Long COVID and your heart (2023)

If you've had a COVID-19 outbreak, common symptoms likefor % s,chills, and shortness of breath may disappear in 1 to 2 weeks. But if some or all of your symptoms are like fatigue, a runheart rhythm, chest pain, dizziness, diarrhea, joint pain ordifficulty breathingcome back or continue for 4 or more weeks after you have COVID, you may have what doctors call "long-term COVID".

For some people, symptoms can continue for months or even longer. Experts also call it by other names, such as long-distance COVID, post-acute COVID-19, post-acute sequelae of SARS-CoV-2 infection (PASC) or chronic COVID, among others.

As research into COVID-19 and its side effects continues, experts aren't sure howlong greedthis can affect your health in the long run. While COVID-19 primarily affects the lungs, studies are starting to show that, for a small number of people, long-term COVID can also affect other organs in the body, including the heart.

How does prolonged COVID affect your heart?

When you have long-term COVID-19, the SARS-CoV-2 virus attacks your body and heart cells and muscles in a variety of ways.

Temporary or permanent heart problems can look like:

Heartproblems due to lack of oxygen.When the virus takes root in the lungs, it causesinflammation.This causes the alveoli responsible for oxygen exchange to fill with fluid. When this happens, it reduces the amount of oxygen that can enter the bloodstream.

To compensate for this, the heart has to pump much harder to get oxygen-rich blood to the rest of the body. This can affect your heart and it can fail if it is overworked, especially if you had heart disease before you got a COVID-19 infection.

Or if your body doesn't get enough oxygen, your cells can die or damage heart tissue or other organs. Low levels of oxygen in your body can cause symptoms such as shortness of breath, dizziness or chest pain.

Myocarditis.It is a condition that occurs when there is inflammation in the heart. The SARS-CoV-2 virus can attack endothelial cells, the cells that line the inner walls of blood vessels, such as veins and arteries.

This can cause inflammation within the blood vessel, damage very small vessels, or cause blood clots. This can cut off blood flow between the heart and the rest of the body.

The virus can also directly infect and damage heart muscle and tissue and cause inflammation. You can also develop myocarditis because of the immune response your body mounts to fight COVID-19.

StresscardiomyopathyWhen you're infected with COVID-19, the virus can stress your body and flood it with chemicals called catecholamines. This increase can shock your heart and affect its ability to pump properly. But this is usually temporary. Your heart will recover once the infection is gone.

Arrhythmiayatrial fibrillation.The virus can affect your heart rate, especially if you've had COVID for a long time. You can make it beat too fast or too slow. Or it can make it beat very fast in a specific pattern, known as aatrial fibrillation.

POTS (postural orthostatic tachycardia syndrome).New findings on long-term COVID show that even if you have a mild case of COVID-19, you are at higher risk for POTS. It's a condition in which your heart starts beating too fast when you get up from lying on your back. You may feel very tired or dizzy or have trouble breathing. In severe cases, the sudden change in heart rate can cause you to faint (called syncope).

POTS is found to be five times more common among women than men.

Symptoms of a heart attack.Long-term COVID can cause heart attack-like symptoms, such as:

  • difficulty breathing
  • heart palpitations
  • Chest pain
  • changes in yourelectrocardiogram(electrocardiogram) – oneultrasoundfrom your heart

But when your doctor does a test called an angiogram to check for large blockages in the heart's blood vessels, you may not see anything. Doctors are trying to understand more about this.

If you think you might be having a heart attack, don't try to wait or look for home remedies. Get emergency medical help right away.

How does prolonged COVID cause heart problems?

For the most part, COVID-19 attacks the lungs andRespiratory system.But it is possible for the virus to damage other organs and tissues in the body to cause prolonged COVID. Experts are still trying to figure out exactly how.

When the virus enters your body, yourimmunity systemlaunches an attack against what it believes to be an invader. To mount a defense, it floods your body with a type of protein called a cytokine. These cytokines have the ability to communicate with each other and work together to kill the virus.

But in some people, when the immune system releases cytokines, it releases too many. This causes a dangerous increase in inflammation that will likely overwhelm your body. This is called a "cytokine storm". This is a serious complication.

Excessive inflammation not only attacks the virus, but it can also damage good cells and tissue and damage organs, including the heart.

