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COVID-19 - Mysterious Heart Damage

 

Last updated on July 31, 2020, John Hopkins Corona Virus Dashboard and Worldometer

Cases Worldwide

  

                    John Hopkins                                                       Worldometer

  • TOTAL CASES       -  17,533,034                      TOTAL CASES       -  17,753,802

Recovered                                                       Recovered        -  11,161,510

  • TOTAL DEATHS    -       678,775                      TOTAL DEATHS    -       682,999

 

Cases in the U.S.

            POPULATION      - 331,002,651, as of 30 July 2020 

  • TOTAL CASES       -   4,561,511                          TOTAL CASES       -     4,705,889

Recovered            -   1,438,160                           Recovered         -     2,327,572

  • TOTAL DEATHS    -      153,415                          TOTAL DEATHS    -         156,747
  • Unemployed        -  17 million, up from 16.2 million as of 30 July 2020

 

Cases in California

  • TOTAL CASES       -     492,934                                    TOTAL CASES     -         501,909 

Recovered          -    

  • TOTAL DEATHS   -         9,214                                     TOTAL DEATHS  -             9,194
  • Unemployed        - Down to 16.3 % from 16.4 % statewide

 

Covid and children worldwide – 890,000 cases, 45,000 deaths

United States:

  • 288,000 tested positive
  • 88,103 new cases from 7/9 to 7/23
  • Only half of hospitalized children had at least one underlying medical condition  

 

7/31/2020                   Cases                           Deaths                         Recovered

Daily death totals:  7/29 – 186, 7/29 – 216, 7/30 – 253, 7/31 - 257

  • New York  - 443,745                            32,689                                 73,055
  • Texas       - 443,745                              6,683                                273,191
  • Arizona     - 174,010                             3,694                                  22,714

 

The focus of the COVID-19 pandemic has been on respiratory problems, but doctors are grappling with a new medical mystery.  In addition to lung damage, COVID-19 patients are also developing heart problems and dying of cardiac arrest.  Physicians have reported changes to the circulatory system in people with COVID-19, sometimes leading to blood clots and cardiac complications, such as changes to the heart rhythm, damage to heart tissue and heart attacks.

As more data comes in, cardiac experts believe the COVID-19 virus can infect the heart muscle.  An initial study found cardiac damage in 1 in 5 patients, leading to heart failure and death even among those who show no signs of respiratory distress.  COVID-19 seems to be more of a respiratory picture first and then at the later stages becomes more of a cardiac issue.

 

How does COVID-19 affect the heart?

The effects of COVID-19 on the lungs are well-known.  As COVID-19 continues, more information is becoming available about the role the virus, SARS-CoV-2, has on the heart. "Individuals with known cardiovascular disease are at an increased risk of more severe complications from respiratory viral illnesses, including the flu and COVID-19," says Dr. Leslie Cooper, chair of the Department of Cardiology at Mayo Clinic.

 

During severe SARS-CoV-2 infection, heart function may decrease, sometimes a consequence of systemic inflammatory response to infection and occasionally direct viral infection in the heart.    Recent evidence into COVID-19 shows the disease can also cause neurological, cardiac symptoms and includes a cough, shortness of breath and pneumonia.

 

In a new study appearing in the journal Cell Reports Medicine, scientists are showing that SARS-CoV-2 can infect heart cells and change their function.  Their findings from experiments in human stem cells, suggests the cardiac symptoms of COVID-19 may be the direct result of the infection of heart tissue.

 

SARS-CoV-2 behavior in heart cells

Scientists used a type of stem cell called induced pluripotent stem cells (iPSCs) to generate heart cells, which can be produced from a person’s skin cells, then reprogram them to become any cell type in the body. They provide a useful tool for research into human disease and a way to test new treatments.

 

In this study, the team programmed the iPSCs to become heart cells and later incubated them with SARS-CoV-2.  Researchers found that SARS-CoV-2 could directly infect the heart cells.  The research also showed the virus can rapidly divide inside heart cells, which caused changes to the heart’s ability to beat after a period of less than 3 days.

 

The role of the ACE2 receptor

Additional experiments focused on the different genes expressed by heart cells before and after the virus infected them. These studies showed activation of the immune response and antiviral clearance pathways to help fight the virus.

 

How does the virus get into the heart in the first place?  One way may be by using angiotensin-converting enzyme 2 (ACE2).  This is the same receptor the virus uses to infect cells in the lungs.

Studies have shown that treatment with an ACE2 antibody can help stop SARS-CoV-2 from replicating and save cells in the heart.

