FORT WAYNE – Although commonly thought of as a respiratory illness, COVID-19 can affect multiple organs, including the heart and vascular system, explains cardiologist Matthew Bilodeau, MD, Ph.D. with Lutheran Health Network.
Mild COVID-19 illness is typically recognized by upper respiratory tract symptoms, loss of taste and smell and gastrointestinal symptoms. Moderate illness occurs in about 15 percent of people who may have fever, shortness of breath, cough and lower respiratory tract infection. Severe illness occurs in about five percent of people who develop severe pneumonia, respiratory failure, sepsis and shock.
“COVID-19 does cause severe illness and death in younger and otherwise healthy people; however, advanced age, coronary artery disease, diabetes mellitus, and hypertension, are major risk factors for the worst outcomes,” says Bilodeau.
Roughly one-third of adults hospitalized with COVID-19 are diagnosed with heart and vascular complications. The most frequent problem is heart muscle inflammation and injury. Other serious problems include abnormal blood clotting, heart rhythm abnormalities, cardiomyopathy and heart failure, pericarditis and pericardial effusion, heart attack and stroke.
Children and young adults infected with SARS-CoV-2 can develop a rare illness 4-6 weeks after the infection called multisystem inflammatory syndrome in children (MIS-C). Resembling Kawasaki disease, MIS-C is characterized by hyper inflammation in the body and severe heart and vascular problems including hypotension and shock, cardiomyopathy and heart failure, coronary artery abnormalities and heart rhythm abnormalities.
“Heart involvement and myocardial inflammation can be demonstrated by cardiac magnetic resonance (MR) imaging months after acute COVID-19 resolves,” says Bilodeau. “Chronic or ‘long’ COVID-19 is defined as symptoms persisting more than 12 weeks. It is estimated that 10-30 percent infected people including those with asymptomatic or mild symptoms experience chronic COVID-19.”
Common persistent symptoms include profound fatigue, loss of taste and smell, shortness of breath, palpitations, lightheadedness and chest pain. Blood work may identify persistent inflammation, abnormal lipid levels and disordered glucose metabolism. Chronic heart failure and development of orthostatic intolerance syndromes—resting or postural low blood pressure and/or rapid heart rates—can become severely disabling conditions.
Those recovering from COVID-19 should watch for symptoms that could suggest heart and vascular problems. Bilodeau recommends patients should consult their primary care provider or cardiologist if they experience symptoms or have concerns. You can learn more about cardiac and vascular services at Lutheran Heart Center by visiting https://www.lutheranhospital.com/heart-center.