31/03/2020
Why is the corona virus also dangerous for the heart?
I, 55 years old, belong to the risk group of corona virus after having had a myocardial infarct and a stent-implantation. I’m trying to follow the recommendations, but I don’t really understand: why does the virus affect the heart?
Answer: Thank you so much for your question. It has been asked quite frequently in different forms in our practice in the last few days.
First of all, a positive note to the corona-virus (SARS-CoV-2) and to the associated disease (Covid-19): Most of the infections (over 80%) have had a moderate course with flu-like Symptoms up till now. For example: cough (55%), fever (39%), runny nose (28%), sore throat (23%), or shortage of breath (3%). The numbers are derived from the Robert Koch Institute in Germany.
Besides having distinct symptoms, around 3% to 6% of people testing positive could become seriously ill and develop a life-threatening condition of lung- or multiple organ failure.
These life-threatening conditions could happen in any age group, but the risk increases with age above 60. The death rate for people over 85 years old of age can rise up to 25% for example.
In addition to age, the cardiovascular disease counts as the most important risk factor causing an unfavorable course, especially in patients with constricted heart vessels (for example after stent-implantation or heart operations).
The risk also increases for patients who have had a cardiac infarction or a stroke, and also for patients who suffer from cardiac insufficiency, hypertension, diabetes or are excessively overweight.
Because the Covid-19 is primarily a disease of the respiratory system, smokers or people
who have conditions like asthma or COPD are also exposed to higher risk than others.
Other factors include severe organic diseases (like liver, kidneys, cancer, immune system disorders: occurring also for instance by taking cortison)
Caution! Even when the heart patient feels healthy…
Although high-risk-patients could also have milder courses of disease, but it’s a hard thing to
estimate who gets what.
Even people who feel fit and healthy should strictly stick to the recommendation of the BAG
(Federal Office of Health). Stay at home as much as possible, the hygienic measures,
minimize contact (also to one’s children and grandchildren), maintain a distance of 2 meters
except for people who live in the same household.
The questions which you are asking are not easy to answer. There is not a lot of assured
information up till today, and the processes are quite complex.
A possible clarification: SARS-CoV-2 binds to a receptor, which is available in both the lung
and the heart and vascular system. This receptor also plays a role in the immunity and
diabetes.
Furthermore it is conceivable, that the virus could directly damage the cardiac muscle cells
in terms of myocarditis, a condition which is particularly stressful for a pre-damaged heart.
The fundamental thing to mention is, patients with heart disease should not take personal
decisions to change or stop any medication prescribed by their doctors.
In case of uncertainty, please consult your general doctor or your cardiologist by phone.
They can also provide advice on flu vaccine, which is sensible at the moment, and pneumococcal vaccines, aiming to protect from pneumonia.
Short Answer:
The Covid-19 could be very dangerous for heart patients but the reasons are still not clarified enough.
Not each heart patient will develop the severe symptoms, nevertheless everyone should
adhere to the recommendations of the federal office of health. Incase of uncertainty always call your doctor!
PD Dr. med. Georg Fröhlich
Cardiologist at the Herz-Clinic Luzern
St. Anna, Lucerne, Switzerland
translated from article of the Luzerner Zeitung
https://www.luzernerzeitung.ch/leben/ratgeber/warum-ist-das-corona-virus-auch-eine-gefahr-furs-herz-ld.1206699
