News & Events

Getting a beat on COVID-19 and the heart

By Darcie Fisher, Tufts Medical Center Correspondent 

You have probably heard that people with pre-existing heart conditions are more likely to become seriously ill when infected with the COVID-19 virus. We spoke with Amanda Vest, MBBS, MPH from the CardioVascular Center at Tufts Medical Center about what doctors have learned so far about this connection.

Are people with pre-existing heart conditions more likely to contract COVID-19?

“Patients with underlying heart conditions are not necessarily more likely to contract COVID-19,” said Dr. Vest. “However, if infected they are more likely to require hospitalization and are also, unfortunately, more likely to die from COVID-19.” 

Dr. Vest says this is true for those with hypertension, coronary heart disease and heart failure. These patients are more likely to be admitted to the Intensive Care Unit (ICU) and have a higher probability of requiring mechanical ventilation. Dr. Vest points to a recent study by the American Academy of Cardiology which looked at outcomes for patients with and without a heart failure diagnosis admitted for hospital care during the pandemic. It found that patients with pre-existing heart failure hospitalized for COVID-19 did have a higher percentage of ICU admissions and mechanical ventilation as well as a 24 percent hospital mortality rate, compared to a 14 percent mortality rate for those who did not have pre-existing heart failure.

What is known about why people with cardiovascular disease are less likely to survive COVID-19?

“Unfortunately, we don’t fully understand why patients with underlying medical conditions are at highest risk for dying or developing severe complications from COVID-19,” said Dr. Vest. “We suspect that having these chronic medical conditions decreases their resiliency and ability to fight off the virus.”

Can you explain the damage COVID-19 can do to even a healthy heart?

“We have learned a lot over the last year about the ways COVID-19 can affect the heart,” said Dr. Vest. “It became evident early in the pandemic that pericarditis, or inflammation of the thin membrane around the heart, as well as myocarditis, which is inflammation and damage of the heart muscle, is a complication associated with a COVID-19 infection. In fact, we’ve seen from biopsies that the virus can actually be observed inside the heart tissue between the muscle cells. A proportion of patients may have detectable heart inflammation after infection. The overall message I’d like to give though is that clinically significant cardiac involvement, meaning heart damage needing hospital attention related to COVID-19, has actually turned out to be relatively rare.”

What can people with pre-existing heart issues do to protect themselves?

“Like with many other health issues, it’s important for those with a cardiovascular condition to keep their weight down and keep their fitness up,” said Dr. Vest. “If you were to contract COVID-19, you are more likely to do well if you’re at a normal, healthy weight.” Dr. Vest also points out the need to keep up with mask wearing and handwashing. “In addition, it is critical that people understand they should not skip routine health check-ups during this time,” said Dr. Vest. “Health care facilities are doing everything possible to keep people safe. Routine health care should not be put on the backburner. And if you’re suffering from chest pains, difficulty breathing or other symptoms associated with a cardiac emergency, please go to the hospital immediately.”

The American Heart Association as more information on COVID-19 which you can read about here.

Posted February 2021 

The above content is provided for educational purposes by Tufts Medical Center. It is free for educational use. For information about your own health, contact your physician.