Coronavirus May Have Lasting Impact on the Heart

COVID-19 was first thought to be a respiratory illness alone, but two recent studies show the disease caused by the coronavirus could have an impact on the heart.

One German study found that 78 of 100 middle-aged adults who recently recovered from asymptomatic or mild cases of COVID-19 showed some type of cardiac involvement in magnetic resonance imaging (MRI) scans. Also, the study showed, 60 percent had ongoing inflammation in the heart.

The second study, also from Germany, looked at 39 autopsies of older adults ranging in age from 78 to 89 who had COVID-19. The researchers found that 16 had the virus in their heart, but their hearts did not show signs of unusual inflammation. The researchers said it is unclear what that could mean.

Both studies were published recently in the journal JAMA Cardiology.

More Studies Needed

UH cardiologist Eiran Z. Gorodeski, MD, MPH, says that much remains unknown about coronavirus and its possible effects on the heart.

“We have a puzzle that we need to solve with this disease, and this is one piece of it,” Dr. Gorodeski says. “We know that COVID-19 can affect the heart, but this doesn’t happen with everyone who is infected with the virus. At this point in time, it’s unclear why.”

More studies will be needed, Dr. Gorodeski says, noting that the two German studies were small in size.

“Any time we do research in small numbers of people, the results need to be replicated in larger studies before we can draw definitive conclusions,” he says. “For now, it would be premature to conclude that everyone who gets infected with COVID-19 is going to have permanent heart damage.”

Intriguing Questions

The two studies, however, do raise some areas that are ripe for further inquiry, Dr. Gorodeski says.

“One interesting question is why does coronavirus have this impact on the heart,” Dr. Gorodeski says. “Is it because the virus itself infects the heart, or is it that the virus triggers the immune system in such a way that it causes inflammation in the heart? The answer is unknown.”

Another as-yet unanswered question is whether the effects on the heart resolve on their own over time or are permanent, he says.

Heart inflammation can have other causes in addition to coronavirus, and people with underlying heart conditions may be more susceptible to changes caused by COVID-19, Dr. Gorodeski says.

Dr. Gorodeski hopes that as more medical research is conducted, physicians will have more effective methods to treat patients and prevent severe illness, he says.

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