COVID-19's Hidden Threat: Lasting Heart Damage Even After Mild Cases

Over the past two to three years, a substantial body of evidence has emerged about COVID-19 and long COVID, a condition that often proves far more complex and varied than the acute infection itself. Common complications include polyneuropathy (nerve damage), while long COVID may also involve symptoms affecting the kidneys, liver, heart, and peripheral blood vessels, Almaty.tv reports, citing the press service of the Research Institute of Cardiology and Internal Diseases.

Numerous studies indicate that many complications arise in the later stages of the disease, with cardiovascular conditions manifesting as pain, arrhythmias, and conduction disorders. Some researchers have documented nonspecific cardiac changes in 7.3% of COVID-19 patients, while arrhythmias were observed in 16.7% of cases.

According to Kuat Abzaldiyev, head of the Consultative and Diagnostic Center at the Research Institute of Cardiology and Internal Diseases, Doctor of Medical Sciences, and a top-tier physician, even those who experienced mild or asymptomatic COVID-19 may develop complications over time. During the first wave of the pandemic, the virus primarily targeted the respiratory system, but as it mutated, reports emerged of damage to other organs—including the cardiovascular system—as hypoxia and inflammation spread to the myocardium and coronary vessels.

Viral infections frequently affect the myocardium. The severity of inflammatory responses in the heart muscle depends on the extent of myocardial damage, the degree of intoxication, and the body's immune response. Untreated myocarditis can lead to dangerous complications, such as cardiomyopathy, life-threatening arrhythmias, and blood clots from increased coagulation, which may result in sudden death. Heart palpitations with minimal exertion and shortness of breath are key signs of myocardial inflammation. Patients often dismiss these symptoms as general weakness from COVID-19 or intoxication and fail to seek medical attention. Without timely diagnosis and treatment—instead resorting to self-medication—mild symptoms can progress, worsening the condition and leading to further complications.

For this reason, once you have recovered from COVID-19 and your condition has stabilized, it is essential to undergo an electrocardiogram, cardiac ultrasound, and blood tests for inflammatory markers, followed by a consultation with a cardiologist to restore cardiovascular health.

The so-called "cytokine storm"—an extreme systemic inflammatory response—is diagnosed in 40% of patients and can damage not only the heart but also trigger multiple organ failure. Therefore, continuous monitoring of the risk of cardiotoxicity is critical throughout COVID-19 treatment.

Computed tomography (CT) and magnetic resonance imaging (MRI) can aid in diagnosing both lung diseases and cardiovascular conditions, including the exclusion of coronary artery disease. CT scans may also help detect cardiomyopathy, infective endocarditis, newly identified cardiac masses, and other conditions.

Patients with chronic coronary artery disease, as well as those experiencing exacerbations of previously stable ischemic heart disease, are at high risk for severe COVID-19 and death.

Studies by Chinese researchers found that chronic heart failure was present in 23% of patients hospitalized with COVID-19. In the U.S., clinically significant heart failure was observed in 42% of COVID-19 patients. Among those with chronic heart failure, 72% required mechanical ventilation within just 1.5 days of hospitalization. The development of severe heart failure results from an uncontrolled immune response to the coronavirus infection—a "cytokine storm"—which can be likened to septic shock.