SALT LAKE CITY—An Intermountain Health Care doctor shares that mounting evidence proving a clear link between COVID-19 and heart disease.
Kirk U. Knowlton MD, from the Intermountain Healthcare Heart Institute in Salt Lake City, looked at more than 100 published studies related to COVID-19 and heart disease. It’s published this week in the Journal of Molecular and Cellular Cardiology. He talks about his findings in a Zoom call and a statement from IHC released Tuesday.
TWO WAYS VIRUS ATTACKS HEART
Dr. Knowlton says, “There’s clear evidence that COVID can cause heart disease… it affects around one in five patients admitted to the hospital with [the virus.]” He says this works in two ways. One is from increased clotting in heart vessels, the other from inflammation triggered by the immune system’s fight against the virus.
The clotting manifestation includes a disorder that may appear as deep-vein thrombosis, pulmonary embolism, stroke, and peripheral artery disease.
The inflammatory effects are varied and can damage the heart as well as other organs. Dr. Knowlton found multiple reports of myocarditis, an inflammation of the heart muscle, that can damage the heart and affect its ability to pump blood. Virus-driven myocarditis was one of the reason’s the NCAA’s PAC 12 conference gave when they postponed fall sports this year.
Dr. Knowlton explains the inflammation that can come with COVID is a reaction from our own defenses against the virus. “Many patients with severe disease experience a cytokine storm. The immune system goes into overdrive and attacks its own cells. This causes multi-organ failure,” he said. “These attacks to the heart are one of the ways that we believe the virus can cause heart damage and myocarditis.” He says the link is not absolutely clear.
Knowlton believes this also is the culprit behind the Kawasaki-mimicking Multisystem Inflammatory Syndrome, that’s seen in children who’ve had COVID. MIS-C is rare.
A GOOD STRATEGY FOR TREATMENT?
Interestingly, Dr. Knowlton thinks the body’s potential inflammatory reaction to COVID gives us insight in how to treat the virus. Treating COVID-19, he said, “is about finding a balance between allowing the immune system to fight the virus, but not so hard that it hurts the heart.” Knowlton says treatments that hurt the virus’s ability to replicate itself would prevent such a severe immune response. He noted this is how anti-body treatments and the drug Remdesivir can be successful.
Dr. Knowlton points out that this link between heart diseases and transmittable viruses isn’t new. Autopsies of patients who died during the 1918 flu pandemic found heart damage, and 50% of patients who died of polio from 1942 to 1951 had myocarditis, he said.