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COVID-19 may lead to an increase in sudden heart diseases
Pulmonologists, emergency services, and intensive care teams have been at the forefront of the medical fight against the COVID-19 pandemic in the U.S. for the past 12 months, but soon, another group of specialists is expected to be more involved than ever: cardiologists. Take a nation that already eats too much, drinks too much, exercises too little, and doesn’t show up for regular medical checkups very often, lock them down for a year or more, and those behaviors—all of which are drivers of cardiovascular disease—will only worsen.
In a recent survey in Circulation, the American Heart Association (AHA) predicted an increase in cardiovascular deaths and diseases in the coming months and years as a lagging indicator of the lifestyle changes the pandemic has imposed on the world. “We don’t have a lot of well-examined data right now about the cardiovascular impact of COVID because we are living through the pandemic now,” says Dr. Mitch Elkind, president of the AHA and professor of neurology and epidemiology at Columbia University. “That new data will come in the next year or two, but we anticipate the pandemic will have a significant impact.”
SARS-CoV-2, the virus that causes COVID-19, sometimes directly infects and damages heart tissue. A study published over the summer in JAMA Cardiology, for example, found that out of a sample group of 100 people who had recovered from COVID-19, 78 had some degree of inflammation of the myocardial tissue or other damage such as scarring. In another JAMA cardiology study, researchers reported finding SARS-CoV-2 in the heart tissue of 61.5% of the 39 patients who had died from COVID-19. The sample groups in both studies were small, and in the overwhelming number of coronavirus-related deaths, heart failure is not the immediate cause. But there’s a related truth: the pandemic seems to be driving people to develop the same lifestyle factors that lead to long-term heart disease.
Consider a September 2020 study in JAMA showing that alcohol consumption had increased by 14% in a sample group of 1,540 adults during the pandemic. Or the study (from the same month) in Psychiatry of 3,052 adults showing a decrease in physical activity in 32.3% of adults who had previously been physically active. Or the survey from the COVID Symptom Study (again, from September 2020) showing that 31% of adults reported eating more snacks during the lockdowns.
It’s not just eating, drinking, and staying still that can be deadly. Elkind and the AHA also cite the emotional stress caused by financial difficulties and depression as quarantine isolation prolongs. When hospitals and medical offices are considered high-risk viral zones, people are less likely to show up for routine checks of hypertension, cholesterol levels, and other chronic conditions that may have cardiovascular impacts. Acute heart events are also ignored. “We know people have delayed their needed care for heart attacks and strokes, which can lead to worse outcomes,” said Dr. Salim Virani, who chaired the committee that drafted the AHA's statistical update, in a statement.
In the U.S., about 655,000 people die from heart disease every year, according to the Centers for Disease Control and Prevention (CDC), a figure that exceeds the 360,000 who died from COVID-19 in 2020. But those statistics don’t tell the whole story. Elkind estimates up to 500,000 additional deaths in the U.S. last year due to people not receiving immediate medical help for serious or emergency medical conditions, many of which were cardiovascular in nature.
The good news buried in the bad is that some of the cardiovascular risks associated with COVID-19 can be controlled. Just as masks mitigate the transmission of COVID-19, healthier lifestyle choices can mitigate the risks of heart disease. A pandemic is a fierce challenge, but at least some aspects can be overcome with effort.
