As we continue to live with COVID-19, researchers are learning more and more about the havoc it can wreak on the human body. While initially just thought of as a respiratory illness, COVID-19 has been found to affect far more than just the lungs.
In fact, a growing number of studies are finding that COVID long-haulers, or people who have symptoms long after being infected with the virus, are experiencing an increase in heart failure.
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One July 2020 study in JAMA Cardiology performed cardiac MRIs on 100 patients who'd recently recovered from the virus and detected abnormalities in 78 percent and ongoing inflammation of the heart muscle in 60 percent.
Another December 2020 study in Circulation (conducted during the first wave of the pandemic) found that nearly 20 percent of people hospitalized for the virus had some sort of cardiac injury.
More research needs to be done on the long-term effects of COVID-19 on the heart, especially because we already have a heart-health crisis in the U.S.
"As the pandemic has peaked, COVID has temporarily become the leading cause of death in the U.S. on a daily basis, however heart disease is still the second leading cause of death," says Steven Schiff, MD, cardiologist and medical director of Cardiac Catheterization Laboratory for MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in Fountain Valley, California. "It will almost certainly become the leading cause again as the pandemic eases in the coming months."
Get tips on how to stay healthy, safe and sane during the novel coronavirus pandemic.
How COVID-19 Affects the Heart
Although there are certain instances where the COVID-19 virus can directly attack the heart muscle and cause damage, Dr. Schiff notes that more often the heart becomes involved as a secondary effect when the virus attacks other organs.
"When a patient with COVID develops severe and overwhelming pneumonia, their oxygen level drops and their heart has to work harder with less oxygen to do the work," he explains, adding that we still have much to learn about the longer-term effects.
In Dr. Schiff's opinion, the greatest effect of COVID on heart health isn't what the virus does physically to the body, but rather that the pandemic itself has led to an increased fear of going to the doctor or hospital, which has caused people to avoid or delay seeking care.
"People experiencing symptoms of heart attack or stroke including chest pain, palpitations or shortness of breath have stayed home out of fear of exposure to the virus, which increases the chances of bad outcomes from heart disease," he says. "The risks of staying home out of fear of exposure to COVID is far more dangerous than seeking care."
Richard E. Collins, MD, a Nebraska-based cardiologist and author of agrees, adding that, as a result of the pandemic, hospitals have been inundated with COVID patients, intensive care units have been packed and elective procedures have been canceled or held back. "All of this equates to eventual 'pay-back' time for heart disease emergence," he says.
What You Can Do to Rebuild Heart Health Post-COVID
If you've had or are still recovering from COVID-19, heart health should be a top priority. It is quite possible, however that your road to recovery may not be straight and narrow, and you may feel tired as you gradually get back into your routine.
"Recovery time is different for different people," notes Saurabh Rajpal, MD, a cardiologist and assistant professor in the Division of Cardiovascular Medicine at The Ohio State University College of Medicine. "While some people may recover within days, others may feel fatigued for weeks after a viral infection."
Here are some of the ways you can work to rebuild your heart health as your body recovers from COVID.
1. Keep Moving as Much as You Can
Although you may be sluggish, it's important not to stay sedentary as your body recovers from the virus, notes Dr. Rajpal.
"Complete immobility is a risk factor for blood clots and should be avoided," he warns.
After a few rest days, he recommends getting back into your exercise routine gradually, aiming to start at 50 to 60 percent of your best capacity and increasing that gradually over the next few days.
"If you have any symptoms as you get back into activity such as chest discomfort, shortness of breath or fast or irregular heart beat, consult with your doctor," he says.
2. Eat a Healthy, Nutritious Diet
You know the importance of eating a healthy diet, but you may not realize the crucial role it plays in terms of your heart health. In fact, a 2015 study in the Journal of the American College of Cardiology found that a diet rich in fruits, vegetables, whole grains, legumes, nuts, fish, poultry, good-for-you fats and moderate in dairy can reduce the risk of heart disease by about a third.
When it comes to the list of foods you should avoid, keep away from anything overly processed (think: fast food or packaged foods with long lists of ingredients), fried or that contains a lot of saturated fats, which can raise your levels of LDL ("bad") cholesterol, notes Michael Blaha, MD, Director of Clinical Research at the Ciccarone Center for the Prevention of Cardiovascular Disease and Professor of Medicine at Johns Hopkins Medicine.
3. Stay Up-to-Date With All of Your Medical Appointments
Even though it might seem like an inconvenient time to have your physical, it's never a good idea to avoid preventative care.
"Doing this could result in progression of disease to a severity that would not occur if people were keeping regular medical follow-ups," says Alexandra Lajoie, MD, a non-invasive cardiologist at Providence Saint John's Health Center in Santa Monica, California.
In addition to just showing up to those doctor's visits, it's important to be open with your doctor about any symptoms you may be experiencing. Dr. Schiff recommends making sure your lab values are being monitored regularly, especially for blood sugar, cholesterol and triglycerides, and following up with your doctor if you experience any symptoms of heart disease, including chest discomfort, shortness of breath, or fast or irregular heart beat.
4. Quit Smoking ASAP
The list of health implications related to smoking is a pretty convincing reason to quit if you haven't already — and heart health is one of them. In fact, Dr. Lajoie, believes that the single most important thing someone can do to boost their heart health is to avoid smoking altogether.
"Smoking is almost a guarantee that you will develop some form of cardiovascular disease during your life," she says.
Read more stories to help you navigate the pandemic:
- Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19)
- Late-Breaking Science Abstracts and Featured Science Abstracts From the American Heart Association’s Scientific Sessions 2020 and Late-Breaking Abstracts in Resuscitation Science From the Resuscitation Science Symposium 2020
- Heart Disease in the United States
- Steven Schiff, MD, cardiologist and medical director of Cardiac Catheterization Laboratory for MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in Fountain Valley, California
- Richard E. Collins, M.D., a Nebraska-based cardiologist and author of The Cooking Cardiologist
- Saurabh Rajpal, MD, a cardiologist and assistant professor in the Division of Cardiovascular Medicine at The Ohio State University College of Medicine
- Food Consumption and its impact on Cardiovascular Disease: Importance of Solutions focused on the globalized food system
- Michael Blaha, MD, Director of Clinical Research, Ciccarone Center for the Prevention of Cardiovascular Disease and Professor of Medicine at John Hopkins Medicine.
- Alexandra Lajoie, MD, non-invasive cardiologist at Providence Saint John’s Health Center in Santa Monica, California
- Smoking & Tobacco Use
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.