CLEVELAND, Ohio We know that COVID-19 damages the lungs. Now there is evidence that the virus causes collateral damage to the heart.
Heart abnormalities have been found in 5% to 25% of patients hospitalized with COVID-19, said Dr. Paul Cremer, associate director of the cardiovascular intensive care unit at the Cleveland Clinic.
Of those with severe cases of COVID-19, 10% to 15% show heart abnormalities, he said. The Clinic is participating in two studies that may find ways to help COVID-19 patients with damaged hearts due to the illness.
One trial, sponsored by the Clinic, looks at whether a specific early treatment prevents heart and respiratory failure in COVID-19 patients with heart injury and extreme inflammation.
A multi-center trial looks at a specific treatment that targets inflammation, to determine if it can prevent respiratory failure in patients with severe COVID-19 and extreme inflammation. The Clinic will collect and analyze data for the study.
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COVID-19 causes an outsized immune response, resulting in inflammation throughout the body. In the heart, this Inflammation impairs blood flow and reduces the amount of oxygen. This inflammation also causes plaque, or fatty substances that narrows arteries, to become unstable and cause blood clots, he said. This could affect people with pre-existing heart disease.
Restricted blood vessels cause damage similar to that caused by a heart attack, he said. Heart attacks and heart infections related to COVID-19 do happen, but rarely, he said.
A German study published in JAMA looked at COVID-19 patients who recovered and were released from the hospital. Subsequent MRIs showed heart inflammation in 60% of the patients, who did not have preexisting conditions.
People with coronavirus-caused heart injury are likely to be older, male and have underlying conditions, such as high blood pressure, high cholesterol and diabetes. But COVID-19-related heart damage also happens to people who dont have these risk factors, Cremer said.
Its possible that heart inflammation will persist after patients recover from COVID-19, but researchers are not certain. The long-term effects on the heart are unclear, he said.
Cremer is the principal investigator for the two trials that may uncover clues for how to help COVID-19 patients with heart damage. Patients are currently being enrolled, and Cremer couldnt say when work might be ready for publication.
The question of whether COVID-19 will increase the number of Americans with long-term heart problems is important, and complex, Cremer said. We dont know the answer to that, he said.
A bigger problem is the high number of patients who put off routine care for existing heart problems during the pandemic, he said. The Clinics heart unit was busy last month with heart patients coming back in for care, and some had become sicker because they skipped appointments, he said.