Covid's Tell-Tale Heart
When scars tell a story
"…tear up the planks! — here, here! — it is the beating of his hideous heart!” -Edgar Allen Poe
Lately a string of publications and epidemiological data have noted an increase in heart conditions and sudden death, and it seems the public have been caught surprised. In this write-up, we will briefly discuss the history of Covid research and the heart, along with the interested parties and information campaigns.
It was 2020 when the first data came out that Covid was exceptionally bad for the heart. This conclusion was proportionally bad for football seasons, as the data generated was from athletes that had been infected with Covid. To the relief of football fans, President Trump would aid in an “information campaign” to keep Big 10 football open, despite growing concerns of cardiac inflammation. There emerged several key sources of information. What eventually happened is that the signs of cardiac inflammation on MRI were dismissed as not truly representing myocarditis or a level of inflammation that one should stop athletic activity for.
The controversy was buried, like the Tell-tale heart, and Americans went about their sports seasons assured that covid was not destroying the heart of the athletes. Other pieces of information arose, showing direct harm to the cells of the heart, but this was not significantly weighted. Now we have ample evidence linking mild covid to heart problems. If reinfections were not occurring, and if there were not recurrent waves of SARS Cov 2, would these issues have been swept under the rug? Very likely. It is only because more and more people are experiencing the effects of Long Covid and organ damage that the evidence is becoming indisputable. It is a shame we have done little to prevent widespread transmission.
For the people worried about fibrosis as I was, and therefore arrhythmia, mild covid indeed can cause fibrosis of the heart. What this means is that contractility and electrical conduction become compromised, leading to poor rhythms.
So what is the take-home message? The cardiac fibrosis and damage was a sure bet, in my opinion. The harbingers like cardiac inflammation were downplayed and now we are reaping the consequences. Or, maybe I was just lucky in my call once-again. I don’t think so. “It's difficult to get a man to understand something when his salary depends on not understanding it." -Upton Sinclair
Stay safe out there,
AJ
Good afternoon, Dr. Leonardi. As you know from Twitter, I am an older immunocompromised cardiologist. Thi article simply reinforces the bad news about COVID and the heart. Clinically, I am seeing patients with various cardiac and autonomic nervous system problems in droves. Bad, bad stuff and more of it all the time. Not just arrhythmias, but much worse coronary artery disease, and reduced heart function in all ages. It is very ugly out there. Thank you for all your efforts to educate and provoke thought. I, for one, am very appreciative.
Good day Dr Leonardi, early in the pandemic, my first patients were nurses who worked the floor. All c/o heart palpitations, dyspnea, elevation of pulse while walking, showering. Symptoms caused anxiety in some. Some had reduced EF on echo. It is disheartening as a primary care provider to see these patients suffer. And things just keep getting worse because public health officials telling the masses to wash their hands.