Studies suggest heart problems associated with COVID-19

Recently, new aspects of the SARS-CoV-2 virus related to the effects on the heart have emerged that are of potential clinical concern. The virus can affect the heart in conditions such as myocarditis, inflammation of the heart, arrhythmias that are disturbed in the rhythm of the heart, and necrosis of heart cells that can mimic a heart attack. Importantly, these conditions have also been reported to occur in mild or asymptomatic cases.

However, the exact way the disease affects the heart has not yet been identified. Two possibilities that emerge in this regard are the direct attack of the virus inside the cells of the heart and the indirect way of claiming its effect through overreacting immune inflammation.

The SARS-CoV-2 virus uses the angiotensin converting enzyme 2 (ACE2) protein as an entrance to human cells, and the spike protein on the surface of the virus attaches to the ACE2 receptor. The heart is clearly one of the organs of our body, which contains high levels of ACE2. Although SARS-CoV-2 genomic RNA has been found to be very high in the lungs, non-lung presence is still found in significant amounts in the kidneys, heart and liver.At autopsy Investigation Viral copies performed in Germany were found in significant amounts in 16 of the 22 patients who died of the disease.At another autopsy InvestigationPerformed on a series of 39 patients who succumbed to COVID-19, 31% of them were found to have significantly higher viral loads in the heart, exceeding 100 copies.

Studies have shown the ability of new coronaviruses to invade cardiomyocytes, the cells that build the heart muscle. Most of these studies have been performed on cardiomyocytes derived from induced pluripotent stem cells (iPSCs). iPS cells are laboratory-derived stem cells that have the same characteristics as embryonic stem cells. These stem cells can eventually differentiate into all cell types of the body, except for cells of extraembryonic tissue such as placental cells. Pluripotent stem cells are characterized by differentiating into other cell types. Cardiomyocytes derived from iPS cells are used today in the study of various heart diseases. IPSC-derived heart cells are used to look for SARS-CoV-2 infectivity in cardiomyocytes.

One of such Investigation It shows that the virus has a prominent ability to infect cardiomyocytes and cause fragmentation of these cells. In addition, some of these findings have been validated in autopsy specimens of patients with COVID-19 severity.Meanwhile, another Investigation It was shown that the heart beat stopped within 72 hours of the viral infection of cardiomyocytes. This happened when a viral infection led to the process of cardiac cell apoptosis, programmed cell death.

In addition to directly infecting heart cells, the findings show that the immune response triggered by a viral infection can also lead to heart damage. The virus has also been found to resent the endothelial cells that line the blood vessels that carry blood to the heart. Overreaction of the immune response in endothelial cell infections has been shown to be another aspect of the viral effect on the heart.

Recent MRI and ECG reports from patients with COVID-19 also raise concerns about heart problems associated with the disease.For example, in the cohort Investigation Of the 100 patients who recovered from COVID-19, 78 were reported to develop cardiac abnormalities. Interestingly, some of these also include asymptomatic patients. Of the 18 asymptomatic patients, 12 developed heart problems. Again, 60 patients developed myocarditis. This is a consistent phenomenon of myocarditis.

Another large cohort Investigation Patients consisting of 1,216 patients from 69 countries on 6 continents also reported heart abnormalities. Of these patients, 667 (more than half) had abnormalities in their ECG reports.

Since these reports are currently medical and asymptomatic patients can also develop these complications, the prevalence of heart problems is estimated to be much higher than expected. I will. It accounts for at least 30-40% of all infectious diseases worldwide. In addition, asymptomatic people may have lung abnormalities found in symptomatic patients.

There are reports that athletes recovering from COVID-19 died of heart failure.Recent Investigation According to a report at The Ohio State University, several asymptomatic athletes with mild symptoms suffered from myocarditis.

Recent discoveries of heart-related problems in COVID-19 have also raised concerns about the limitations of a basic understanding of the disease and the virus. The findings emphasize that COVID-19-related heart problems may have affected more people than previously thought. This concern is further heightened by reports suggesting that even people with asymptomatic and mild symptoms can develop heart problems.

On top of that, there are still pressing issues. What leads to the cause of some patients? It remains to be seen whether it is due to an individual’s hyperreactive immune response, the development of an autoimmune state, or other explanations needed.