Can Corona also damage the heart?

So far, the Sars-CoV-2 coronavirus has been described primarily as a trigger for sometimes severe respiratory and lung diseases. Above all, the pneumonia caused by Covid-19, for example, led in some places in Italy to the fact that more people needed ventilators than were available. Voices are now louder, indicating that corona not only restricts lung function, but also – more or less directly – could damage the heart. Such an emerging knowledge should not come as a surprise, since researchers first have to get to know the virus step by step.

Several (small) studies revealed that a certain biomarker (troponin) in the blood was released in people who had to suffer a severe corona course, which is released by cardiac muscle cells when they die.

A worrying case from Italy

The Italian scientist Riccardo Inciardi reports in the cardiac journal “JAMA Cardiology” about the case of a 53-year-old woman who suffered from heart disease as a result of Corona. One week after symptoms typical of Corona (dry cough and fever), she went to a clinic without a fever because she suffered from extreme weakness and circulatory problems. After numerous examinations, acute myocarditis was diagnosed. Means: In the affected person (without previous illnesses on the heart) the heart muscle had become inflamed.

Untreated myocarditis heals without consequences in many cases, but can also lead to heart failure, cardiac arrhythmias and even death. Inciardi is quoted in “JAMA” as follows: “This case shows that if complications occur, Covid-19 can also affect the heart – even if there are no symptoms and signs of atypical pneumonia.”

The good news: Since the myocarditis was discovered very early, the disease seems to have ended lightly for those affected. Because by the time Inciardi and his colleagues submitted the study, the patient was already on the mend.

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Two studies from China: corona and heart damage

Data from China also come in a similar direction: that Covid-19 can not only go to the lungs, but also to the heart of those affected. For example, scientists from the University of Wuhan have observed that around 20 percent of 416 corona patients showed damage to the heart muscle. Those among the other 82 affected had a significantly higher risk of dying from corona (51.2% mortality rate) than those 334 who remained without cardiac damage and increased troponin values ​​(4.5% mortality rate). This can also be read in “JAMA Cardiology”.

Another study from China with 187 corona patients treated in hospital showed that 52 of them (27.8%) had elevated troponin values, meaning that damage to the heart muscle was to be expected. As expected, the highest mortality rate was in the group with people who had elevated troponin levels and had previous coronary disease (69.4%). Yes, says Dr. med. Robert Bonow in an editorial in “JAMA Cardiology”, the “mortality rate” was also “remarkably” high among those who had elevated troponin levels but no prior illnesses (37.5%). It was precisely this case that the affected person from Italy was concerned with. In this context, he also writes of a “wake-up call”, ie a warning call.

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Is the heart directly or indirectly affected by corona?

The main question that doctors still have to answer is: Did the virus directly lead to heart damage in the patients examined or was a weakening of the heart only a consequence or complication of other inflammations caused by Covid-19? Either way, researchers like Inciardi or Bonow are already pointing out the need to have possible heart damage in people with corona infection on the screen. Especially in people with previous coronary diseases. But – as the case of the 53-year-old Italian shows – not just there. Against this background, Inciardi encourages the standard measurement of troponin values ​​in corona patients in order to prevent heart damage at an early stage.

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This is what the expert says about the observed cases

The internist Dr. med. Matthias Riedl, medical director of medicum Hamburg, considers a connection between Covid-19 and heart complications to be quite plausible, but also makes it clear that this would not be anything corona-specific. He told FITBOOK: “Some viruses have a more or less pronounced affinity for organs. Mumps primarily affects the parotid gland or testicles. Others show less than Corona. ”At the moment it can be assumed that this affinity for the heart is only moderate, otherwise it would occur more frequently. “But it just occurs. But that can also happen with a flu virus, ”explains Dr. Riedl continues.

In addition, everyone has their own “threat situation”: “Some immune systems do not protect us enough, so the different courses come about – regardless of age.” And not everyone has the same organic weak point: “Everyone knows that: some know , everything goes straight to my lungs. Others, on the other hand, get myocarditis more easily. ”

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