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AUGUST 20, 2O21

COVID-19 and the heart

While respiratory illness associated with the coronavirus disease 2019 (COVID-19) are well known, there is growing evidence that infection from the severe acute respiratory coronavirus 2 (SARS-CoV-2) also increases the risk for a heart attack or stroke.

A recent study (1) from Sweden published online July 29, 2021 in The Lancet showed that the risk for a heart attack or stroke is increased 3 times during the first two weeks following COVID-19 infection.

The researchers compared data from 86,742 COVID-19 patients with 348,481 control (non-COVID-19) patients, making this the largest study to date to analyze the association between COVID-19 and cardiovascular complications.

"Our findings indicate that cardiovascular complications represent a part of the clinical picture of COVID-19," the authors of the study said.

How does COVID-19 increase the risk of heart attack or stroke?

While there is data from endomyocardial biopsies (2) suggesting that SARS-CoV-2 can directly infect the heart, the mechanism is probably similar to how chest infections like severe influenza can trigger a heart attack. The virus enters the body through the nose or mouth and attacks the cells of the respiratory tract. The body recognizes the threat and activates the immune response. During this response, the body induces an inflammatory state to make the blood vessels “leaky” and allow virus-killing cells to move quickly from blood vessel into the tissues where the virus is multiplying. This leaky state releases chemicals which causes the blood to clot more easily than normal. A prolonged inflammatory state, like what happens in severe COVID-19 disease, can lead to a huge build-up of the blood clots which can block blood vessels in various parts of the body. If the clot blocks a heart vessel, it leads to a heart attack. If the clot blocks blood flow to the brain, it causes a stroke.

COVID-19 is a complex disease and with the current surge of the delta mutation worldwide, it is now more important than ever to practice a healthy lifestyle and maintain established infection prevention practices such as getting the vaccine, hand hygiene, cough etiquette, and social distancing.

References:
1. Katsoularis, I., Fonseca-Rodríguez, O., Farrington, P., Lindmark, K., & Fors Connolly, A. M. (2021). Risk of acute myocardial infarction and ischaemic stroke following COVID-19 in Sweden: a self-controlled case series and matched cohort study. The Lancet. Published. https://doi.org/10.1016/s0140-6736(21)00896-5

2. Pietsch, H., Escher, F., Aleshcheva, G., Baumeier, C., Morawietz, L., Elsaesser, A., & Schultheiss, H. P. (2021). Proof of SARS-CoV-2 genomes in endomyocardial biopsy with latency after acute infection. International Journal of Infectious Diseases, 102, 70–72. https://doi.org/10.1016/j.ijid.2020.10.012

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