A growing number of studies suggest many COVID-19 survivors experience some type of heart damage, even if they didn't have underlying heart disease and weren't sick enough to be hospitalized.

For the most part, severe damage is limited to patients that had severe infections with COVID-19, but from time to time, there are cases of significant cardiac damage in a more moderate or even mild case. Our blood tests that identify damaged heart tissue, the same test we use to help identify heart attacks, are frequently positive in COVID-19 patients and sometimes to an alarming degree.

We are seeing patients with heart disease that surfaces after an infection with COVID-19, although we are still uncertain the extent to which COVID-19 caused the heart disease.

Did COVID-19 place added stress on the body that, in turn, caused symptoms in a person who had pre-existing asymptomatic heart disease? As you might expect, pre-existing heart disease is a risk factor for more severe COVID-19 infections.

While more research and data are needed, we know that COVID-19 can damage the heart in one of three ways.

First case: The heart is damaged by the immune system, which is attempting to target COVID-infected cells, but non-infected heart cells get caught in the crossfire.

Second case: The immune system hurts the heart indirectly by forcing the heart to pump so much blood that it gets overworked and can start to fail.

Third case: Some cells in the heart can indeed become infected with COVID, though they typically appear to be “support cells”, and not the actual muscle cells. These cells are appropriately targeted by the immune system and destroyed. This can leave the heart lacking the support it needs, leading to some damage until those cells can be replaced.

While COVID-19 does harm the heart, it is becoming clear that what is more damaging is patients avoiding hospitals when they are sick with cardiac conditions. It’s important that you do not delay care if you are experiencing the below issues:

• Increasing or extreme shortness of breath with exertion
• Chest pain
• Swelling of the ankles
• Heart palpitations or an irregular heartbeat
• Not being able to lie flat without shortness of breath
• Waking up at night short of breath

If you are currently COVID-19 positive, here are some things to keep in mind during your quarantine:

• Stay hydrated
• Eat well
• Rest
• Continue with your day-to-day medications

In addition, Methodist offers monoclonal antibody infusion therapy that can help patients with mild-moderate COVID-19 avoid getting sicker to the point of needing hospitalization. This therapy, at the moment, is reserved for individuals who have recently tested COVID-19 positive and have multiple higher risk medical conditions or are of advanced age. This therapy should be given within the first 10 days of infection — earlier is better — in order to be effective. If you think you may qualify, contact your doctor to discuss monoclonal antibody infusion therapy for COVID-19.

While the COVID-19 vaccine is not yet widely available, we encourage all individuals who do not have contra-indications to get the vaccine. In the meantime, it is extremely important for people to follow guidelines on social distancing, masking and avoiding contact with those who are sick to prevent becoming infected.