Two new studies highlight a potential risk of long-term heart complications for patients who have recovered from Covid-19. The virus can in fact directly affect the heart muscle with continued inflammation detectable months after recovery, even in patients initially suffering from a mild form of the disease.
Signs of myocardial inflammation in 60% of subjects
While attention was initially focused on the number of deaths caused by the Covid-19, six months after the start of this global pandemic, researchers are starting to see signs of chronic health problems in patients recovering from the disease. This offers them an overview of the potential lingering health consequences of this new virus, as shown by these two studies recently published in the journal JAMA Cardiology exploring the impact of Covid-19 on the cardiovascular system, just weeks after it was revealed that it can cause serious neurological sequelae.
Last March, it quickly became apparent that patients with Covid-19 and with underlying cardiovascular disease were more likely to develop fatal complications. However, researchers did not know if the virus directly damaged myocardial cells, or if it caused longer-term cardiovascular damage, after recovery.
The first study involved 100 patients recovered from Covid-19 (whose median age was 49 years), on average 71 days after initial diagnosis. Using thecardiac magnetic resonance imaging (MRI), scientists detected cardiovascular abnormalities in 78% of them, while signs of myocardial inflammation were detected in 60% of subjects. These unusual results were then compared to a healthy control group.
It was also found that only 33% of the subjects of the study cohort had to be hospitalized after having contracted the Covid-19. Suggesting that some degree of cardiovascular damage appears to result from the disease itself, regardless of the severity of the infection or the presence of any pre-existing condition.
Significant levels of viral load detected in heart tissue
” Our work has shown that subjects with a relative rarity of pre-existing cardiovascular conditions and whose convalescence was mainly done at home presented frequent cardiac inflammatory attacks, similar to those of the subgroup of patients who had been hospitalized in terms of severity. and extent ”, Underline the authors of the study.
While the researchers do not rule out that the problems highlighted by the MRI predate the infection, they believe it is also likely that the viral infection amplified any pre-existing cardiovascular damage. At present, it is impossible to know whether this post-cardiovascular damageCovid-19 will be permanent or have long-term health consequences.
As part of the second study, the researchers examined cardiac tissue collected during autopsies from 39 patients with Covid-19. The average age of the latter was 85 years, while pneumonia was the most frequently cited cause of death. And it turned out that traces of SARS-CoV-2, the virus causing the Covid-19, were present in heart tissue in more than 60% of subjects. Including sixteen of the patients with clinically significant levels of viral load in their heart tissue at the time of death.
Again, at this point, the presence of the virus in heart tissue does not demonstrate that the disease can cause long-term negative effects on the cardiovascular system. But these two studies combined suggest that the coronavirus has a clear effect on this one in the short / medium term.
“It is likely that we have a population of people surviving Covid-19 but subsequently suffering from chronic heart problems”
” It is now established that the virus can directly attack heart muscle cells, and that the cytokine storm it triggers in the body does not only damage the lungs, but also the cardiovascular system. », Comments John swartzberg, expert in infectious diseases ofberkeley university. ” While we don’t yet know what the long-term effects will be, it is likely that we have a population of people surviving Covid-19 but subsequently suffering from chronic heart problems.. “
In a commentary accompanying the publication of this new research, Clyde Yancy and Gregg Fonarow, editors-in-chief of the cardiology section of the journal JAMA, call for the urgent continuation of research to better understand the cardiovascular complications associated with Covid-19, in order to have adequate means to deal with this possible new facet of the pandemic.
” We do not wish to generate additional anxiety but rather encourage other researchers to carefully examine existing data and collect new prospective data from other populations in order to confirm or refute these results. », They write.
” If this high risk rate is confirmed, the pathological basis of progressive left ventricular dysfunction validated, and especially if the longitudinal assessment reveals new heart failure in the post-Covid-19 recovery phase, then the health crisis will not will not subside but instead will move to recurrent cases of heart failure and other chronic cardiovascular complications. “