 

“By blocking the ACE2 protein with an antibody, the virus is not as easily able to bind to the ACE2 protein and cannot easily enter the cell.  This helps in understanding the mechanisms of how the virus functions and therapeutic approaches that could be used as a potential treatment for SARS-CoV-2 infection.”

 

2 Main Cardiac Issues

According to Dr. Cooper, there are two dominant cardiac issues related to COVID-19 heart failure and arrhythmias or abnormal heart rhythms

 

  • Heart failure, when the heart muscle doesn't pump blood as well as it should and develops a systemic inflammatory response to the infection, high lung pressure from lung damage, or occur from heart inflammation known as myocarditis.

 

"For many people who present with heart failure in the context of COVID-19 infection, we don't know if the heart failure is related to myocarditis or to a response to systemic inflammation from COVID-19," says Dr. Cooper.

 

  • Abnormal heart rhythms can be related to the infection or to the effect of medications used to treat the virus.

 

For older patients, with existing coronary artery disease or hypertension, it is likely heart failure resulting from the increased demand placed on the heart and the body’s decreased cardiac reserve capacity.  In younger patients, it's likely primary myocarditis caused by the virus.

 

Virus or Illness?

The question of whether the emerging heart problems are caused by the virus itself or a byproduct of the body’s reaction to it is one of the critical unknowns facing doctors.   Determining how the virus affects the heart is difficult, in part, because severe illness can influence heart health

 

There are many reasons viruses can become deadly.  Three common reasons are:

 

 

Cytokines are proteins that regulate several biologic functions such as inflammation and repair,” said Dr. Ashesh Parikh, DO, FACC, RPVI, a cardiologist at Texas Health Presbyterian Hospital Plano and Texas Health Physicians Group.  The inflammatory response of cytokines can lead to heart damage via the mechanism of heart failure which can cause a deadly condition called myocarditis, the inflammation of the heart muscle which can result in weak pumping function of the heart muscle. 

 

Dr. Robert Bonow, professor of cardiology at Northwestern University Feinberg School of Medicine and editor of JAMA Cardiology and other cardiac specialists believe a COVID-19 infection could lead to damage to the heart in four or five ways.  Some patients may be affected by more than one of those pathways at once.

 

Why does the coronavirus cause blood clots?

Evidence indicates that COVID-19, leads to blood clots in an estimated in 20–30% of critically ill patients.  A blood clot or thrombus, increases the risk of complications and death among those who have COVID-19.  This disease causes blood clots.

 

One theory is that the clotting occurs when the coronavirus attacks the endothelial cells that line the blood vessels. The virus does this by binding to the ACE2 receptors, which are present in the endothelial cell membrane.  Once the virus binds to these receptors, the blood vessels start releasing proteins that trigger blood clotting.

 

Blood clotting is a natural body response to injury.  It occurs when the volume of blood changes to a semi-solid state in order to prevent excessive blood loss.  Chemical reactions in the body facilitate this change.  Clots forming inside a deep vein can be extremely dangerous and may not dissolve on their own and can stop blood flow - which can be fatal.  A clot that breaks off and travels to other parts of the body are known as an embolus.  If the embolus reaches the brain, heart, or lungs, it can result in a life threatening condition, such as a heart attack or stroke.  According to a paper in the British Journal of Haemotology, people with COVID-19, clots appear to form within the lungs.  Typically, clots tend to form in other areas of the body before breaking off and traveling to the lungs.  Clots seem to form in the tiny vessels of the lungs, rather than the major vessels, as is the case in typical strokes

 

The symptoms include:

 

Other factors may also play a role in blood clotting in people with COVID-19, such as those requiring hospital care due to the disease.  Other factors include:

  • being older
  • having overweight
  • having hypertension, or high blood pressure
  • having diabetes
  • taking medications that increase the risk of blood clotting
  • having heart failure
  • having periods of inactivity, such as prolonged bed rest
  • undergoing surgery
  • smoking
  • having a personal or family history of DVT or pulmonary embolism
  • having a blood clotting disorder

 

Other complications from blood clots.

  • Stroke - When a blood clot blocks an artery in or around the brain, triggering a stroke.  Younger COVID-19 patients, with no other risk factors for stroke have an increased risk, even if they do not have symptoms of the disease.  The researchers also report seeing strokes in people in their 30s, 40s, and 50s that tend to be typical of people in their 70s and 80s.

 

  • Heart damage - A blood clot in the arteries can cause a heart attack or other cardiac issues.

