A Canadian heart researcher says a rapid response is needed to address the surge in cardiovascular cases linked to COVID-19 following recent studies that show the virus can increase a person’s risk of developing heart problems.
“This is not new…. We’ve known about it for a long time that the risk is there … and now what we’re seeing two or three years in is that the risk is starting to manifest,” Dr. Glen Pyle, professor of biomedical science at the University of Guelph and a heart researcher, told Global News.
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Pyle pointed to a study called Long COVID-19: A Primer for Cardiovascular Health Professionals in the Canadian Journal of Cardiology published in 2021, which states that “cardiac injury has been documented in up to 45 per cent of inpatients with COVID-19 and has been linked to worse outcomes” like a stroke or heart failure.
“Clinicians are seeing these complications…. That’s why we need to respond rapidly because these things take a while. But once they pop up, it’s very difficult to reverse,” said Pyle.
In a recent U.S. study published in late September by the Smidt Heart Institute at Cedars-Sinai in Los Angeles, researchers found that “deaths from heart attacks rose significantly during pandemic surges, including the COVID-19 Omicron surges, overall reversing a heart-healthier pre-pandemic trend.”
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The study, which was published in the peer-reviewed Journal of Medical Virology, showed that the increase in deaths caused by a heart attack could be “tracked with surges of COVID-19 infection—even during the presumed less-severe Omicron phase of the pandemic.”
“The dramatic rise in heart attacks during the pandemic has reversed what was a prior decadelong steady improvement in cardiac deaths,” Dr. Yee Hui Yeo, first author of the study and a Cedars-Sinai physician-scientist, said in a blog post by Cedars-Sinai. “We are still learning the many ways by which COVID-19 affects the body, regardless of age, gender, ethnicity or race.”
According to the Cedars-Sinai blog, the research team identified 1,522,699 deaths from heart attacks between April 1, 2012, and March 31, 2022, based on the data they used from the Centers for Disease Control and Prevention’s National Vital Statistics System.
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In another U.S. study that was published in February on PubMed, researchers found that “even a mild case of COVID-19 can increase a person’s risk of cardiovascular problems for at least a year after diagnosis.”
Researchers found that conditions like heart failure and a stroke “were substantially higher in people who had recovered from COVID-19 than in similar people who hadn’t had the disease,” according to the Nature Journal, where the study is referenced.
In addition, the risk was elevated even for those under 65 years of age who lacked underlying risk facts like obesity or diabetes.
“It doesn’t matter if you are young or old, it doesn’t matter if you smoked, or you didn’t,” study co-author Ziyad Al-Aly at Washington University in St. Louis and the chief of research and development for the Veterans Affairs (VA) St. Louis Health Care System, said in the Nature Journal article. “The risk was there.”
For the Long-term cardiovascular outcomes of COVID-19 study, Al-Aly and his co-researchers compared more than 150,000 veterans who survived for at least 30 days after contracting COVID-19 with two groups of uninfected people.
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But both the Cedars-Sinai study and the one published in PubMed pose many unanswered questions, said Pyle, especially on why and how the COVID-19 virus increases the risk of heart disease.
“The short answer is we don’t know … but we’re (looking into) what exactly the virus does to the heart, what are the mechanism that causes damage and so that’s something (my research team and I) hope to do in the next month or so,” he said.
This is why it’s difficult to reverse the damage caused by COVID-19, Pyle said, because researchers and health-care providers don’t know what the problem is.
Since no one knows how the link between heart problems and COVID-19 works, Pyle says right now clinicians are trying to treat heart conditions like long COVID.
Long COVID refers to any of more than two dozen symptoms that can either be physical or psychological that can appear more or less than 12 weeks after getting COVID-19, according to the government of Canada website.
Symptoms may include fatigue, shortness of breath and general pain and discomfort.
“We don’t know how long COVID-19 or even COVID-19 itself damages the heart, so it becomes very difficult to manage that or treat it because essentially what you’re doing is treating the symptoms only,” said Pyle.
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As a result, he says more investment in basic research is urgently needed and that’s the kind of response that needs to be happening right now.
“We need these questions answered: how does the virus damage the heart? How does the virus damage the circulation?” said Pyle.
He explained that it’s one thing to know that a blood clot can develop and another thing to know how they develop.
“Because if you don’t know how, you can’t treat it effectively,” Pyle said.
“(Hospitals) are at the brink now … and if you put long COVID on top of that and start to deal with people with now chronic conditions like heart failure … we’re not ready to handle that,” said Pyle.
A report from the Heart and Stroke Foundation published in February said hospitals across Canada have postponed hundreds of thousands of surgeries, procedures and treatment consultations for heart patients, even as heart failure was reported to be on the rise.
According to the report, treatment options for heart conditions were found to be severely limited in Canada.
At least 27 per cent of hospitals don’t have access to one of the two essential procedures used to diagnose heart failure and 16 per cent don’t follow published heart failure care guidelines, the report showed.
According to Pyle, the signs of having a cardiovascular disease are “very generic” and they include getting fatigued easily, brain fog and breathlessness.
“All these things are very broad signs, but they’re also early signs of cardiovascular disease,” he said.
The U.S. Centers for Disease Control and Prevention (CDC) says on its website that “sometimes heart disease may be silent and not diagnosed until a person experiences signs or symptoms of a heart attack, heart failure, or an arrhythmia,” which is fluttering feelings in the chest.
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When it comes to having a heart attack, symptoms to watch out for are chest pain or discomfort, upper back or neck pain, indigestion, heartburn, nausea or vomiting, extreme fatigue, upper body discomfort, dizziness and shortness of breath.
Symptoms of heart failure are shortness of breath, fatigue or swelling of the feet, ankles, legs, abdomen, or neck veins.
— with files from Global News’ Keesha Harewood
