As public health experts race to learn everything they can about coronavirus disease (COVID-19), a rapid review of the latest reports and research indicates that people with heart conditions, such as cardiovascular disease and high blood pressure, are especially vulnerable to severe problems and death from the infection.
The global outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, has infected nearly 2 million people around the world and killed more than 125,00. Because there have been reports that people with heart conditions may be especially vulnerable to COVID-19, researchers reviewed the most up to date reports and studies to get a better picture of the risk.
There are no completed clinical trials yet, but they note in the partially NHLBI-funded study published in the Journal of the American College of Cardiology that reports from more than 44,000 COVID-19 cases in China indicate that people with cardiovascular disease, high blood pressure, or diabetes were more likely to die. For example, overall, just over 2% of people in those China cases died but this jumped to 10.5% in those with cardiovascular disease—a more than five-fold spike.
The disease itself might also damage the heart. The researchers note that a review of 68 deaths found that some cases may have been due to inflammation of the heart. Another study found that nearly 1 in 4 people with COVID-19 had heart failure, but it was unclear if the SARS-CoV-2 infection directly caused the condition or if it just worsened a pre-existing heart problem.
Although there is no proven treatment for COVID-19, the researchers said several medications that are being investigated may be risky for people with heart problems because they have side effects that can worsen or trigger heart conditions. These include the anti-malaria drug hydroxychloroquine, the steroid methylprednisolone, and several anti-viral medications, such as ribavirin and remdesivir.