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Your Guide to COVID-19 and Cardiovascular Disease

Published February 14, 2023

If you’re like most people, you still have a lot of questions about COVID-19. Whether you’ve been infected or not, you probably know someone who has. And you’ve probably noticed that it affects everyone differently and sometimes in unexpected ways. 

We’ll know much more about COVID-19 in the years to come, but scientists already have evidence that shows people with preexisting conditions, like cardiovascular disease, may have a greater risk for complications. Some people have also developed heart conditions after recovering from COVID-19.                    

Understanding your risks and knowing how you can protect your heart is an important first step to staying healthy. 

Check out the Center for Disease Control’s (CDC) COVID-19 Guide for the latest on vaccines, community case data, travel guidelines, and more.

What is COVID-19?

Coronavirus disease 2019 (COVID-19) was first seen in Wuhan, China in 2019 and quickly spread around the world within months. The specific virus that causes COVID-19 is severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2.

The virus spreads when an infected person coughs, sneezes, or breathes, causing droplets to linger in the air or on surfaces. The infection spreads when another person breathes in these droplets or touches a contaminated surface, then touches their eyes, nose, or mouth. 

Symptoms

Symptoms usually occur between 2 and 4 days after being exposed to COVID-19. For most, these symptoms are mild and flu-like, but they can vary widely from person to person. 

How does COVID-19 get into the body?

Early on, scientists thought COVID-19 was a lung disease. But it turned out to be much more than that. The virus gets into the cells of the body by binding to a body enzyme called the ACE2 receptor. This enzyme is present in the lungs, the heart, the gastrointestinal system, some nerve cells, and in the lining of blood vessels throughout our bodies. That’s why COVID-19 has been known to cause blood clots and affect our health in a variety of ways. 

Take one of Quest’s convenient, at home or in-person COVID-19 tests.

How does COVID-19 affect the cardiovascular system?

People with COVID-19 have experienced symptoms that are similar to a heart attack, like shortness of breath or chest pain. There may even be visible changes on an echocardiogram, or ultrasound test of the heart. But further tests usually do not reveal any blockage of the heart vessels or evidence of heart attack.

Though very few people have a life-threatening heart attack due to COVID-19, post-COVID heart imaging has shown small changes in the heart muscle in those who have recovered from the virus.

Inflammation and your heart

There is evidence that suggests COVID-19 can lead to heart damage due to the inflammatory process caused by the virus. In some severe cases, a person’s immune system can overreact, causing excessive inflammation that can harm the cardiovascular system in different ways.

Myocardial injury

COVID-19 can cause what’s called myocardial injury, which means that cells in the heart muscle have died. This injury is associated with symptoms like chest pain or shortness of breath. Sometimes there are no symptoms, and the injury is diagnosed with blood tests and cardiac imaging.  

We’re still learning about this process, but researchers currently estimate that between 7 and 40 percent of people infected with COVID-19 are affected with myocardial injury. Those who have existing heart damage or require ICU care are at increased risk.

Myocarditis, heart failure, and arrythmias

Serious heart inflammation, or myocarditis, can also happen with COVID-19 infection. Myocarditis is a condition that prevents the heart from working effectively. “We don’t yet know why or how, but COVID-19 infection can directly damage the heart and cause arrhythmias and heart failure. So, it's an important risk factor to understand and use to monitor hospitalized patients,” according to Penn Medicine cardiologist Helene Glassberg, MD.1

To determine if a patient is experiencing heart failure, doctors measure brain natriuretic peptide (BNP) levels. “When the heart muscle stretches, this protein gets released into the bloodstream,” explains Dr Glassberg. “If BNP levels are elevated in COVID-19 patients, that means there’s heart injury and heart failure, which translates into potentially higher risks for worse outcomes.” 

Children and COVID-19

  • COVID-19 generally poses fewer risks for complications in children than adults. Though it’s uncommon, some children can experience a serious condition called multisystem inflammatory syndrome in children (MIS-C). This can cause heart damage or cardiac shock, which is when your heart cannot pump enough blood and oxygen to the brain. In some cases, there may be lingering effects such as abnormal heart rhythms or stiffened heart muscle that prevents the heart from beating normally.

Does having a pre-existing heart condition increase my risk of becoming seriously ill?

If you are older or have heart conditions such as heart failure, coronary artery disease, cardiomyopathies, or high blood pressure you may be more likely to get very sick from COVID-19.

People with cardiovascular disease are more likely to experience higher levels of inflammation from an overactive immune response known as a cytokine storm. “Surprisingly, heart disease seems to be an even greater risk factor than underlying lung disease,” says Dr Glassberg.

Other related conditions such as high blood cholesterol, chronic pulmonary disease, diabetes, and smoking can also raise the risk for more serious illness.

Do people develop cardiovascular conditions after COVID-19?

Long COVID-19 

Most people recover from COVID-19 in a few weeks. But others, even those who had a mild case, have symptoms that linger long after. Common names for this are post COVID-19 syndrome, long COVID-19, among others.

