Effects of COVID-19 on Heart Patients


An increasing number of clinical studies are now reporting preexisting cardiovascular disease to be linked with a higher risk of complications and worse outcomes in patients with COVID-19. While most coronavirus research has been focused on respiratory complications, recent evidence suggests that COVID-19 has a significant impact on the cardiovascular system by worsening heart failure in patients with preexisting heart disease. Researchers are looking at COVID-19 not only as a pulmonary disease, but also as a cardiac one.

To better understand the association between COVID-19 and heart patients, Sandeep Hindupur, MD, a board-certified specialist in cardiovascular disease and interventional cardiology at Barnes-Jewish St. Peters Hospital, provided answers to a few frequently asked questions. Dr. Hindupur’s practice — Cardiology Diagnostics — is part of BJC Medical Group.

Q: Why are patients with cardiovascular disease at higher risk for COVID-19 complications? Are people with heart problems more likely to be infected by the virus?

A: We know that patients with cardiovascular disease have a higher likelihood of having other risk factors, such as diabetes, high blood pressure, high cholesterol, obesity and other conditions. The more risk factors a patient has, the more difficult it is for the body to fight and recover from significant infections. In addition, we know that while COVID-19 is primarily a respiratory syndrome, there are other significant consequences, such as the development of a form of heart failure and increased risk of blood clots that can occur either during or after the illness.

Q: What are some of the complications or severe outcomes heart patients face?

A: There is a well-described form of heart failure, or weakness of the heart muscle, that has been noted to occur in some patients who were infected with COVID-19. This heart failure, in many cases, is actually much worse than a patient’s initial COVID-19 symptoms. Such heart failure has also been described to occur not only during active infections, but in the weeks following recovery from COVID-19. Patients with COVID-19 are also at risk of developing new abnormal heart rhythms, particularly while the body is actively fighting the infection. In addition, COVID-19 infection has been found to increase the risk of blood clot formation, which can result in strokes, blood clots in the legs and in the lungs, and acute heart attacks due to a blood clot in arteries providing blood supply to the heart muscle.

Q: What is your experience in treating high-risk cardiology patients with COVID-19?

A: We have seen a significant number of high-risk heart patients who were infected with COVID-19. As expected, these patients tended to have more significant symptoms, took longer to fight off the infection, had longer length of stays in the hospital and had higher incidences of complications.

Q: Can COVID-19 cause heart damage or heart failure in people without previous heart problems?

A: Yes. There are patients who had no prior heart conditions who suffered from COVID-19, and a complication of the infection resulted in a new diagnosis of heart failure, or a weakness of the heart muscle. Also, complications of increased risks of blood clots, such as heart attacks and strokes, have occurred in patients with no underlying heart disease. In some cases, abnormal heart rhythms that developed while the patient was actively fighting the infection persisted after the patient recovered from COVID-19.

Q: What recommendations do you have for high-risk heart patients?

A: Wearing a mask and practicing social distancing are absolute musts for high-risk heart patients. However, it is also extremely important to understand that masks prevent others from becoming infected. Therefore, if you wear a mask, but are around or near other people who aren’t wearing masks, your mask will be far less effective at protecting you from the spread of the virus. Avoiding large gatherings where people are not practicing social distancing and not wearing masks should be paramount. In addition, frequent and correct hand-washing — 20 seconds with soap and water or using alcohol-based hand sanitizer — is an easy and simple practice.

Q: What recommendations do you have for heart patients recovering from COVID-19?

A: Potential complications can vary for heart patients who are recovering from COVID-19. While we hope their recovery is quick, we also know that higher risk patients can have a very prolonged recovery. It’s extremely important that they continue to take their prescribed medications and follow the instructions of their physician. I also recommend all patients who have recovered from COVID-19 to consider plasma donations if they are eligible. Finally, since we don’t know the length of time and degree of immunity that a COVID-19 infection provides to patients, they should continue to practice the precautions and recommendations we make for the general public — including hand washing, facemask wearing, social distancing, avoiding large crowds and other such precautions.

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