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Wednesday, July 29, 2020

How Covid-19 Coronavirus May Affect Your Heart, Here Are Two New Studies


Groove may not be the only thing in the heart when one has a Covid-19 coronavirus infection. Two studies just published in JAMA Cardiology found evidence that the Covid-19 coronavirus can make it to your heart. And not in a good rom-com or BTS type of way.


Both studies were from Germany. One of them was a series of autopsies performed on 39 people who had passed away after having Covid-19. Thirty-five of these patients had succumbed to pneumonia. A team from the University Heart and Vascular Centre in Hamburg, Germany, (Diana Lindner, PhD, Hanna Bräuninger, MS, Katharina Scherschel, PhD, Paulus Kirchhof, MD, Stefan Blankenberg, MD, Dirk Westermann, MD), the University Medical Center Hamburg-Eppendorf (Antonia Fitzek, MD, Caroline Edler, MD, Kira Meissner, and Klaus Püschel, MD), and the Institute for Cardiac Diagnostics and Therapy in Berlin, Germany, (Ganna Aleshcheva, PhD, Felicitas Escher, MD, and Heinz-Peter Schultheiss, MD) reported on the findings.



A majority (61.5%) of these autopsies revealed evidence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) in the heart. Of these 24 cases, 16 had more than 1000 copies per microgram of viral RNA, suggesting that there were quite significant amounts of the virus. In fact, in the five cases with the highest viral load, even when the heart didn’t go on, the virus did. These viruses were still replicating, which means that they were still reproducing or essentially doing the viral version of the nasty.


The other study was conducted by a team from the University Hospital Frankfurt in Frankfurt am Main, Germany (Valentina O. Puntmann, MD, PhD, M. Ludovica Carerj, MD, Imke Wieters, MD, Masia Fahim, Christophe Arendt, MD, Jedrzej Hoffmann, MD, Anastasia Shchendrygina, MD, PhD, Mariuca Vasa-Nicotera, MD, Andreas M. Zeiher, MD, Maria Vehreschild, MD, and Eike Nagel, MD) and the Institute for Cardiac Diagnostic and Therapy in Berlin, Germany (Felicitas Escher, MD). They followed up with 100 patients in the State of Hesse (which rhymes with “bench press”) who had previously tested positive for the SARS-CoV2.




For the study, these patients underwent MRI (magnetic resonance imaging) of their hearts and blood testing to check for evidence of heart damage. This didn’t happen right after their Covid-19 coronavirus diagnoses but a median of 71 days afterwards, which is over two months after the initial diagnosis. These also were people who were still fairly young at heart, literally, with the median age being 49 years old. Many of them hadn’t gotten super-sick either, as two-thirds of the patients hadn’t even been hospitalized. 


Nevertheless, the MRIs did show that 78% of the patients had some type of abnormality in their hearts. These ranged from signs of inflammation to enlarged left ventricles to decreased ability of the heart to pump blood to the rest of the body. Many of these findings were consistent with patients having myocarditis or pericarditis.


What’s myocarditis? Well, the myocardium isn’t the opposite of your-o-cardium but instead is another way of saying heart muscle. Adding “-itis” to the end of myocardium means that your heart muscles are inflamed. It’s not good to have your heart muscles inflamed. (Actually, inflamed anything tends to not be good.) Inflammation can lead to damage. When your heart muscles are damaged, they can’t pump as well. That’s how severe myocarditis can lead to heart failure. It can also lead to a heart attack or stroke because when your heart isn’t pumping properly, blood can pool in your heart and form clots. These clots can then travel to your coronary arteries or the arteries providing blood to your brain. Messed up heart muscle can result in abnormal heart rhythms as well because damaged muscles may not conduct electricity properly. One possible outcome of abnormal heart rhythms, when they are really abnormal, is sudden cardiac death. And as you can imagine, death is not a good outcome.


What’s pericarditis? It’s not two carditises but instead inflammation of the pericardium, the membranous sac that encases your heart. It essentially is a bag around your heart. Inflammation of this bag can interfere with your heart rhythm and function too.



Myopericarditis is when you have both pericarditis and myocarditis. Not a good two-for-one deal to have.


Twelve of the patients in the study had evidence that portions of their heart muscles were not getting enough oxygen. Three patients had such severe abnormalities that they had to undergo biopsies of their heart tissue for a closer look as to what was happening. Samples of their heart tissue revealed active inflammation but no signs of the virus.


That’s not all folks. A majority (76%) of the patients had detectable troponin in their blood. Seeing troponin in the blood is like seeing ping pong balls on the floor when they are supposed to be in a lottery ball machine. That means something must have happened to the lottery ball machine. Similarly, troponin is a protein typically found in your heart muscles. When your heart muscle gets damaged, troponin can then leak into your bloodstream. Moreover, on the day of the MRI, 17 patients were still suffering from chest pain, 20 from heart palpitations, and 36 from ongoing shortness of breath and general exhaustion.


From this study alone, it’s not completely clear what was causing all of these findings. Remember this was over two months after the Covid-19 diagnoses. Were these patients still infected with the virus? Was the immune response to the virus still causing problems? Was this residual damage from the infection? Were blood clots the culprit? After all, as William A. Haseltine has covered previously for Forbes, studies have found that Covid-19 coronavirus infection could lead to blood clot formation. How permanent is the damage? How common is such damage? As with the movie Donnie Darko, there are still so, so many questions.


The Covid-19 coronavirus certainly wouldn’t be the first virus to cause myocarditis or pericarditis. A range of viruses can cause such conditions such as the adenovirus, hepatitis B and C viruses, parvovirus, Epstein Barr virus, and herpes simplex virus. It’s become increasingly clear that the Covid-19 coronavirus is like that best man who talks about the groom’s past relationships during his wedding toast. It doesn’t respect boundaries and can travel well beyond your respiratory system.


These two studies in JAMA Cardiology along with a case study of an otherwise healthy 53-year-old developing acute myopericarditis published in a March issue of JAMA Cardiology raise the possibility that the Covid-19 coronavirus could do some serious tearing up of the heart, and not in the way that *NSYNC meant it. Could the infection eventually lead to cardiomyopathy (heart muscle problems) and heart failure? Perhaps. Possibly. Maybe. More studies are necessary to get to the heart of what this still mysterious SARS-CoV2 may end up doing to you.






#News | https://sciencespies.com/news/how-covid-19-coronavirus-may-affect-your-heart-here-are-two-new-studies/

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