvard Medical School advisory. Heart-vessel blockages, infection, fever, and inflammation caused by COVID-19 can destabilize fatty plaques inside the heart vessels, accelerating previously existing heart disease. COVID-19 fever and inflammation might also increase the metabolic demands of many organs, while the lungs are working at reduced capacity, starving the heart of oxygen. Lastly, the virus sometimes directly infects the heart, causing severe and sudden inflammation.
What does this mean to your workout?
Inflammation of the heart can seriously restrict a person’s activities. The National Heart, Blood and Lung Institute and the Myocarditis Foundation recommend that myocardial inflammation patients refrain from sports and rigorous exercise until given permission by a doctor, which may be months or longer after treatment.
The American College of Cardiology recommends athletes with myocarditis restrict their exercise for three to six months under the guidance of a physician, allowing inflammation to reduce before returning to the field.
The study is another sign that the complications of COVID-19 stay with the patient long after the virus passes.
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