COVID-19 is not just metaphorically taking a toll on the heart. A recent study looked at the hearts of 100 patients who have recovered from the novel coronavirus that has hit the globe. 78 of the 100 showed signs of cardiac complications and 60 showed persistent myocardial inflammation of the heart muscle.
Myocarditis can cause chest pain, fatigue, and even heart attacks, and can make physical activity dangerous, meaning the scars left by COVID-19 would leave patients with years of complications and danger. The study’s authors warn that early diagnosis using magnetic resonance imaging (MRI) is important to treat, or possibly stop, the relentless course of inflammatory damage.
The German study, published in the JAMA cardiologyis the first to randomly select test subjects from a pool of coronavirus patients ̵
Which COVID-19 patients get these types of heart problems?
Patients differed in pre-existing conditions, disease severity, and time since diagnosis. Fifty-three were male and the median age was 49 years. Sixty-seven recovered at home and the other third were hospitalized. Of those who recovered at home, 18 were asymptomatic and 49 had mild or moderate symptoms.
Neither of these factors appeared to predict cardiovascular complications. The researchers used MRI to look for signs of heart disease and myocardial inflammation, and found that both were common across all groupings. Although it is a respiratory disease, the burden of inflammation that COVID-19 puts on the body damages the heart.
The study, led by Dr. Eike Nagel and Dr. Valentina O. Puntmann, both headed by the Frankfurt University Hospital, was published on July 27th and soon referenced in thousands of other academic literature. Some researchers criticized it for incorrect data processing and inconsistent numbers within the study. It was corrected this week and the journal said the conclusions are valid.
There are several mechanisms COVID-19 can use to attack the heart, according to an opinion from Harvard Medical School. Cardiovascular blockages, infections, fever and inflammation caused by COVID-19 can destabilize fatty plaques in the heart vessels and accelerate pre-existing heart diseases. COVID-19 fever and inflammation can also increase the metabolic needs of many organs while the lungs work at reduced capacity and the heart starves for oxygen. After all, the virus sometimes directly infects the heart, causing severe and sudden inflammation.
What does this mean for your training?
Inflammation of the heart can seriously limit a person’s activities. The National Heart, Blood and Lung Institute, and the Myocarditis Foundation recommend that patients with myocardial inflammation not exercise or exercise rigorously until a doctor has given permission, which may take months or more after treatment.
The American College of Cardiology recommends that athletes with myocarditis limit their movement for three to six months, under the guidance of a doctor, so the inflammation can subside before returning to the field.
The study is yet another sign that the complications of COVID-19 remain with the patient long after the virus dies.
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