Research Finds the Reasons Covid-19 May Cause Heart Issues

A new and unnerving addition to Covid-19 symptoms was recently brought to light: despite the fact that it is considered an illness of the lungs, many patients who are infected with the novel coronavirus experience cardiac issues. The findings suggest that 1 in 5 patients show signs of heart injury, regardless of whether or not they had respiratory symptoms. Many of these patients had underlying cardiovascular issues prior to contracting Covid-19 but they do not outnumber the patients who were otherwise healthy, yet developed heart problems including blood vessel injuries, blood clots, arrhythmia, strokes, and heart attacks.

These numbers have baffled physicians and health experts, but it seems a new study that was published in the journal Frontiers in Cardiovascular Medicine has some of the answers. The main reasons that coronavirus leads to heart conditions are the widespread inflammation the infection causes, the possibility that the virus directly infects and injures the cardiovascular system, and the overall stress the infection puts on preexisting heart conditions. 

It is important to note that like many other coronavirus related studies, more research is needed to draw concrete conclusions, and verify exactly how the coronavirus affects heart function, and which patients with COVID-19 are most at risk for running into heart troubles.

1. Inflammation
Inflammation is one of the key reasons why some patients experience Covid-19 so harshly. The virus is known for causing a very high level of inflammation due to a phenomenon called “cytokine storm,” in which the body produces too big of a response against an intruder. 
Inflammation and a fever accelerate the heart’s rate, making it work much harder to pump blood throughout the body, and subsequently, lead the heart itself to inflammation and failure. According to a statement from Shuyang Zhang, a cardiology professor at Peking Union Medical College Hospital in Beijing, the more intense the inflammatory response a patient has the more likely they are to develop heart issues.

2. Direct Injury of the Heart
There is a risk that the coronavirus attacks cells in the cardiovascular system itself, through a receptor called ACE2. “Once inside the heart cell, damage to the cellular machinery directly from the virus and the human immune cell response leads to cell dysfunction and cellular death,” explained  Dr. Jack Wolfson, a cardiologist and a fellow of the American College of Cardiology.

A similar process was observed in the early 2000s in patients infected with SARS, a disease caused by a different coronavirus.

3. Underlying Heart Issues
 People with preexisting heart disease are at a greater risk for severe cardiovascular and respiratory complications from COVID-19. Research has shown that heart attack can actually be prompted by respiratory infections like the flu.  

Moreover, people with previously undiagnosed heart disease may experience previously silent symptoms that are unmasked by the viral infection. 

4. Certain Medications
Some medications used to treat the infection may increase one’s risk to develop heart problems - for example, nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin and ibuprofen, and some antiviral drugs. 

NSAIDs can increase a person’s blood pressure while anti-inflammatory medication might “impact the immune system and the heart muscle in many different ways, some of which could lead to lethal heart rhythms in the short term or worsen heart recovery in the long term,” as explained by Dr. Wolfson.

As you can see, the underlying causes of cardiac symptoms in COVID-19 patients can happen in several ways, and most likely, the increased number of coronavirus patients with heart damage is due to a combination of all these causes. Hopefully, more and more clinicians will take the possibility of heart issues as a result of a COVID-19 infection into account and minimize the risk of serious complications.

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

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Most anti-cancer drugs can affect the cardiac pumping function

Cancer therapy has been at receiving end for quite some time now. A few years ago, a British doctor shot to fame when he refused to accept modern medicare for his cancer treatment. He opted to die of cancer than suffer from the adverse effects of its therapy. Recently, a lady who claimed to have found a cure for cancer in fruits and vegetables died of cancer, too. A film actor and director managed to stall a government proposal to start a cancer center in central Kerala, out of his conviction that modern medicine has no cure for cancer and cancer drugs if dumped is capable of killing the entire fish population of the Arabian Sea. Not just that, someone even put a fake post in the name of a celebrated oncologist on Facebook promoting alternative therapy for cancer, which was then shared widely. 

Why is cancer treatment alone is singled out by the public and lamented at? Why do those who have no basic training in medicine call the shots in cancer care? Why are oncologists and others involved in cancer care taken for granted as agents of multinational drug firms trying to sell expensive concoctions to unsuspecting cancer victims?

Statistics tell us that cancer survival rate has improved by over sixty per cent during the last 40 years, owing to advances in chemotherapy, oncosurgery, radiation, oncology, imaging sciences and other supportive specialties including oncocardiology. Cancers like nasopharyngeal cancer, pancreatic cancer and cancers among young adults have less impressive cure rates. Breast and prostate cancer are curable. These patients when diagnosed and treated appropriately, do not die of cancer, but of other illnesses. Evidence-based medicine has proved beyond doubt that alternative therapies and nature cure is not effective for treatment of cancer.

Why do people expect a cure for cancer like a common cold, malaria, or an infective diarhoea? Anti-cancer drugs have significant side effects and sensitive dose ranges. Most anticancer drugs can potentially affect the heart, especially cardiac pumping function leading to heart failure. Some can cause elevation of blood pressure, cardiac rhythm abnormalities, heart attacks, venous thromboembolism and even new cancers. Reports show that immunotherapy too can cause fulminant heart failure. 

A pertinent question arises here. If these medications cause such damage, why they should ever be used? Reason: They cure cancer. We see more and more people with adverse effects because patients survive cancer and live longer. If they were dead, you won’t get to see adverse events too. More patients are alive with cancer, so you see more relics of cancer.As life expectancy improves, and population survives infectious diseases out of better living standards, antibiotics, vaccination and social engineering, lifestyle disorders and cardiovascular disease by improvement in physical activities, diet modifications, medications, other interventions and conquer death out of it, then it is a biological plausibility that most of us will catch cancer or degenerative disorders in due course of time. Unlike many doomsayers scream, life expectancy is improving all over the globe, including in some of the most underprivileged societies.

This is a reality. When population ages, natural conditions like cardiac illnesses, cancer, kidney failure and degenerative diseases will be on the rise.We will have to live with all of these maladies. Scientific approach to issues are critical and government policies will be crucial. Radical changes in health care delivery systems will become the need of the hour, hospices will become more relevant that can accommodate and care for people who need attention, short of hospitalisation. We will have to promote research; improve social infrastructure, public conveyances, and social security. That is the way population will live longer, healthier and better. 

Can you imagine even someone like Steve Jobs was a fan of alternate therapies for cancer and died out of an eminently treatable form of cancer of the pancreas denying us more advanced iPhones, iMacs, and iscreens?

The author is an Interventional Cardiologist, with a special interest in cardiac involvement in cancer therapies. He was a fellow in cancer biology and therapeutics.

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