These lingering symptoms and conditions can involve the kidneys, skin, brain, and heart. Inflammation and immune system disturbances can also occur and lead to diabetes, nervous system disorders, or heart conditions.


Check up on your heart with Heart Health Tests.


Lingering heart-related symptoms:

  • Chest pain
  • Rapid heat rate
  • Heart palpitations
  • Dizziness or lightheadedness
  • In rare cases, shortness of breath or swelling in the legs can happen 

Your heart after COVID-19

The risk for developing heart issues after COVID-19 is greater if you ended up in intensive care (ICU) or were on a ventilator. But even people who had mild cases may have heart problems after recovery.

Though it’s rare for COVID-19 to directly infect your heart muscle, it can affect your heart even after the virus is no longer in your body. People who’ve never had heart problems before can also experience issues. But those who had cardiovascular disease prior to being infected run the greatest risk.

Research from the University of Pennsylvania also shows that people who’ve had a severe case of COVID-19 had a greater chance of cardiac arrest (sudden heart stoppage) or arrhythmias (abnormal heart rhythms).

How can I protect my heart from COVID-19?

Prevention basics:

  • Wear a mask in public  
  • Social distance (6 feet or more from people not in your household)
  • Wash hands often or use hand sanitizer
  • Avoid touching common surfaces 
  • Don’t touch your face

Assess your community risk level with a COVID-19 by County Check.

If you have heart disease, now is the time to be more careful about following your cardiologist’s guidelines for a healthy lifestyle. 

5 ways to protect your heart:

Watch your diet

Swap out highly processed foods and foods with high fat and sugar with lean meat, whole grains, and fresh fruits and vegetables to build up your immune system.

Exercise

Find ways to stay active, whether it’s walking outside or doing doctor-approved exercises at home

Prioritize sleep

The recommended amount of sleep is around 7 to 8 hours per night, depending on your age. Staying well rested is important for helping your body fight off infections.

Continue taking your meds

Taking your medications as prescribed is the best way to manage any conditions you may have. If you feel the need to make changes, first check with your doctor

Manage stress

Keeping your stress under control is important for your heart and immune health. In these challenging times it’s more important than ever to find a way to reduce your stress, whether it’s talking to friends, exercising, or some form of meditation.

For more tips on protecting yourself from COVID-19 see How to Protect Yourself and Others.

No doctor visit is required to buy your own lab test at questhealth.com. PWNHealth and its affiliates review your purchase to ensure its medically appropriate before submitting the test order for processing. PWNHealth also reviews your test results and will contact you directly if they require prompt attention. Included in each purchase is the option to discuss your test results with an independent physician; however, you are also encouraged to speak with your primary healthcare provider. 

References

  1. Coronavirus and Heart Disease. Penn Medicine Heart and Vascular Blog. July 7, 2022. Accessed January 24, 2023. https://www.pennmedicine.org/updates/blogs/heart-and-vascular-blog/2020/june/coronavirus-and-heart-disease

Sources

  1. American Heart Association. Questions We All Have About the Coronavirus. Last reviewed April 14, 2021. Accessed January 23, 2023. https://www.heart.org/en/coronavirus/coronavirus-questions/questions-we-all-have
  2. Collins, Sonya, Coronavirus: What Happens When You Get Infected? WebMD. Medically reviewed by Dan Brennan, MD, December 29, 2022. Accessed January 23, 2023. https://www.webmd.com/covid/coronavirus-covid-19-affects-body
  3. How COVID-19 Impacts the Whole Body. Elkind, Mitch, President, American Heart Association. Accessed January 24, 2023. https://youtu.be/B7_R6zZysbo; https://www.heart.org/en/coronavirus 
  4. Post, Wendy Susan & Gilotra, Nisha Aggarwal. Heart Problems After COVID-19. Last updated April 28, 2022. Accessed January 24, 2023. https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/heart-problems-after-covid19
  5. COVID Heart Damage. Cleveland Clinic. Last reviewed May 10, 2022. https://my.clevelandclinic.org/health/articles/23011-covid-heart-damage
  6. Coronavirus and Heart Disease. Penn Medicine Heart and Vascular Blog. July 7, 2022. Accessed January 24, 2023. https://www.pennmedicine.org/updates/blogs/heart-and-vascular-blog/2020/june/coronavirus-and-heart-disease
  7. COVID-19 – People with Certain Medical Conditions. Centers for Disease Control and Prevention. Updated December 6, 2022. Accessed January 24, 2023. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fneed-extra-precautions%2Fgroups-at-higher-risk.html#serious-heart-conditions
  8. COVID-19: Long-term effects. Mayo Clinic. June 28, 2022. Accessed January 24, 2023. https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-long-term-effects/art-20490351
  9. COVID-19 and Your Heart. Cleveland HeartLab. July 24, 2020. Accessed January 24, 2023. https://www.clevelandheartlab.com/blog/covid-19-and-your-heart/
  10. Protecting Your Heart & Health During the Coronavirus Outbreak. The Heart House. Accessed January 24, 2023. https://www.hearthousenj.com/learning-center/diet-nutrition/protecting-your-heart-health-during-the-coronavirus-outbreak/