COVID-19 and the heart: 5 insights from a UCSF cardiologist

The COVID-19 pandemic has presented a whirlwind of unknowns, stirring up conversations about how the virus may affect the heart. In a recent edition of the University of California San Francisco's magazine, Nisha Parikh, MD, cardiologist and associate professor of medicine, recapped what researchers and physicians now know about what the novel coronavirus may be doing to the heart. 

 Five insights: 

1. COVID-19 may impair the heart's blood-pumping ability. In some cases, infection may lead to inflammation of the heart muscle and the membrane around the heart, which was observed early on in the pandemic. When conducting an echocardiogram, Dr. Parikh said she also keeps an eye out for an abnormality on the right sight of the heart that can arise from blood clots or injury in the lungs — both common occurrences in COVID-19 patients. 

2. COVID-19 probably affects heart muscle cells and other tissue, regardless of symptomatic or asymptomatic infection. Dr. Parikh cited a study that indicates people who recovered from the illness were more likely to have heart muscle damage than those who hadn't had COVID-19. A separate cell culture study analyzed infected heart cells with COVID-19 and found the infection caused the muscle building blocks to break apart into small pieces, which can interfere with the heart's beating ability. 

3. Some heart effects may be related to delays in care. Some people may have delayed medical care related to a heart problem as a result of the pandemic, leading to serious complications that are typically preventable with treatment, such as holes in the heart muscle and valve tears. 

4. Long-term effects of COVID-19 may include heart and neurological symptoms. Past COVID-19 patients who experience cardiovascular symptoms like chest pain or palpitations often report brain fogginess, headaches or numbness, among other neurological symptoms, Dr. Parikh said. Some of these symptoms share characteristics with postural orthostatic tachycardia syndrome, a condition where an abnormal increase in heart rate when standing up can cause symptoms like dizziness or fainting. Researchers want to look into whether people experiencing this collection of symptoms actually have POTS. 

5. The ACE2 receptor may be an explanation for why people with obesity, diabetes and high blood pressure are at increased risk of severe infection. SARS-CoV-2 enters a cell using the ACE2 receptor, the same one involved in the regulation of the body's blood pressure and level of water and salts. 


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