The Heart of Covid-19

The Heart of Covid-19

The coronavirus can take a harmful toll on the cardiovascular system

Diane Weibeler didn’t give much thought to the headache she developed one spring weekend. Two days later, though, when she suddenly lost her sense of taste and smell, Weibeler realized she might have Covid-19. 

A positive Covid-19 test confirmed her suspicion. As a nurse practitioner at UChicago Medicine who specializes in cardiology, Weibeler, 31, realized just how lucky her relatively minimal symptoms made her. 

While Covid-19 is a respiratory disease that can wreak havoc on the lungs, it can also take a toll on the heart and blood vessels.

“Covid-19 is seen as a spectrum disease. It can affect all parts of the body,” including the heart, liver, kidneys, brain, endocrine system, and blood system, says Sandeep Nathan, MD, a UChicago Medicine cardiologist.

The disease’s toll on the cardio-vascular system can be particularly harmful, as it can cause blood vessel injuries, blood clots, arrhythmias, strokes, and heart attacks.

An inflammatory response

One of the key problems associated with Covid-19 is the amount of inflammation the infection causes.

Diseases commonly put stress on the body and cause widespread inflammation, and Covid-19 is no exception. The strong inflammatory response that Covid-19 can elicit can cause the heart to work harder to pump blood throughout the body. It can also lead to a buildup of fluid in the lungs. As a result, less oxygen reaches the bloodstream, and the heart works faster and harder to provide oxygen to major organs.

The virus reproduces in part by disabling ACE2 protein molecules that cover heart, lung, and blood vessel cells and act as a port of entry into the body. Then, the virus begins to multiply.

In some cases, a body’s immune system responds too strongly to Covid-19, thereby injuring healthy cells and spurring inflammation. Inflammation may also injure the cells lining blood vessels and make blood more likely to form clots throughout the body, increasing the risk of a heart attack or stroke. 

Many researchers now theorize that the virus infects the blood vessels, which helps explain the prevalence of blood clots, strokes, and heart attacks, as well as the range of symptoms people experience.

Staying healthy

Those with heart conditions, such as high blood pressure, may be at a higher risk for Covid-19 complications.

“We don’t know exactly why hypertension, even when it’s being treated, can cause more severe cases. It likely has to do with the pressure high blood pressure exerts on the heart,” says Subir Shah, DO, a cardiologist with Loyola Medicine.

Americans with underlying health conditions who tested positive for Covid-19 were hospitalized at a rate six times as often as healthy individuals and died 12 times more often, according to a June report from the Centers for Disease Control and Prevention.

If you experience symptoms of stroke — numbness and trouble speaking or moving — and signs of a heart attack, such as chest pain and shortness of breath, call 911 immediately, Shah says.

Many researchers now theorize that the virus infects the blood vessels, which helps explain the prevalence of blood clots, strokes, and heart attacks.

Despite what one might read online, it is risky to take medicines for Covid-19 that the Food and Drug Administration (FDA) has not yet approved, Nathan says. The FDA warns that hydroxychloroquine can cause severe heart problems in those with Covid-19.

“I’ve had patients ask if they should take hydroxychloroquine or chloroquine derivatives as prophylaxis or treatment for presumed Covid-19 infection, and I tell them absolutely not,” he says. “But I am glad they are asking questions. There is a barrage of information on the internet and in the media.” 

The vast majority of people who contract the novel coronavirus will survive, including those with heart disease and other underlying medical conditions, Nathan says. Whether survivors will experience long-term or permanent health problems isn’t yet known, due to the newness of the virus.

The coronavirus is not going away, Nathan says. “It’s way premature to let your guard down. Don’t follow the politics. Follow the science,” he advises.

Taking preventive steps against heart disease — such as avoiding obesity, following a heart-healthy diet, getting regular exercise, not smoking, managing hypertension — may also help prevent serious complications from Covid-19.

As a cardiology nurse, Weibeler knows the risks of the coronavirus and how it affects the heart. She also knows the importance of eating nutritiously and exercising regularly. By sharing her story, she hopes to help the public understand that Covid-19 attacks younger people, too, including those in their 20s and 30s.

“I’m not sure how I got it,” Weibeler says. “I think my family and friends were surprised initially but understood my chances of contracting it were higher since my husband and I both work in the medical field.”

As physicians, scientists, and the general public learn more about Covid-19, we’re getting to the heart of the risks the virus poses.

Originally published in the Fall 2020/Winter 2021 print issue.