By American Heart Association News
The coronavirus should have everyone's attention by now, health
experts say. And people with heart disease have extra reasons to be
alert.
COVID-19, which was first reported in the Chinese city of
Wuhan in December, has sickened tens of thousands of people and killed
hundreds around the globe. On Tuesday, Dr. Nancy Messonnier, director of
the National Center for Immunization and Respiratory Diseases at the
Centers for Disease Control and Prevention, said its spread in the
United States seemed certain.
"It's not so much a question of if
this will happen anymore, but rather more a question of exactly when
this will happen and how many people in this country will have severe
illness," she told reporters during a news conference.
For people with underlying heart issues, the concerns are serious enough that the American College of Cardiology issued a bulletin this month to warn patients about the potential increased risk and to encourage "additional, reasonable precautions."
Based
on early reports, 40% of hospitalized COVID-19 patients had
cardiovascular disease or cerebrovascular disease (which refers to blood
flow in the brain, such as stroke), according to the bulletin.
"That
statistic doesn't mean people with heart disease are more likely to
contract the coronavirus," said Orly Vardeny, associate professor of
medicine at the Minneapolis VA Health Care System and University of
Minnesota. "It just means that those folks are more likely to have
complications once they do get it."
Vardeny, an adviser on the ACC bulletin, said the virus could affect heart disease patients in several ways.
The
virus's main target is the lungs. But that could affect the heart,
especially a diseased heart, which has to work harder to get oxygenated
blood throughout the body, she said. "In general, you can think of it as
something that is taxing the system as a whole."
That could exacerbate problems for someone with heart failure, where the heart is already having problems pumping efficiently.
Someone
with an underlying heart issue also might have a less robust immune
system. People's immune systems weaken as they age, Vardeny said. And
"in those with chronic medical conditions, the body's immune response is
not as strong a response when exposed to viruses."
If such a person catches a virus, she said it's likely to stick around and cause complications.
A
virus also may pose a special risk for people who have the fatty
buildup known as plaque in their arteries, Vardeny said. Evidence
indicates similar viral illnesses can destabilize these plaques,
potentially resulting in the blockage of an artery feeding blood to the
heart, putting patients at risk of heart attack.
Vardeny emphasized that information about COVID-19
is changing almost hourly. But previous coronaviruses, such as SARS and
MERS, offer insight. They were linked to problems such as inflammation
of the heart muscle, heart attack and rapid-onset heart failure, the ACC
bulletin said.
COVID-19 also has similarities to influenza,
Vardeny said. At the moment, she said, "We don't think the actual risk
is any higher per se. It's just that the spread is quicker." And unlike
the flu, there's no vaccine.
COVID-19 numbers change rapidly. The
World Health Organization reported the fatality rate from the illness
was between 2% and 4% in Wuhan, and 0.7% outside Wuhan.
By comparison, as of mid-February, the CDC
estimated there had been at least 29 million flu illnesses, 280,000
hospitalizations and 16,000 deaths from it in the United States this
season.
Many of the same precautions that work against the flu
should be helpful against COVID-19, Vardeny said, because it appears to
spread the same way – through droplets in the air when someone coughs or
sneezes.
For now, she suggests people defend themselves by
hand-washing, keeping surfaces clean and avoiding travel to areas with
outbreaks.
The ACC bulletin recommends people with cardiovascular
disease stay up to date with vaccinations, including for pneumonia. The
ACC also supports getting a flu shot to prevent another source of
fever, which could potentially be confused with the coronavirus
infection.
In the news conference, Messonnier summed up her advice as, "Stay home if you're sick; cover your cough; wash your hands."
She also warned that people need to prepare for the possibility of closures of work, school and more.
"I
understand this whole situation may seem overwhelming and that
disruption to everyday life may be severe," she said. "But these are
things that people need to start thinking about now."
