Although there are concerns about patients developing issues post-COVID-19, including heart problems, a study involving 280 recovered healthcare workers at the State-run Sri Jayadeva Institute of Cardiovascular Sciences and Research has revealed that none of them had any cardiac problem.
Institute director C.N. Manjunath told The Hindu that the 280 patients, half of whom are female employees, were evaluated through ECG, Echo, X-Ray Chest and Cardiac MRI. “There was no cardiac involvement in any one of them,” he said.
The age of the 280 patients varied from 23 years to 60 years. While 30 are doctors, the rest are staff nurses, technicians, ward helpers, security and housekeeping staff. Although none of them had any pre-existing cardiac issues, 15% had hypertension and diabetes.
According to some European studies, the cardiac involvement assessed by MRI scan is around 70% in acute phase but it is microscopic with no clinical symptoms. But even in those patients, heart function by echocardiography is normal. Although COVID-19 infection primarily affects the lung, it can also involve the heart, blood vessels, and brain with a cascading effect on the kidney.
During infection
During acute phase of the infection, 10%-20% can have heart involvement in the form of heart attack, heart muscle involvement (Myocarditis) and fluid collection around the heart (Pericardial Effusion), heart failure and abnormality in the form of slow heart rate or fast heart rate. There is a tendency of clot formation in the arteries of the heart and the lung, the doctor explained.
“In those who have recovered from COVID-19, less than 3% face a risk of a heart attack since it is brought about by clotting of blood in the arteries of the heart. Such a problem occurs in those who had severe COVID-19 infection with low oxygen saturation and those who were treated in an ICU. We are glad that none of the 280 evaluated had any cardiac involvement,” Dr. Manjunath said.
However, among those who do not have any pre-existing heart disease, cardiac morbidity and mortality is less when compared to those who have pre-existing heart diseases, he said.
Recovered patients who are likely to develop cardiac manifestations can be predicted by a D-dimer blood test. If the D-dimer values are very high, patients should be carefully monitored and blood thinning medicines should be given as prophylaxis.
Also, the condition of pre-existing heart failure patients can worsen with COVID-19 infection. Such patients need aggressive treatment, Dr. Manjunath added.
