India UK & Europe

Covid-19 and Heart Health

Do you feel like you’re going through a post covid fatigue? Your energy levels are not what they were and you’re finding it difficult to motivate yourself to exercise like you used to? According to studies, you’re definitely not alone! 

Covid-19 disrupted our way of life considerably over the last few years. But one of the most significant impacts we have noticed is the way it has changed our approach to health. 

During the first few months of the lockdown, stay-at-home orders, closures of parks, gyms, and fitness centres made it difficult for us to continue with our fitness routines. 

Data from studies done in early 2020 revealed that physical activity levels dropped dramatically in many countries. This was determined by analysing more than 19 million smartphone-based, step-counting measurements taken over 1 year. Another study in 2021, found that people who used to have steady walking, running, and cycling habits before the pandemic, decreased their activity levels considerably. 

As we start off 2022, with a new vaccine, a steadily declining number of Covid cases and easing up of restrictions around the world, people are now ready to go back to the way things were. 

But, this may be more challenging than we realise! 

How does post covid fatigue affect our long-term fitness levels? 

Although Covid19 is a respiratory illness that affects the lungs first, studies have shown that it can cause long-lasting effects on our overall health. 

Studies show that more than one-third of people affected by Covid could develop signs of Post-acute sequelae of COVID-19 (PASC). Another study revealed that post covid fatigue and body pain after exercise were the most common symptoms, even after 7 months of the initial infection, as shown in the figure below. 

Covid & its long term effects
 
Ref: Front. Microbiol., 23 June 2021 | https://doi.org/10.3389/fmicb.2021.698169
 

Perhaps the most significant complication of the covid19 infection is its ability to directly affect our heart.

Covid Induced Myocarditis 

Research has shown that the virus does infect and damage cardiomyocytes or heart muscle cells, and interfere with their contraction. The inflammation in heart muscles is called myocarditis and it is known to occur even in patients who only had mild symptoms.  15% of the athletes at a US-based university developed myocarditis after Covid, while another study revealed that 78% of the people evaluated had cardiac involvement when they were infected, and nearly 60% of them still showed ongoing myocardial inflammation. 

In addition, studies also showed that there were increased risks of atrial fibrillation, sinus tachycardia, sinus bradycardia, ventricular arrhythmias, and atrial flutters. Data revealed that dysrhythmias were 1.69 times more likely to occur, even 12 months after an acute Covid 19 infection, when compared to control groups in the study.

Covid Induced Myocarditis

How do you recognise Signs of myocarditis? 

Patients with acute viral infection may initially have headaches, body aches, joint pain, fever, a sore throat or diarrhoea. Later on, they could also experience chest pain, shortness of breath, at rest or during activity, swelling of the legs, ankles or feet and fatigue. 

Another effect of myocarditis is irregular heartbeats or arrhythmias. A study reported that 78.7% of myocarditis patients experienced ventricular arrhythmia. It is believed that myocarditis causes direct damage to the membranes of the cardiac cells and disrupts the electrical conduction needed for regular heartbeats. The inflammation around the heart muscle may cause swelling, fibrosis and scar formation which also leads to irregular beats. 

How would you diagnose myocarditis? 

Cardiac markers or enzymes like troponin [cardiac troponin I (cTnI), cardiac troponin T (cTnT)] and N-terminal pro–B-type natriuretic peptide [NT-proBNP]) are elevated and can be determined with simple blood tests. 

An ECG may also show abnormal wave patterns like bundle branch blocks, QT prolongation, premature ventricular complexes, and bradyarrhythmia, along with ST-elevation or PR depression.

The American Heart Association (AHA) recommends further testing for people who experience signs of myocarditis using more advanced cardiac imaging methods such as an echocardiogram or cardiovascular magnetic resonance (CMR). 

How soon after having myocarditis can you exercise? 

The European Society of Preventive Cardiology recommend that people who had myocarditis should begin to exercise if they are free from symptoms, have a normal 12-lead ECG, echocardiography, and exercise testing with no abnormal patterns seen in Holter ECG monitoring as well. 

*The information contained in this blog is provided on an as-is basis with no guarantees of completeness, accuracy or usefulness. The content in this blog is not meant to be a substitute for medical advice, diagnosis or treatment. All content is meant for informational purposes only. This blog contains copyright material, the use of which has not been specifically authorised by the copyright owner.