 

  • Pulmonary embolism - Blood clots that travel to the lungs

 

  • Deep vein thrombosis (DVT) - when a blood clot forms in a vein deep in the body, such as in a leg or an arm.  In an autopsy study, DVT was present in almost 60% of those who died from COVID-19.  Without treatment, DVT can lead to pulmonary embolism, amputation, or death.

 

  • Kidney damage – patients with severe COVID-19 develop kidney damage, even if they did not have kidney issues before contracting the virus.  In some cases, the damage is so severe people require dialysis treatment.  

 

Initial Data From China

In March, doctors from China published two studies how prevalent cardiac problems were among patients with COVID-19.  The larger of the two studies looked at 416 hospitalized patients.  The researchers found that 19% showed signs of heart damage and were significantly more likely to die:  51% of those with heart damage died versus 4.5% who did not have it.

 

Patients who had heart disease before coronavirus infections were more likely to show heart damage afterward.  Patients with no preexisting heart conditions who incurred heart damage during their infection were more likely to die than patients with previous heart disease but no COVID-19-induced cardiac damage.  It’s unclear why some patients experience more cardiac effects than others. 

 

Facing Obstacles

Ideally, doctors take biopsies of the heart to determine whether the heart muscle is infected with the virus.  COVID-19 patients are often so sick it’s difficult for them to undergo invasive procedures.  Many hospitals aren’t using electrocardiograms on isolated patients to avoid adding additional staff into the room and depletion of protective equipment.

 

That work has already resulted in changes in the way hospitals deal with the cardiac implications of COVID-19.  Doctors have found that the infection can mimic a heart attack.  Patients have been taken to the cardiac catheterization lab to clear a suspected blockage, only to find the patient wasn’t really experiencing a heart attack but had COVID-19.

 

New protocol includes bringing in a cardiologist and getting an EKG or ultrasound to confirm a blockage.  Sorting out how the virus affects the heart should help doctors determine which therapies to pursue to keep patients alive.

 

Medication concerns

There has been debate if medications used to support blood pressure increases the risk of heart failure.  Dr. Cooper advised, “right now, there is no evidence that commonly used medications for any cardiovascular disorders in the United States creates a heightened risk of contracting COVID19 or the consequences of infection.  People should continue their medications, unless their physician has directed them otherwise.

 

Doctors may treat or prevent blood clots by prescribing blood-thinning medications.  Many start treatment during a hospital stay, continuing for 2 weeks after discharge to reduce the risk of blood clots.  Taking blood thinners increases the risk of bleeding, which is unsuitable for high risk patients.  Some reports indicate people on mechanical ventilation with COVID-19 prescribed blood thinners had a lower mortality than those who did not take the medication.

 

FDA NOTICE

The FDA Trusted Source has removed the Emergency Use Authorization (EUA) for hydroxychloroquine and chloroquine for the treatment of COVID-19.  Based on a review of the latest research, the FDA determined that these drugs are not likely to be an effective treatment for COVID-19 and that the risks of using them for this purpose might outweigh any benefits.

 

The Latest Research Projections on COVID-19 Treatments and Medications.

  • There are no approved coronavirus treatments at this time.

 

  • The drug furthest along in clinical trials for treating COVID-19 is Remdesivir, a new intravenous antiviral the FDA has not yet approved, though they did grant an emergency use authorization for it to make it more accessible.

 

  • Researchers are also testing older medications, typically used to treat other conditions, to see if they are also effective in treating COVID-19.

 

Hospitals and research labs all over the world are testing different therapies on coronavirus-positive patients in an effort to find a potential COVID-19 treatment.  Below are a few medications and treatments that have been making a buzz in the science community. 

 

  • Remdesivir an antiviral given by intravenous (IV) infusion in the hospital.  Remdesivir is a new drug not yet approved by the FDA for use and is being tested in carefully controlled environments.  It was previously shown to have some effect against SARS, MERS, and Ebola in cell and animal models.

 

Early results from a study of 1,063 patients showed hospitalized patients who received Remdesivir recovered faster than those who got a placebo, 11 days vs. 15 days respectively.  The death rate in the Remdesivir group, 7%, was lower than that of the placebo group, 12%.  Patients who needed oxygen saw the most benefit. 

 

  • Dexamethasone - a common corticosteroid (steroid) medication used for many years to treat various health conditions, such as autoimmune conditions and allergic reactions.  The medication seems most helpful for patients on a ventilator, 35% lower death rate, or needed extra oxygen, 20% lower death rate.  There was no benefit for those with less severe symptoms.

