Why COVID-19 is so dangerous for the heart

Medical Watch

The list is comprehensive and disturbing. Virtually all of those who succumbed to COVID-19 in Cook County had heart disease or high blood pressure or diabetes. They were in their 50s, 60s, 70s, 80s and 90s. The comorbidities are so common in this country, doctors are concerned.

More than 18 million people ages 20 and older have heart disease. It’s the number one killer in the U.S.  And people with it are 50 percent more likely to die from COVID-19.

Dr. Clyde Yancy is Northwestern Medicine’s Chief of Cardiology.

“The risk for getting the infection might not increase but if you have the infection, and underlying heart disease, the consequence is not only more serious, they can be dire,” he said. “We have to be careful with the original language that suggests, ‘but this was a trivial illness for younger people.’ They can be carriers and can impact their older adult; parents and friends, grandparents. That’s a concern. But particularly if they are the ones who have underlying heart disease, and that includes high blood pressure or diabetes. Once this infection occurs, it could have grave consequences and unfortunately, we’re seeing deaths of people in their 40s and 50s. It’s very chilling.”

To understand the danger of COVID-19, doctors are looking at how it attacks the cells and ultimately grows in the respiratory tract.

COVID-19 gains entry through the nose, eyes or mouth.

The droplets from an infected person who comes within 6 feet of someone else are able to either land on surfaces and be picked up on the hands, or go directly into the face of an unsuspecting person.

Alone on a table or door handle, the virus cannot replicate, but it can live for a time waiting to be picked up.

Once the particles are in the body, they attach to cells where they thrive and replicate, beginning in the mucous membranes of the nose and throat.

Spikes, which are so descriptive of cornoavirus, latch on tightly to their new host.

The latest research shows high levels of the virus in the upper respiratory tract first. But as you breathe deeply, the droplets are inhaled into the lungs, where COVID-19 has a special protein that acts like a tentacle binding to cells in the lower respiratory tract. Soon millions of viral particles flood the body.

That`s when the immune system begins to wake up, creating a fever in an attempt to kill the virus. But the immune response also causes inflammation making it even more difficult for people to breathe.

In China, roughly 80 percent of people recovered from this phase of illness.

But for some, as the virus takes up residence in the lungs, new disorders overwhelm the body, infecting the cells that line the air sacs. Pneumonia develops as the lung itself is damaged, not just the upper airway.

How does that differ from the flu? The flu often leads to bacterial pneumonia with one, very dense infection in the lungs.

In the case of COVID-19, the lungs turn grey all over as the infection works from the outer air sacs of the lungs. Fluid, pus and debris build. And patients develop Acute Respiratory Distress Syndrome or ARDS.

There is no cure for ARDS. Ventilators buy time as the body tries to heal but the lack of oxygen and the assault on the body put a tremendous strain on the heart. Many patients develop heart failure. Those with weak hearts to begin with are most at risk.

“If we can practice these important public health measures, we really can help flatten the curve,” Yancy said. “People may tire of hearing this, but I am not going tire of saying it because I think the exposure here is to a very dark consequence.”

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