Over the weekend, the first case of a heart disease linked to novel Covid-19 infection has been reported in South Korea, suggesting the most widely known to cause respiratory distress’s virus may have a wider range of complications.
A 21-year-old woman in Daegu – Korea’s worst affected city, was found suffering from acute myocarditis (inflammation of the cardiac muscle) from Covid-19 even she has no preexisting medical conditions.
The patient was tested positive in late February with mild symptoms such as cough, sore throat, fever, and diarrhea, said Dr. Kim In-cheol, a cardiologist who treated the patient.
The patient started experiencing worsening breathing difficulties after 3 days of being diagnosed and was sent to the intensive care unit of Keimyung University Dongsan Hospital, which is a coronavirus-only hospital for treating severe or critical patients.
Dr. Kim said that the MRI, X-ray and CT imaging result of the patient showed signs of infections in her lungs and heart as well.
“Her chest scans revealed an enlarged heart and patterns of viral pneumonia, such as ground-glass opacities, ” said the cardiologist in a phone call interview.
The doctor explained that her cardiac size was estimated to be about 65% of the thorax (which a healthy people is estimated to be less than 50%), indicates that the ability of her heart to pump blood had been compromised and thus resulted in disproportionate cardiothoracic ratio.
Dr. Kim also said that the extent of cardiac damage from the virus may be lasting even after the patient has recovered from Covid-19.
Close to half of the patients at his hospital where more critical coronavirus patients are treated as signs of heart damage and the fatality rate was also higher among those who have developed heart complications.
According to Dr. Kim, there are 3 main ways the Covid-19 virus can provoke heart injury.
First is when the patients have low levels of oxygen in the blood or hypoxia. The lung capacity for trading carbon dioxide for oxygen declined and thus leads to heart muscle injury.
Second is an extreme immune response, known as a cytokine storm, which may lead up to the damage of healthy tissues, including that in the heart.
Lastly, the Covid-19 virus could be attacking the heart muscle directly by binding to the receptors known as ACE2 in heart cells.
An infectious disease specialist Dr. Kim Woo-joo of Korea University Hospital in Guro, southern Seoul, said that the coronavirus entered human cells by clinging onto the ACE2, which are found in lungs and other organs such as kidneys, gastrointestinal tract and heart, which is why the virus is capable of causing inflammations in not just lungs, but also other organs.
“In the worst of cases, a patient dies from multi-organ system failure after developing not just pneumonia but heart, kidney, gastrointestinal problems, ” he said.