It was already known that people with pre-existing heart conditions such as hypertension (high blood pressure) were more likely to suffer more severe symptoms if they became infected with the SARS-CoV-2 virus. A recent analysis of electronic medical records for more than 45,000 people found that the converse may also be true. Infection with COVID-19 can subsequently endanger a normal heart, and it was significantly associated with the subsequent development of high blood pressure.
This is a significant reversal of the understanding of cause and effect in the relationship between COVID-19 and heart disease.
What are the observed symptoms of COVID-19?
COVID-19 can cause increased risks of complications not directly associated with the heart but involving the lungs, kidneys, and other organs.- Lung injury that impairs oxygenation and can result in the need for mechanical ventilation is called Acute Respiratory Distress Syndrome (ARDS). Even in non-severe cases, pneumonia-like symptoms are common in people infected with the virus, and individuals may experience long-lasting respiratory issues after recovery.
- COVID-19 can lead to acute kidney injury (AKI), particularly in critically ill patients, due to direct viral damage to kidney cells, inflammation, or problems with blood clotting that affect renal blood flow.
- While COVID-19 primarily affects the respiratory system, it can also cause gastrointestinal symptoms, including nausea, diarrhea, and abdominal pain. Some patients with severe COVID-19 may develop bowel ischemia, where blood flow to the intestines is compromised.
- COVID-19 can have neurological effects. These range from mild symptoms like loss of taste and smell to more severe complications like strokes, encephalitis, or Guillain-Barré syndrome. The exact mechanisms are still under investigation, but COVID-19 can affect the nervous system.
- COVID-19 has been associated with an increased risk of blood clots, which can affect various organs. This hypercoagulable state can lead to complications like pulmonary embolism (clots in the lungs) or strokes.
- While children generally experience milder cases of COVID-19, a rare but serious condition known as MIS-C has been reported. This syndrome involves inflammation of multiple organ systems, including the heart, kidneys, lungs, and gastrointestinal organs.
- Many individuals who have recovered from COVID-19 continue to experience lingering symptoms, often referred to as “Long COVID.” These symptoms can affect many organs and systems, including the heart, lungs, and brain, and can persist for months.
How does COVID-19 affect people with pre-existing cardiac problems such as hypertension?
Although it is understood that individuals with cardiac conditions are not inherently more susceptible to infection by the SARS-CoV-2 virus, there is risk that COVID-19 can endanger the heart and create more severe symptoms if they do become infected. There is substantial evidence to suggest that hypertension can exacerbate the severity of COVID-19 in those who do become infected. There may be many reasons for this:- Hypertension can lead to structural changes in the heart and blood vessels, making it harder to handle the additional stress of a viral infection like COVID-19 on the cardiovascular system. This can result in a more severe course of the disease.
- People with hypertension often have coexisting conditions such as diabetes, obesity, or other cardiovascular problems, which further increase the risk of complications from COVID-19. The combination of these existing morbidities can contribute to a higher likelihood of hospitalization, the need for intensive care, and a longer recovery period.
- Studies have demonstrated a higher risk of death among COVID-19 patients with hypertension compared to those without this pre-existing condition. The exact mechanisms underlying this association are still under investigation but may involve the virus’s effects on the cardiovascular system, inflammation, and clotting abnormalities.