A cytokine storm can disrupt your heart's regular rhythm. This can lead to arrhythmias, which can be dangerous for your health. If the arrhythmias in your heart's ventricles are severe enough, it can be difficult to survive a cytokine storm.

Another possible cause that researchers are investigating could have to do with the structure of the virus. The SARS-CoV-2 virus has spike proteins on its surface. The proteins attach to healthy cells in your body through what are known as "ACE2 receptors". This allows the virus to enter your body's cells, including your heart cells. When it enters a cell, it can destroy or damage it.

In some cases, the virus can cause cells in thearteriesand veins inside the heart to die and formblood clotsThis can lead to a variety of heart problems.

Who is at risk?

Studies show that up to three out of 10 people with COVID-19 will develop prolonged COVID.

Research shows that you are more likely to have long-term COVID if you have a severe case of the virus, especially if you need to be hospitalized or go to the intensive care unit (ICU). You are also more likely to get it if you are not vaccinated.

But recent evidence shows that almost anyone who has had COVID-19 can have long-term COVID and have an increased risk of heart problems for up to a year after testing positive. This includes people who:

  • You had a mild or moderate infection.
  • had no symptoms
  • Had other health conditions prior to COVID-19

What's more, researchers found that you're also at risk if you're fit, healthy, don't smoke or drink alcohol, or if you have any previous medical conditions, such as diabetes,kidney disease,oobesitybefore contracting the viral infection.

As with most other COVID-19 data points, Brookings Institution research shows that racial and ethnic minorities are more likely to have prolonged COVID.

This includes indigenous peoples, African Americans and Latinos. This is because they have higher rates of infection and exposure to COVID-19. They are also more likely to have previous health problems that make them more likely to have symptoms that last longer.

Inequal access to adequate and timely healthcare due to where they live or work can also put racial and ethnic minorities at greater risk for long-term COVID-related heart problems.

Long-Term COVID and Your Heart: Symptoms to Watch Out For

If you have COVID for a long time you can have a wide range of symptoms, some return or continue to have some since you tested positive.

Long-term COVID doesn't affect everyone the same. It can be difficult to know if your symptoms are related to COVID-19 or something else, especially if you didn't have any problems before you got the virus.

If you suspect you have long-term COVID that is affecting your heart, watch for symptoms such as:

  • sudden shortness of breath
  • low oxygen levels
  • ankle swelling
  • Fatigue
  • Chest pain (mild to severe) afterexerciseor strenuous movement. Normally this should go away within 15 minutes.
  • nausea
  • stun
  • Perspiration
  • run orirregular heart rhythm(palpitations)

If your symptoms, such as sudden chest pain or palpitations, do not go away within 15 minutes, if your face or lips turn blue, or if your oxygen levels drop below 92%, seek medical help immediately. Call 911 or go to the nearest hospital. You will need to be evaluated by a heart specialist (called a cardiologist).

If your symptoms aren't severe but you're concerned about how long COVID may be affecting your heart, talk to your primary care doctor.

What does the research say?

To study the link between prolonged COVID and heart problems, researchers analyzed COVID-19 data from the US Department of Veterans Affairs. This is the largest study ever conducted to learn more about the link between prolonged COVID and the heart.

They assembled a list of more than 153,000 veterans who tested positive for COVID-19 to see what the long-term effects ofviral infectionthey were at the 1 year mark. They were compared to nearly 6 million veterans in a control group who were uninfected.

In this study, after regular follow-up, they found that people who contracted an infection had a higher risk of several heart problems, including abnormal heart rhythms, heart disease from poor blood flow, myocarditis,cardiac insufficiency, youblood clot-related heart problems.

To be specific, those who had COVID-19 were more than 70% more likely to have heart failure, more than 60% more likely to have a heart attack, and more than 50% more likely to have a stroke.carrerathan those who have never contracted COVID-19.

Can long-term heart problems related to COVID be prevented?

As experts learn more about the link between COVID-19, long-term COVID and the heart problems it can cause, the best way to prevent these problems or protect yourself is to avoid getting the virus in the first place.

Get fully vaccinated as soon as you are eligible for shots and boosters. This can help prevent a serious infection, which reduces the risk of prolonged COVID.

Research also shows that among those who have advanced infections, when you become infected despite being fully vaccinated, you are less likely to have long-term COVID, compared to those who have not been vaccinated.

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