 

RECOVERY, a randomized clinical trial in the UK, is studying many medications, including dexamethasone, for effectiveness against COVID-19. 

 

  • Convalescent plasma - March 24, 2020, the FDA issued an Emergency Investigational New Drug (eIND) application for the use of convalescent plasma to treat people with COVID-19.  Plasma is the liquid part of blood that carries blood cells.  Convalescent plasma is collected from people who have recovered from COVID-19, then transfused into someone with active coronavirus infection.  It is thought that antibodies found in the convalescent plasma can help fight the coronavirus infection.

 

Staying heart-healthy

This is a stressful time because of the economic and social impact of this disease.  For those with known heart issues, high blood pressure or other diseases, stay focused on good heart health practices.  Being health conscious with vigilant hand hygiene, maintaining an exercise regimen and healthy diet are vital to maintaining health.  Although trying to adhere to social distancing by avoiding large group gatherings seems impossible, build in time to stay connected through social media or telephonically – which keeps the heart emotionally healthy.

 

The Immune System

White blood cells are the first line of defense!  The immune system fights off disease causing microorganisms and engineers the healing process.  The immune system is vital to fighting every assault on the body!  Understanding the role the immune systems plays in overall health will provide you the ability to take responsibility for your own health.  The responsibility of the immune system is to learn and identify those things that naturally belong in the body and those foreign or harmful.

 

The Best Immune Boosters

  • Sovereign Silver - Colloidal Silver - is a solution of microscopic silver atoms suspended in a liquid solution.  Colloidal silver can kill certain germs by binding to and destroying proteins.  It has been shown in studies to be antimicrobial and antibacterial.  It doesn’t disrupt the body’s balance of good bacteria or microflora.   It is totally safe to take on short term basis - especially for an immune system boost.  Sovereign Silver checks all of these boxes for purity and bioavailability

 

  • Echinacea - is well known for its ability to support the immune system especially during the colder months.  For years doctors and herbalists in Europe have commonly suggested Echinacea to support immune health.  Echinacea appears to activate chemicals in the body's immune system that decrease inflammation, which might reduce cold and flu symptoms.
     
  • Elderberry - affects the immune system.  Elderberry promotes activity against viruses including the flu and might reduce inflammation.   It has very high concentrations of a few immune supporting compounds like vitamin C and antioxidants.

 

  • Probiotics - Not all bacteria is bad! 70-80% of your immune system resides in the digestive tract.  Probiotics help to populate your gut with good microflora that not only help with digestion but also support the immune system.

When taking probiotics for an immune boost, get one with a variety of Lactobacillus and Bifidobacterium strains and a high concentration of CFUs, colony forming units – this is the amount of live microorganisms that help to populate the gut.

 

  • Zinc - is a mineral or an "essential trace element," because very small amounts of zinc are necessary for human health.  The human body does not store excess zinc it must be consumed regularly as part of the diet.  It is found in several systems and biological reactions, and it is needed for immune function, wound healing, blood clotting, thyroid function and much more.  Zinc might have effects against viruses.  It appears to lessen symptoms of the rhinovirus, common cold, but researchers can’t yet explain exactly how this works. 

 

  • Vitamin C the single most important antioxidant for the immune system.  It is essential for the formation on adrenal hormones and lymphocytes.  It also has a direct effect on bacteria and viruses

 

  • Coenzyme Q10 – Supports the immune system, an oxygen enhancer to protect the cells and heart function. 

 

  • Garlic – stimulates the immune system

 

  • Kelp supplies a balance of minerals needed for immune integrity

 

  • Maitake, Reishi or Shitake extracts build immunity and fight viral infections and cancer

 

  • Grape Seed extract – one of the most potent antioxidants, protects cells

 

  • Oregonal helps digestion by increasing bile flow and fighting against some bacteria, viruses, fungi, intestinal worms and other parasites.  Research published in the International Journal of Food Microbiology found that oil of oregano is an excellent germicide capable of killing a wide range of fungi and bacteria.

 

  • Bayberry, Fenugreek, Hawthorn, Horehound, Licorice Root and Red Clover enhance the immune system.

 

  • Power Greens – “a glass a day!”   Should include spirulina, kelp, chlorophyll and made from:  
  • Natural ingredients
  • High veggie to lower fruit ratio
  • Complete vegetable blend
  • Vitamins and minerals
  • Low in sodium and sugars
  • Includes probiotics
  • Includes super mushrooms

 

ALWAYS CONSULT YOUR PERSONAL HEALTH CARE PROFESSIONAL

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