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Thursday, May 19, 2022
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The Jewish Link recently had the opportunity to pose questions about the “long COVID” effects on heart health to Jeffrey Lander, MD, FACC, co-director, Sports Cardiology, co-medical director, cardiac care unit, Cooperman Barnabas Medical Center, RWJBarnabas Health. Dr. Lander also serves as president and governor, New Jersey Chapter of the American College of Cardiology.

According to a recent study reported in Nature, people who had COVID-19 are at high risk of developing heart and blood vessel issues even up to a year after being diagnosed with the virus.

“It doesn’t matter if you are young or old; it doesn’t matter if you smoked or you didn’t,” said study co-author Ziyad Al-Aly at Washington University in St. Louis, chief of research and development for the Veterans Affairs (VA) St. Louis Health Care System. “The risk was there.”

According to the study, Al-Aly and his colleagues based their research on an extensive health-record database curated by the United States Department of Veterans Affairs.

The study compared more than 150,000 veterans who survived for at least 30 days after contracting COVID-19 with two groups of uninfected people: a group of more than 5 million people who used the VA medical system during the pandemic, and a similarly sized group that used the system in 2017, before SARS-CoV-2. The study showed that people who had recovered from COVID-19 showed significant increases in 20 cardiovascular problems over the year after infection. For example, they were 52% more likely to have had a stroke than those in the contemporary control group. The risk of heart failure increased by 72%.

What was perhaps more alarming was that the cardiovascular impact of COVID-19 appeared not to be restricted to people who had severe COVID. Even those with mild disease and those under 65 years of age and lacking risk factors, such as obesity or diabetes, appeared to be at a higher risk.

Lander addressed the most common post-COVID heart conditions the cardiologists are seeing.

“Cardiac involvement in patients with COVID who are hospitalized is very common. Fortunately, cardiac involvement with less severe cases of COVID seems to be less common. One of the most worrisome complications following COVID, as well as other viral infections, is myocarditis. Fortunately, this has proven to be rare.

“Post-acute sequelae of SARS-CoV-2 infection (PASC), commonly known as long COVID, can be seen in up to 10-30% of people. It consists of persistent or new symptoms four or more weeks after COVID infection. The heart conditions we see after COVID infection can include pericarditis, coronary artery disease, clots and arrhythmias,” Lander added.

Describing the symptoms to look for, Lander said: “Some of the cardiac symptoms we can see are chest pain, shortness of breath, racing heart, lightheadedness, palpitations and exercise intolerance. If someone is experiencing symptoms it is always recommended to have an evaluation. A good place to start is with your primary care physician. However, if you are having worrisome acute issues the emergency department may be the best place to go.”

Another issue is whether these conditions are reversible or can become chronic. “Fortunately, most of the time these symptoms are reversible; however, they may become life-long issues,” Lander noted. “As this is a newer entity our treatments and prognoses may change over time.”

Moving on to the topic of treatment, Lander stated: “Most of our treatment recommendations are based upon current guidelines; however, we tailor them to the specific symptoms or conditions the patient is experiencing. We still have a lot to learn about these conditions and there are currently ongoing studies to help us better understand how to best manage them.”

Regarding the drug Ivermectin, Lander said: “There has been public talk of using Ivermectin for treatment of COVID. There have been several studies; however, most have been small and some have been withdrawn from publication due to credibility concerns. What we have seen from some of the more reputable studies is that Ivermectin does not help in the treatment of COVID.”

For more information please visit: www.rwjbh.org/covidcare. 

By Ellie Wolf

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