COVID’s cardiac consequences

With new COVID-19 cases continuing to occur, scientists are paying more attention to a variety of short and long-term health effects of the virus. As of now, there are around 30 mutations of the latest variant of COVID-19, and more research is needed to understand the effects of each form. Long COVID-19 has been a known possibility after infection, and now, years after the virus’ introduction, medical professionals can look into the connections between COVID-19 infections and cardiovascular disorders. 

Aside from the common flu-like symptoms that arise from COVID-19 infection, some people develop characteristics such as weakened heart muscles, blood clots, and fluid in the lungs, all from a heightened immune system. Proinflammatory cytokines, proteins activated by macrophages, serve as a chemical messenger that causes increased activation of the immune system. Though seemingly helpful in treating COVID-19 infection, too much of a cytokine production can be a huge problem. Working in a positive feedback loop, the production of cytokines can cause a “cytokine storm” and lead to the destruction of vital organs by the immune system.

“Though seemingly helpful in treating COVID-19 infection, too much of a cytokine production can be a huge problem”

In addition, a 2023 study found that COVID-19 infections were the fourth most common diagnosis associated with patients who died from heart attacks. A type 2 myocardial infarction is a type of heart attack where there is an imbalance in the supply and demand of oxygen in the heart. Given that the body requires more oxygen to overcome fevers and other immune responses when fighting COVID, the increased risk of type 2 myocardial infarction resulting from an oxygen imbalance makes sense. Together, this combination can add additional stress to the heart and lead to possible damage.

Dr. Dara Lee Lewis, a Harvard Medical School instructor and cardiology expert, expressed concern for student-athletes, explaining that these students not only need to continue attending school and working, but also need to get back into competitive play and training following COVID-19 infection. Magnetic resonance imaging of these student-athletes revealed signs of myocarditis through chest pain and shortness of breath. Despite the initial worry, Lee Lewis has since acknowledged that affected students were able to make a full recovery.

On top of the observed increase in Type 2 myocardial infarction, there is also an increased possibility of the formation of blood clots that lead to arterial blockages, even in young people without predisposing risk factors. Postural orthostatic tachycardia syndrome (POTS) has also been seen to be affecting up to one-third of all long-term COVID-19 patients. POTS can manifest into symptoms such as lightheadedness and fainting, due to the exceedingly reduced volume of blood returning to the heart after being pumped around the body. Despite the lack of knowledge surrounding the exact cause of POTS, studies have postulated that the autoantibody production against COVID-19 by the immune system could have adverse effects on the autonomic nerve fibers responsible for involuntary processes like heart rate, blood pressure, respiration, and many more. 

With all this in mind, it is essential that more research be done to understand the longitudinal impacts of COVID-19 infection. Only time will tell the full effects of the COVID-19 infection on our health. With that being said, it is important to note any and all possible symptoms — including those as minute as lightheadedness — for months after infection, as disorders like POTS can suddenly present. It is salient that we as a community look out for each other and our health — seeking vaccinations and wearing masks if sick can help protect not only ourselves, but also those around us who are immunocompromised and limited in their options.