COVID-19 AND HEART DISEASES
Coronavirus disease 2019 (COVID-19) is a viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first identified in December 2019 in Wuhan, China, and rapidly evolved into a global health crisis. Among patients with severe COVID-19 symptoms, hypertension (HT) is present in 58%, cardiovascular disease in 25%, and arrhythmias in 44%. One study reported an overall case-fatality rate of 2.3%, which increased to 49% among critical cases. Accordingly, the mortality rate in patients with preexisting heart disease was found to be 10.5%, and 6% in those with known hypertension, whereas the mortality rate was only 0.9% among individuals without comorbid conditions in the same study conducted in China.
During viral infections, an excessive inflammatory response may rupture atherosclerotic plaques in the coronary arteries, leading to acute coronary syndrome (heart attack). Severe systemic inflammation may also trigger arrhythmias or palpitations in some individuals. Since COVID-19 is a viral infection, it may present with a wide range of cardiovascular conditions, including myocardial injury, arrhythmias, sudden cardiac arrest, hypertension, heart failure, acute coronary syndrome, myocarditis, and pericarditis. The first manifestation of COVID-19 may even be symptoms related to cardiovascular disease. It has been reported that 7.3% of COVID-19 patients experienced palpitations as their initial symptom. Individuals presenting with chest pain, palpitations, or similar complaints during active COVID-19 symptoms should seek immediate care in an emergency department or outpatient clinic.
Nearly 90% of patients who required intensive care treatment during this period were unvaccinated, and heart-related complications were particularly prominent among them, underscoring the importance of timely vaccination. According to the results of the TURKMI-II study conducted nationwide by the Turkish Society of Cardiology, the number of patients admitted to hospitals with heart attacks during the pandemic decreased by 47.1% compared to the pre-pandemic period (TURKMI-I). These findings indicate that nearly half of the patients who suffered heart attacks during the pandemic did not seek hospital care. Heart attacks represent the most critical emergency in cardiovascular diseases. In Turkey, more than 40% of all deaths are due to cardiovascular diseases, and over 200,000 deaths occur annually due to coronary heart disease. Therefore, individuals at high risk—such as those with hypertension, a family history of early cardiovascular death, diabetes, smoking habits, or high cholesterol—should be more vigilant about chest pain and seek medical attention whenever such symptoms occur.
Which Groups Are at Risk for This Disease?
Transplant patients, cancer patients receiving chemotherapy or radiotherapy, individuals with leukemia or lymphoma, and those with preexisting heart disease are theoretically at high risk of contracting and struggling to recover from the effects of the virus. Other high-risk groups include the elderly, pregnant women with cardiovascular disease, and frail individuals. Patients with heart failure, dilated cardiomyopathy, advanced arrhythmogenic right ventricular cardiomyopathy, and congenital cyanotic heart disease constitute the highest risk group. Patients with obstructive hypertrophic cardiomyopathy may also fall into the high-risk category.
What Preventive Measures Can Be Taken?
To minimize risk, one should avoid contact with sick individuals and maintain at least a 2-meter distance from others whenever possible. Hands should be washed thoroughly with warm water and soap for at least 20 seconds. When coughing, the mouth should be covered with a tissue or the inside of the elbow. A tissue should also be used when sneezing; alternatively, sneeze into the elbow. Avoid touching the eyes, mouth, or nose. Frequently touched surfaces such as door handles, handrails, steering wheels, and light switches should be disinfected regularly. Stay home as much as possible, and work from home if feasible. If fever ≥37.8°C, cough, or symptoms of chest infection develop, self-isolation is necessary, and the nearest healthcare facility should be contacted.
Taking formulated vitamin supplements does not protect against COVID-19. Fresh fruits and vegetables are recommended not only during the pandemic but at all times for maintaining a strong immune system. Fresh produce contains a broader range of essential nutrients compared to vitamin tablets. Therefore, consuming plenty of fresh fruits and vegetables is always more beneficial than relying on formulated supplements. However, some individuals may have true deficiencies requiring supplementation.
This period is understandably stressful for everyone, making regular and healthy nutrition essential. Keeping the body strong is crucial. Healthy eating provides vital vitamins and minerals that help combat anxiety. Whole grains, fruits, and vegetables help reduce anxiety levels. Although biscuits, cakes, and chocolate are delicious, excessive sugar intake may worsen anxiety. Additionally, adequate fluid consumption is important. Exercise and exposure to daylight (even on cloudy days) benefit mental health. Physical activity can help relieve anxiety. To stay socially connected, virtual communication methods should be used; even one daily video or voice call with friends or family via Facetime, Skype, or WhatsApp can boost morale and help maintain social connection. Thinking of others, talking to them even from a distance, and offering support may help reduce personal anxiety. Engaging in enjoyable activities—such as listening to music, solving puzzles, knitting, sewing, painting, or drawing—can distract the mind from distressing thoughts and improve concentration.
