COVID-19 has killed more than 600,000 Americans, but most people who are infected with the new illness will survive it.
That said, the potential long-term impact of the respiratory condition is causing concern among doctors and medical researchers, though those effects remain only partially known at this point, seeing as the virus has been with us for less than two years.
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Dr. April Stempien-Otero, a cardiologist at UW Medicine’s Heart Institute in Seattle, says she has seen “significant heart damage” crop up in people who had mild bouts of COVID-19, including in some young people.
“It was a big surprise to all of us,” Stempien-Otero told UW Medicine Newsroom in a newly published Q&A. “It wasn’t our high-risk cardiac population, but in retrospect, I think it was a matter of time before we saw the effects of COVID on people with what we call subclinical cardiac disease.”
She said that last fall they started seeing a younger cohort of patients — people generally in the 25-to-40 range — come into hospitals with heart complications some weeks after recovering from COVID-19. It appears that the virus had launched preexisting cardiac issues that had been unknown to them, and that may have developed years or decades later.
“Prediabetes, high blood pressure, mild cardiomyopathy or genetic issues that had not been causing problems,” she said.
Why did mild COVID-19 apparently bring these issues forward, leading people to the hospital? It chiefly comes down to the disease’s ability to create severe inflammation.
“We used to just think that the inflammatory cells that came with conditions like high blood pressure and heart failure were kind of bystanders and a result of damage that had already happened, as opposed to actively promoting disease,” Stempien-Otero said. “COVID has made it clear that those inflammatory cells can be very powerful actors in making heart disease worse.”
She added:
“We hypothesize that people with pre-existing heart conditions probably have some of these macrophages present in their hearts, which become activated with SARS-CoV-2 and cause heart muscle damage. … So one could think of SARS-CoV-2 as an acceleration of chronic heart disease. SARS-CoV-2 causes a different kind of inflammation that, from our experience, is more persistent.”
Stempien-Otero says long-term study needs to be done, though these early signs are worrying.
“The question is what will happen after the SARS-CoV-2 runs its course,” she said. “How much heart muscle will a patient lose due to these inflammatory responses? We don’t make many new heart muscle cells as we age. And we know that, as with other toxins that kill heart muscle cells, for example, chemotherapy, if you lose enough of these cells, those tissue areas are replaced with scar tissue, the heart has to work harder, and you gradually develop heart failure.”
Read the entire interview.
— Douglas Perry
dperry@oregonian.com
@douglasmperry