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The data available so far from Wuhan from China shows that various types of cardiovascular diseases were present in almost 50 percent. cases of patients who contracted COVID-19, and in as many as 70 percent. in those patients who have died. It is similar with individual cardiovascular diseases – arterial hypertension was found in 30% of patients. all patients who fell ill with infection caused by the coronavirus, while as many as 48 percent. patients who did not survive.
Patients who have cardiovascular diseases such as hypertension or have had a heart attack or have diabetes are definitely more likely to die from the coronavirus than patients who do not have these diseases. This is not the end of disturbing information. The virus is not only dangerous for patients with comorbidities. Observations also indicate that it can irreversibly damage the heart in previously healthy people.
Educational campaign “Patient with Awareness”
The Institute of Consciousness Foundation runs a social educational campaign “Patient with Awareness”, under which the most prominent representatives of medicine, the healthcare market and patients support the provision of reliable and relevant information for a given disease. President of the Polish Cardiac Society and Director of the Warsaw Course on Cardiovascvular Interventions, prof. Adam Witkowski, points out to dangers to the heart associated with the coronavirus pandemic not only cardiac patients, but also young and healthy people.
Many factors contribute to the severe course of coronavirus infection. On the one hand, in most cases, patients who suffer from cardiovascular diseases are elderly and therefore have a poorer functioning of the immune system, which is able to fight infections, but also because the virus itself can attack the heart cells. – explains prof. Witkowski. – because the receptors through which the virus enters the lung cells – ACE2 receptors – are also found in the cells of the heart muscle, as well as in the cells of the kidneys and vascular endothelium. The SARS-Cov-2 virus can also damage heart muscle cells by causing the so-called a cytokine storm caused by a distorted T-helper response to infection. – adds the professor.
This may explain the fact that cardiovascular patients are more susceptible to infection with the COVID-19 virus, but may also have a more severe disease because their already damaged heart is compounded by heart cell damage caused by the virus. They are patients with a higher risk of death.
Coronavirus causes cells in the heart to die and the whole heart begins to deteriorate. We know that viral infection itself in people who do not even have cardiovascular diseases can cause such damage to the heart that the left ventricular ejection fraction drops significantly and patients must be treated as in the case of acute myocarditis, i.e. they must receive glucocorticosteroids, immunoglobulins, to support the circulation, they must be given drugs that maintain blood pressure. The fact that COVID-19 damages heart muscle cells has unfortunately already been confirmed, explains Prof. Witkowski.
The risk of coronavirus for heart patients is twofold. Cardiac patients suffer more from interstitial pneumonia and more often require connection to a ventilator. On the other hand, the mechanism of direct damage to the heart muscle by the virus is dangerous, which in the case of cardiac patients, especially in old age, may end tragically.
Age matters a lot. We know that the death rate in people under 50 due to coronavirus infection is about 1 percent, and is already growing to 1,5 percent. for people over 50 years. Then it rises to 3,6%. for people over 60 years and up to 8 percent. in people over 70’s and so on. The higher the age, the greater the risk of death. – says prof. Witkowski.
Coronavirus can cause severe heart failure even in people who do not currently suffer from cardiovascular diseases by entering the heart muscle cells through ACE2 receptors. The same receptors are found in the alveolar cells of the lungs. The mechanism of infection and organ damage is therefore the same.
– Severe heart failure due to coronavirus is relatively rare in healthy people, but it is possible. Heart failure is much more common in patients at an advanced age, with arterial hypertension, after a heart attack or in diabetic patients. A severe course of infection that damages the heart may also be genetic. – explains prof. Witkowski.
Check it out: 10 advice from WHO experts regarding the SARS-CoV-2 coronavirus
Not all are known yet risks for individual groups of cardiac patients related to infection with the COVID-19 virus. It seems that one of the most endangered groups of cardiac patients may be PAH (pulmonary arterial hypertension).
We do not yet have confirmed information that PAH is a specific risk factor for death from coronavirus infection, but it is logical that these patients may be at particular risk of severe COVID-19 disease because they already have heart damage from primary pulmonary hypertension or from because of pulmonary hypertension, which is secondary to the damage to the muscle of the left ventricle, because it can be anyway. – says prof. Witkowski.
Foundation Institute of Awareness draws particular attention to the need to make cardiological patients aware of not only the risks, but also the possibility of dedicated treatment of cardiac patients already infected with the virus. Currently, there are no special therapies dedicated to these groups of patients, they are treated as standard, prof. Witkowski explains that the epidemic is still too short to differentiate treatment between patients with various comorbidities.
– Currently, there is no treatment dedicated to cardiac patients in the event of coronavirus infection. For some time it has been said that it may be dangerous to use inhibitors of angiotensin converting enzyme (ACE), which is an ACE2 receptor homolog, in patients with high blood pressure or heart failure. Drugs that block this enzyme inhibit the conversion of angiotensin 2 to angiotensin 1, but we have yet to confirm that their use, as well as the use of direct angiotensin blockers, may be harmful in patients with COVID-19. Currently, the recommendations of all scientific societies are such that in patients with arterial hypertension continue standard cardiac therapySince discontinuation of essential medications for high blood pressure could be more dangerous for the patient than coronavirus infection, they should be used all the time. – emphasizes prof. Witkowski.
The professor believes that the only obvious change in the current situation in the treatment of cardiovascular patients is that a patient with a confirmed coronavirus, or even in quarantine, should be immediately referred to a homonymous hospital, i.e. an infectious hospital, in the event of exacerbation of symptoms of a cardiological disease, and continued there. or intensify cardiac therapy.
Have a question about the coronavirus? Send them to the following address: [email protected]. You will find a daily updated list of answers HERE: Coronavirus – frequently asked questions and answers.
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