While my recent post addressed the lungs and the blood clotting systems, today we turn our attention to a vital organ, the heart, and how COVID leaves behind nagging problems. For many, after COVID palpitations and chest pains disrupt life up to 6 months beyond the acute illness’s end, according to a Chinese study (1). Some early studies using MRI images suggested that heart muscle inflammation may be occurring in as many as 60% of all COVID patients at 2 months post disease (2). In another study of college athletes, 15% demonstrated signs of ongoing heart muscle inflammation 2 months after the illness. Clearly, the heart takes a beating from this virus.
Why might the heart be facing so much damage from this virus? Several mechanisms have been uncovered. For some, the virus directly invades the heart. In autopsies, 3 in 5 deceased COVID 19 patients showed virus in their heart. For the majority of COVID19 patients, the ACE2 pathway is downregulated. For others, the inflammation and immune response cause further damage. From there, fibrosis or scarring of the muscle may lead to heart rhythm disruptions, especially if the person’s adrenaline is elevated from inflammation. This overdrive of the adrenaline system may contribute to postural orthostatic tachycardia syndrome or inappropriate fast heart rate.
The standard approach from conventional medicine recommends screening post COVID patients with EKG’s and echocardiograms when they are symptomatic. For athletes, they are told to rest for3-6 months to let their heart recover. Initial recommendations were made to stop medications that inhibited the ACE2 system, thinking the drugs may make someone more at risk for severe COVID infection. With study, they determined that stopping the medications actually increased mortality, so now the consensus says to continue the therapies (3).
Functional medicine does not ignore these recommendation but goes beyond this monitor and recommendations for rest. Recognizing the mechanisms of action for the viral damage, we start during the acute infection with anti-inflammatories and natural anti-virals. We want to control and minimize the initial damage to heart muscle. Then as the disease fades and the patient waits for symptom resolution, we amplify our anti-inflammatories and provide nutrients to stimulate healing. Many of these therapies also address the fact that the spike protein may be acting as a biotoxins. By detoxing from the spike protein, we hope to speed recovery rather than waiting for symptoms to drag out weks and weeks.
Restoring healthier lives means that we apply what we do know to the developing situation as far as we can to remove the obstacles preventing our patients from enjoying family time, work productivity, exercise and life in general. Restoring life is possible in Long Hauler Covid.
Ani Nalbandian, Kartik Sehgal, Aakriti Gupta, Mahesh V. Madhavan, Claire McGroder, Jacob S. Stevens, Joshua R. Cook, Anna S. Nordvig, Daniel Shalev, Tejasav S. Sehrawat, Neha Ahluwalia, Behnood Bikdeli, Donald Dietz, Caroline Der-Nigoghossian, Nadia Liyanage-Don, Gregg F. Rosner, Elana J. Bernstein, Sumit Mohan, Akinpelumi A. Beckley, David S. Seres, Toni K. Choueiri, Nir Uriel, John C. Ausiello, Domenico Accili, Daniel E. Freedberg, Matthew Baldwin, Allan Schwartz, Daniel Brodie, Christine Kim Garcia, Mitchell S. V. Elkind, Jean M. Connors, John P. Bilezikian, Donald W. Landry, Elaine Y. Wan. Post-acute COVID-19 syndrome. Nature Medicine, 2021; DOI: 10.1038/s41591-021-01283-z
Thanks to Science Daily:
Columbia University Irving Medical Center. “Long-haul COVID: Physicians review what’s known.” ScienceDaily. ScienceDaily, 22 March 2021. <www.sciencedaily.com/releases/2021/03/210322175018.htm>.
1) Huang, C. et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet 397, 220–232 (2021).
2) Puntmann, V. O. et al. Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from coronavirus disease 2019 (COVID-19). JAMA Cardiol. 5, 1265–1273 (2020).
3) Rey, J. R. et al. Heart failure in COVID-19 patients: prevalence, incidence and prognostic implications. Eur. J. Heart Fail. 22, 2205–2215 (2020).
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.