How COVID-19 is changing the heart

V:While the effects of COVID-19 on the lungs and respiratory system are well known, there is growing research showing that the virus also affects the heart, with potentially lasting effects.

In a speech at the annual meeting of the Biophysical Society, an international scientific group for biophysics, Dr. Andrew Marks, chair of the Department of Physiology at Columbia University, and his colleagues reported on changes in the heart tissue of patients with COVID-19. died of disease, some of whom also had a history of heart disease. The team performed post-mortem analysis and found a number of abnormalities, particularly calcium regulation in heart cells.

All muscles, including heart muscle, rely on calcium to contract. Muscle cells store calcium and open special channels inside the cells to release it when needed. In some conditions, such as heart failure, the channel stays open in a desperate attempt to help the heart muscle contract more vigorously. Calcium leakage eventually depletes calcium stores, eventually weakening the muscles.

“We found evidence of abnormalities in calcium handling in the hearts of patients with COVID-19,” says Marks. In fact, when it came to their calcium systems, the heart tissue of these 10 people who died of COVID-19 was very similar to that of people with heart failure.

Marks plans to further investigate the heart changes that SARS-CoV-2 can cause by studying how the infection affects the hearts of mice and hamsters. He plans to measure changes in the animals’ immune cells, as well as any changes in heart function, both during infection and after recovery, to document lasting effects.

“The data we present shows that there are dramatic changes in the heart,” Marks says. “The exact cause and long-term effects of these need to be further investigated.”

Previous studies have found a link between COVID-19 infections and heart problems. A large 2022 analysis of VA system patients, some of whom had recovered from COVID-19 and others who had never been diagnosed, found that those who had COVID-19 had higher rates of several heart-related risks , including irregular. heart palpitations heart attack and stroke. Dr. Suzanne Cheng, chair of women’s cardiovascular health and population science at Cedars-Sinai, is investigating whether there is a link between heart attacks and the rise in COVID-19 infections to better understand how the virus may affect the disease. heart

read more: You can have COVID for a long time and not even know it

There is also early evidence to suggest that people with hypertension may be at higher risk of heart disease when they get COVID-19.

What links the viral infection to the heart is not yet known, but the body’s immune system is likely a major contributor. “It’s well documented that with SARS-CoV-2, the body responds with an inflammatory response that involves activating the immune system in a very dramatic way,” says Marks. “In the heart, the same inflammatory process appears to activate pathways that can be detrimental to heart function.” But more research needs to clarify that process, says Dr. Mariel Jessup, chief science and medical officer of the American Heart Association. “If infection is supposed to cause inflammation, and inflammation is supposed to cause more cardiovascular events, then how does it do that?”

It is also possible that viruses can infect and adversely affect heart cells. “We’re still at the tip of the iceberg in understanding how COVID-19 affects health,” says Cheng.

Marks hopes to get some of those answers with animal experiments he plans to conduct. “We hope to optimize the animal model to best reflect what we think is happening in patients,” he says. “We want to study at a very, very detailed level what happens in the heart when the virus infects the animal.”

Ultimately, that knowledge will help better treat people who may be at higher risk of heart problems from COVID-19, which could in turn reduce hospitalizations and deaths from the disease. Marks has already developed a potential drug that could address calcium leakage if it proves to be a problem with COVID-19; he is ready and willing to test it if his animal studies justify the experiments.

Until more definitive studies clarify how COVID-19 affects the heart, Jessup says he will advise his patients to “control the things we know how to control,” such as risk factors that can put them at high risk of heart disease. to begin with, such as obesity, high blood pressure, and high cholesterol. And as more data emerges, if people are getting multiple COVID-19 infections, it’s probably worth seeing their doctor to be checked for heart disease risk factors as well.

“We spend a lot of time telling people they should get vaccinated,” he says. “For people who have had COVID-19, we also need to make sure they know their heart numbers and make sure they know their blood pressure. “We know how to prevent heart disease, so let’s do what we know how to do.”

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