A new study makes it clear that there's a lot we don't know about the coronavirus and long-term heart health. Here's what you need to know.

Christine Byrne
August 27, 2020
Advertisement
Credit: Getty / krisanapong detraphiphat

As if we didn't all have enough to worry about right now, a new study on the potential long-term effects of the coronavirus on heart health has been making the rounds in both media headlines and the medical community. In it, the authors find that adults who have recently recovered from the coronavirus—even those with very mild cases—have more inflammation of the heart muscle than those who have never had the disease.

While that certainly isn't good news for anyone who has recovered from the coronavirus, it's also not something to panic about. We asked a cardiologist about what the study results actually mean for individuals who have recovered from the coronavirus, and what these individuals can do to support heart health going forward.

First things first: The study certainly doesn't prove that coronavirus causes poor heart health.

The idea that even a mild case of coronavirus could set you up for heart problems down the line is scary, for sure. But that's not actually what the study shows, says Paul Cremer, MD, a cardiologist at the Cleveland Clinic. "This study looked at 100 patients that recovered from Covid with a range of severity, and had cardiac MRI testing done in all patients. They had one group of controls with risk factors for cardiac disease (57 people), and another control group of healthy patients (50 people). And then they compared cardiac MRIs in all groups." What they found was that the Covid patients had, on average, lower left ventricular ejection fraction and more overall inflammation of the heart muscle, known as myocarditis.

But Cremer warns that we shouldn't jump to conclusions. First of all, this study can't prove that coronavirus causes damage to the heart, because it only looks at each patient at a single point in time—the authors don't know what their hearts looked like before coronavirus, or what they will look like in a year, or in twenty years. He also explains that although the ejection fraction percentages—that is, how much blood the heart pumps out with each contraction—were lower in the recovered Covid patients, they were still within the normal range. And while the study authors found evidence of myocarditis (again, that's increased inflammation of the heart) in the recovered Covid patients, "the clinical significance of this finding is entirely unknown," Cremer says. "We really don't know what this means in terms of long-term prognosis after recovery from Covid." In other words: The differences in the cardiac MRIs of coronavirus patients versus healthy patients aren't indicative of long-term heart damage or serious injury to the heart.

Another thing to keep in mind: All viral infections (the coronavirus, the flu, etc.) cause inflammation, Cremer says, but researchers have never done an experiment like this one, with cardiac MRIs, on patients who have recovered from the flu or a cold. Until that happens, there's no way to know whether myocarditis is more common or severe with coronavirus than it is with any other virus.

If you had a mild or asymptomatic case of coronavirus, it's very unlikely to have caused lasting heart problems.

We're still learning about how Covid impacts heart health, and long-term health in general. "Our current understanding is that if you were either asymptomatic or minimally symptomatic, the prognosis seems quite good," Cremer says. "In the absence of symptoms that indicate something concerning going on with the heart, namely shortness of breath or tightness in the chest, there's nothing to really worry about."

If you had a more severe case of Covid that required hospitalization, make sure you have a clear picture whether or not there was any collateral damage to your heart. If you did suffer some heart damage, talk with your doctor to figure out what treatments or lifestyle modifications are best for you.

Heart healthy eating can lower your risk of heart disease, whether you've had the coronavirus or not.

For recovered Covid patients who had asymptomatic or mild catients, or who had more severe cases without any noted heart complications, Cremer says that it's not necessary to take any protective actions outside of the regular heart health guidelines. The truth is, everyone could benefit from taking steps to reduce their heart disease risk. Heart disease is the leading cause of death in the U.S., and accounts for a whopping one in four deaths. And while we don't have total control over our heart health, eating a heart healthy diet can help lower our risk of heart disease.

The American Heart Association (American Heart Association) recommends getting the vast majority of your calories from fruits, vegetables, whole grains, low-fat dairy, skinless poultry and fish, nuts, seeds, legumes, and unsaturated vegetable oils. They also recommend limiting saturated fat to less than 6% of your overall calories (about 13 grams per day if you're eating about 2000 calories), added sugar to no more than 25 grams per day for women and 38 grams per day for men, and sodium to 2300 mg/day. They also recommend drinking alcohol in moderation, or not at all. That means one drink per day for women, and two drinks per day for men.

While it sounds straightforward, eating this way can take some getting used to if it's new for you. For tons of recipe and meal plan ideas, head to our Heart-Healthy Diet Center.

Regular exercise can also help reduce your heart disease risk.

The AHA also recommends "at least 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity (or an equal combination of both) each week" for better heart health. No doubt you've heard this recommendation before, but here' are two reasons why it might be particularly helpful in countering the increased inflammation and lowered ejection fraction observed in Covid patients, according to Johns Hopkins Medicine: Exercise strengthens your heart muscle, so that your heart can pump more blood with each beat, leading to a higher ejection fraction. It also reduces chronic (long-term) inflammation by forcing all systems in your body to adapt to the challenge of exercise, which causes acute (short-term) inflammation. Regular exercise can also lower overall stress levels, which is helpful because too much of the stress hormone cortisol can put extra stress (no pun intended) on your heart.

Bottom line: So much more research needs to be done on the coronavirus and heart health. For now, adopting heart-healthy habits is all you can do.

The new study on the effects of coronavirus on heart health is noteworthy for the medical community, because it shows that there's more research to be done. But, as Cremer says, the findings don't really say anything about the long-term impact of coronavirus on your heart health. Following the standard heart-healthy lifestyle guidelines—eating healthfully and exercising regularly (and not smoking, which should go without saying)—is the best way to protect your heart and reduce your risk of heart disease. Of course, that doesn't mean you shouldn't also be vigilant about hand washing, mask-wearing, social distancing, and other recommended actions that can reduce your risk of contracting and spreading the coronavirus.