Omicron e heart, story of a difficult and dangerous relationship. Some studies suggest that the risk of cardiovascular problems, such as a heart attack or a stroke, remains elevated even many months after a SARS-CoV-2 infection subsides Researchers are beginning to define the frequency of these problems and the cause of the damage.
In December 2020, a week before cardiologist Stuart Katz received his first vaccine, had a fever. She spent the next two weeks with cough, body aches and chills. After months of helping others overcome the pandemic, Katz, who works at New York University, shared his first-hand experience on Covid. On Christmas Day, Katz’s acute illness finally subsided. But many symptoms remained, including some related to the organ on which she built his career: the heart. Climbing two flights of stairs leaves him breathless, with his heart beating at 120 beats per minute. In the following months he started to feel better and is now back to his normal routine: he walks and rides a bicycle. But reports of Covid-19’s effects on the cardiovascular system have him worried about his long-term health. «I say to myself, well, is it really over?»mirror cat.
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In a study this year, researchers used data from the United States Department of Veterans Affairs (VA) to estimate how often CovidD-19 leads to cardiovascular problems. They found that people who had dealt with the disease had substantially increased risks for 20 cardiovascular conditions – including potentially catastrophic problems like heart attacks and strokes – in the year following coronavirus infection. Researchers say these complications can also occur in people who appear to have fully recovered from a mild infection.
Heart disease after COVID: what the data say https://t.co/qAAYES5ngK
— Helen Lindberg (@_HelenLindberg_) August 2, 2022
Some smaller studies have mirrored these findings, but others find lower complication rates. With millions of people infected with SARS-CoV-2, doctors are wondering if the pandemic it will be followed by a cardiovascular aftershock. Meanwhile, researchers are trying to figure out who is most at risk for heart problems, how long the risk persists, and what causes these symptoms. «It is an open hole in an important area of public health – says Katz -. We don’t understand if this changes the lifelong trajectory for the risk of heart attack or stroke or other cardiac events, we just don’t know.». Nature then examines the questions scientists are asking themselves and the answers they have uncovered so far.
How many people are at risk?
Doctors have reported Covid-related cardiovascular problems during the pandemic, but concerns have increased after the VA study results were published earlier this year. The analysis by Ziyad Al-Aly, an epidemiologist at Washington University in St. Louis, Missouri, and his colleagues is one of the largest efforts to characterize what happens to the heart and circulatory system after the acute phase of the infection. The researchers compared more than 150,000 infected people who had recovered from acute covid with their uninfected peers, as well as with a pre-pandemic control group. People who had been admitted to the ICU with acute infections had a drastically higher risk of cardiovascular problems during the following year (see “Heart Concerns”). For some conditions, such as swelling of the heart and blood clots in the lungs, the risk is increased by at least 20 times that of uninfected peers. But people who weren’t hospitalized also had increased risk – from an 8 percent increase in heart attack rate to a 247 percent increase in heart inflammation rate.
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How Do Researchers Collect More Information?
The answers to many questions about long-term impacts could come from a large study called the Researching COVID to Enhance Recovery, or RECOVER, project, which aims to follow 60,000 people for up to 4 years at more than 200 sites across the United States. The study will include participants with Long Covidpeople who were infected and recovered and others who were never infected. «It is logging throughout the lifespan»says Katz, who is the principal investigator of the trial. He and his colleagues plan to study children, adults, pregnant people and children.
How does the virus damage the heart?
Covid’s effect on the heart could be related to the key protein the virus uses to enter cells. It binds to a protein called ACE2, which is found on the surface of dozens of human cell types. This, says Al-Aly, gives him «access and permission to enter almost any cell in the body». When the virus enters the endothelial cells that line blood vessels, Topol explains, that’s probably where many cardiovascular problems begin. Blood clots form naturally to heal the damage caused as the body clears the infection. These clots can clog blood vessels, causing minor damage such as leg pain or severe such as a heart attack. A study of more than 500,000 cases found that people who had been infected had a 167% higher risk of developing a blood clot in the two weeks following infection than people who had had the flu. Robert Harrington, a cardiologist at Stanford University in California, says that even after the initial infection, plaques can build up where the immune response has damaged the lining of the blood vessels, causing the vessels to narrow. This can lead to problems, such as heart attacks and strokes, even months after the initial wound heals. «Those early complications can definitely translate into later complications»spiega Harrington.
What about reinfection and new variants?
Vaccinations, reinfections, and the Omicron variant of SARS-CoV-2 all raise new questions about the cardiovascular effects of the virus. An article published in May by Al-Aly and her colleagues suggests that vaccination reduces, but does not eliminate, the risk of developing these problems in the long term. Reinfections increase the risk on the heart and the Omicron variant can affect the cardiovascular system as drastically as other variants.