From the pictures From cloudy chest scans and wheezing patients on ventilators, we have been conditioned to consider Covid-19 a respiratory disease. But it’s not just about the lungs. Even in the early days of the pandemic, doctors realized that a novel coronavirus infection could devastate other parts of the body, including the brain, blood vessels and heart. Data from initial outbreaks in China, New York City and Washington state suggest that 20 to 30 percent of patients hospitalized with Covid-19 showed signs of heart injury.
The fact that these patients got sick more often and died more often than patients without cardiac complications did not trigger immediate alarm bells. After all, they were people with serious cases of Covid-19 – serious enough to end up in hospital. Most people who get the virus will experience less severe symptoms. Every third person never feels sick. However, there is now evidence that the virus can cause heart damage even in people with mild or no symptoms, especially if those people are exercising while infected.
When the league commissioners at college conferences Big Ten and Pac-12 announced last month that they were postponing the 2020 fall sports season, one of the main factors they cited was concerns about what is known as myocarditis. This is cardiologist – speak up for what happens when the muscle walls of the heart become inflamed, weakening the organ and making it harder to pump blood. It’s not a newly discovered condition, and it’s fairly rare, but when it does, most of the time it’s caused by an infection. Viruses, bacteria, even invading amoebas, yeasts and worms have been shown to cause this.
What they have in common is that they put the body’s immune system into attack mode, which leads to inflammation. If a person is resting while they are sick and recovering, most of the time the inflammation subsides and the heart muscle heals on its own. But strenuous activity while the heart is weakened can cause swelling in the legs, dizziness, and shortness of breath – in severe Cases – causing irregular heartbeat, cardiac arrest, and sudden death.
These more extreme results are most common in competitive athletes. Because of this, cardiologists are warning of the return of sport in the midst of the pandemic. Just last month, former Florida state basketball player Michael Ojo died of apparent cardiac complications while playing in a pro league in Serbia shortly after the 27-year-old recovered from Covid-19.
To prevent the pandemic from causing similarly tragic heart injuries in athletes, doctors at Ohio State University have developed a new protocol, says Saurabh Rajpal, cardiologist and assistant professor of internal medicine at OSU. Protocol requires every player diagnosed with Covid-19 to undergo a clinical exam, blood test, electrocardiogram, and MRI – an expensive and frugally used imaging technology – before returning to the game. Between June and August, 26 men and women from the school’s soccer, soccer, lacrosse, basketball and track teams were screened after their recovery from Covid-19. MRIs showed inflammation of the heart muscle in four of them – a sign of myocarditis. Of these, two had never experienced symptoms of Covid-19. The case series was featured in the magazine on Friday JAMA cardiology.
Since the athletes’ hearts were not mapped prior to their Covid-19 infections and they were not compared to controls – similar people who did not become infected with the virus – it cannot be said with certainty whether the virus caused the damage observed . But Rajpal, one of the study’s co-authors, says other viral infections cause myocarditis, and SARS-CoV-2 is no different. “It is important for people to know that Covid-19 can affect the heart,” he says.