COVID-19 can stop the heart, and a defibrillator may not help, study shows
Months into the COVID-19 pandemic, physicians still emphasize that key symptoms include a dry cough, fever and shortness of breath – no surprise for a virus that infects the lungs.
Yet in the sickest patients, doctors keep finding collateral damage in the kidneys, liver and other organs.
A new Penn Medicine study suggests that in rare cases, the coronavirus can even stop the heart.
Among 700 COVID-19 patients at the Hospital of the University of Pennsylvania, nine suffered a sudden cardiac arrest after being admitted, the study authors reported recently. Seven of the nine were under age 60.
While doctors managed to resuscitate six of those nine, including five of the under-60 group, the findings are a reminder that COVID-19 can cause injury throughout the body, senior author Rajat Deo said.
The cardiac arrests were among 53 cases of abnormal heart rhythm identified by Deo and his co-authors.
Evidence suggests these heart malfunctions are not the result of the virus’ infecting heart cells, said Deo, a cardiac electrophysiologist and an associate professor at Penn’s Perelman School of Medicine. Instead, they appear to occur when the immune system overreacts to the virus, leading to dangerous inflammation.
“When the body is under so much stress, just general, overt systemic stress and inflammation, then at that time, they’re just predisposed to arrythmias,” Deo said.
Eight of the nine cardiac arrests were “nonshockable,” meaning they were not the type that can be restarted with a defibrillator.
“That means CPR and medication, and you pray that the pulse comes back,” Deo said.
Some of the heart malfunctions may be the result of abnormal blood clots that can occur in COVID-19 patients, he and his co-authors wrote in Heart Rhythm Journal.
Yet one of the abnormal heart rhythms they identified – atrial fibrillation, typically abbreviated as A-fib – can itself lead to clots, so it can be difficult to disentangle what caused what. It is possible that some patients suffer from thrombosis – clotting – as a direct result of COVID-19 and also as a result of the COVID19-induced heart malfunction, Deo said.
“If you have COVID19 and A-fib, it’s sort of like a double thrombotic disease,” he said. “It’s a double whammy.”