Covid-19, the disease caused in humans by the SARS-CoV-2 virus, remains a mystery that needs a lot more unwrapping.
At first, experts believed that the conditions caused by the novel coronavirus were just respiratory diseases. But as the virus circled the globe, doctors saw a wider range of diseases in their patients, fatal in many cases.
These complications include heart failure, heart attacks and blood clots, which were all reported by emergency doctors in a new scientific paper.
What the paper entailed
The paper was published in the American Journal of Emergency Medicine.
According to a news release, the paper, published by the University of Virginia’s Health System, draws emergency doctors' attention to the fact that Covid-19 doesn’t only present with pulmonary complications, but that they should also be on the lookout for cardiovascular symptoms, which may lead to death.
The authors did their research by searching PubMed and Google Scholar for papers containing various keywords on Covid-19 and cardiovascular conditions. They also included case studies, retrospective and prospective studies, systematic reviews, meta-analyses and clinical guidelines.
"In writing this article, we hope to increase emergency physicians' knowledge and awareness of this new pathogen and its impact on the cardiovascular system," stated Dr William Brady from the University of Virginia’s Health System’s Department of Emergency Medicine.
"As we encounter more and more patients with Covid-19-related illness, we are increasing our understanding of its impact on the body in general and the cardiovascular system in particular. The rate of learning in this area is amazingly rapid. Information continues to change weekly, if not daily,” he stated.
The link between cardiovascular complications and Covid-19
The new paper specifically focused on heart failure in patients with Covid-19. In their research, they noted a previous study reporting that almost a quarter of Covid-19 patients were suffering acute heart failure upon first diagnosis – it should, however, be noted that not all patients with Covid-19 will suffer heart failure.
According to the authors, it remains unclear whether heart complications are a direct cause of Covid-19, or whether Covid-19 simply exacerbates previously undiagnosed heart conditions.
Strokes were also mentioned in the paper – the result of severe inflammation in the body, causing a fatty plaque buildup in the blood vessels, which can be negatively affected by influenza and other viruses.
The authors also mentioned potential interactions with drugs used in Covid-19 patients. The highly-reported hydroxychloroquine could, for example, interact with other medications, originally prescribed to regulate heart rhythm.
The immune response in some Covid-19 patients, where a so-called “cytokine storm” is released in the body, can also affect the heart, as it causes the heart to work harder – similar to the effects of severe influenza and other viral conditions.
It has also been reported that remdesivir, an antiviral which has been emergency-approved by the FDA, can cause low blood pressure and abnormal heart rhythm. According to the authors, it is important that doctors are aware of the interactions these medications may cause.
Brady emphasised that doctors must always keep in mind that the new pathogen causes more than respiratory symptoms, and be constantly aware of new presentations as more discoveries about SARS-CoV-2 are made.
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