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| -Signs, Portents, and the Weather- |
| Mysterious Heart Damage, Not Just Lung Troubles, Befalling COVID-19 Patients |
| 2020-04-07 |
| [Kaiser Health News] While the focus of the COVID-19 pandemic has been on respiratory problems and securing enough ventilators, doctors on the front lines are grappling with a new medical mystery. In addition to lung damage, many COVID-19 patients are also developing heart problems ‐ and dying of cardiac arrest. As more data comes in from China and Italy, as well as Washington state and New York, more cardiac experts are coming to believe the COVID-19 virus can infect the heart muscle. An initial study found cardiac damage in as many as 1 in 5 patients, leading to heart failure and death even among those who show no signs of respiratory distress. That could change the way doctors and hospitals need to think about patients, particularly in the early stages of illness. It also could open up a second front in the battle against the COVID-19 pandemic, with a need for new precautions in people with preexisting heart problems, new demands for equipment and, ultimately, new treatment plans for damaged hearts among those who survive. "It’s extremely important to answer the question: Is their heart being affected by the virus and can we do something about it?" said Dr. Ulrich Jorde, the head of heart failure, cardiac transplantation and mechanical circulatory support for the Montefiore Health System in New York City. "This may save many lives in the end." VIRUS OR ILLNESS? The question of whether the emerging heart problems are caused by the virus itself or are a byproduct of the body’s reaction to it has become one of the critical unknowns facing doctors as they race to understand the novel illness. Determining how the virus affects the heart is difficult, in part, because severe illness alone can influence heart health. "Someone who’s dying from a bad pneumonia will ultimately die because the heart stops," said Dr. Robert Bonow, a professor of cardiology at the Northwestern University Feinberg School of Medicine and editor of the medical journal JAMA Cardiology. "You can’t get enough oxygen into your system and things go haywire." But Bonow and many other cardiac specialists believe a COVID-19 infection could lead to damage to the heart in four or five ways. Some patients, they say, might be affected by more than one of those pathways at once. Doctors have long known that any serious medical event, even something as straightforward as hip surgery, can create enough stress to damage the heart. Moreover, a condition like pneumonia can cause widespread inflammation in the body. That, in turn, can lead to plaque in arteries becoming unstable, causing heart attacks. Inflammation can also cause a condition known as myocarditis, which can lead to the weakening of the heart muscle and, ultimately, heart failure. But Bonow said the damage observed in COVID-19 patients could be from the virus directly infecting the heart muscle. Initial research suggests the coronavirus attaches to certain receptors in the lungs, and those same receptors are found in heart muscle as well. INITIAL DATA FROM CHINA In March, doctors from China published two studies that gave the first glimpse at how prevalent cardiac problems were among patients with COVID-19 illness. The larger of the two studies looked at 416 hospitalized patients. The researchers found that 19% showed signs of heart damage. And those who did were significantly more likely to die: 51% of those with heart damage died versus 4.5% who did not have it. Patients who had heart disease before their coronavirus infections were much more likely to show heart damage afterward. But some patients with no previous heart disease also showed signs of cardiac damage. In fact, patients with no preexisting heart conditions who incurred heart damage during their infection were more likely to die than patients with previous heart disease but no COVID-19-induced cardiac damage. It’s unclear why some patients experience more cardiac effects than others. Bonow said that could be due to a genetic predisposition or it could be because they’re exposed to higher viral loads. |
| Posted by:Phomoper Lumplump4826 |
| #9 See COVID-19 and the cardiovascular system Reports suggest that the Middle East respiratory syndrome-related coronavirus (MERS-CoV) can cause acute myocarditis and heart failure5. SARS-CoV-2 and MERS-CoV have similar pathogenicity, and the myo- cardial damage caused by infection with these viruses undoubtedly increases the difficulty and complexity of patient treatment. Myocardial injury associated with the SARS-CoV-2 occurred in 5 of the first 41 patients diagnosed with COVID-19 in Wuhan |
| Posted by: John Frum 2020-04-07 19:11 |
| #8 So no mystery why it is shed in stool and why heart tissue is damaged. The virus dcan irectly infect such tissue. |
| Posted by: John Frum 2020-04-07 19:07 |
| #7 The ACE2 receptor protein, used by the SARS-CoV-2 virus to enter cells is an enzyme attached to the outer surface (cell membranes) of cells in the lungs, arteries, heart, kidney, testes, and intestines. |
| Posted by: John Frum 2020-04-07 19:06 |
| #6 Thanks Mullah Richard, it was a close thing and about 18-20 months to get back to a zero point where I could start to train again. Being fit probably helped somewhat, but during extended coughing fits all the muscle in your mid section contracts violently. You end up feeling like you've had a serious beating. Speaking of iron ions, the Dr I saw in the hospital insisted I take iron pills. A man with a poor command of English and an accent like Chicolini working under Army contract, I believe in retrospect he may well have been the first generation of his family to walk fully erect. |
| Posted by: Cesare 2020-04-07 10:58 |
| #5 Need to up your game from a 3 wood to a driver iron. |
| Posted by: Skidmark 2020-04-07 09:29 |
| #4 Possible damage because it would be grand central for dissociated iron ions? |
| Posted by: gorb 2020-04-07 08:24 |
| #3 I've heard of similar cases that didn't end so well. Glad you're still with us, Cesare. |
| Posted by: Mullah Richard 2020-04-07 08:23 |
| #2 I have seen where it's been observed that the lung damage in victims and survivors is essentially identical to high altitude pulmonary edema. This obviously ties in with the potential of the anti-malarial. On a personal note, I have had double pneumonia and at a point where I was almost certainly in the best physical shape of my life. I could readily do 18 dead hang pull ups with web gear, 100 push up w/web gear and ALCE, 2 mi in 10:20, and walk until. I weighed 183 lbs and was hospitalized with a high fever. When I was released 16 days later I weighed 136 lbs and could not climb a flight of stairs at a slow pace. Short story way too long, the stress on your heart from long, unproductive and unstopable coughing fits is immense and unrelenting. It very nearly killed me in my early 30's. |
| Posted by: Cesare 2020-04-07 07:48 |
| #1 Perhaps Transcutaneous heart pacing (TP) should be examined. Comments ? |
| Posted by: Besoeker 2020-04-07 07:36 |