Will COVID-19 really cause myocarditis? Huaxi cardiologist: Let's make it clear all at once

Recently, whenever you log into social media, you will definitely see everyone discussing “myocarditis”!

So, does COVID-19 infection really cause myocarditis? Is it really true that you can’t exercise after COVID-19 infection?

Next, Dr. Li Chen from the Department of Cardiology at West China Hospital of Sichuan University will explain it clearly to everyone!

First of all, based on the existing clinical cases, we can basically confirm that the new coronavirus may indeed cause myocarditis.

Pathogenesis of myocarditis

When the virus enters the body, it will induce the body's own immune response, thereby producing antibodies to fight the invading virus. However, if the autoantibodies "short-circuit" at this time, they will mistakenly attack our own myocardial cells, leading to the occurrence of myocarditis.

Clinically, myocarditis is a critical disease with a high incidence of sudden death. The mortality rate of fulminant myocarditis is as high as 20% to 30%.

But whether it is ordinary myocarditis or myocarditis caused by the new coronavirus, they are relatively rare diseases and the incidence rate is not high. There are approximately 10 to 100 cases of myocarditis per 100,000 people each year.

In fact, the vast majority of patients suffered damage to their myocardial cells after being infected with the new coronavirus, which was far from reaching the level of myocarditis.

After being infected with the new coronavirus, an important examination indicator for doctors to determine whether the patient has myocardial damage is the detection of myocardial markers, especially high-sensitivity troponin.

Dr. Li Chen

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If we use the detection of high-sensitivity troponin as the standard, then according to relevant research reports from abroad, approximately 20% to 30% of new coronavirus patients actually have elevated high-sensitivity troponin, which means that the patients may have suffered varying degrees of heart damage. This ratio is actually still very scary.

In short, heart damage caused by the new coronavirus is a very common phenomenon, but the degree of damage varies from person to person.

Although patients with severe myocarditis are extremely rare, mild myocardial damage manifested by elevated high-sensitivity troponin is still relatively common.

In addition, there is a large number of people who may not have elevated high-sensitivity troponin levels, but still experience discomfort symptoms such as palpitations and difficulty breathing.

For this group of patients, the possibility of myocardial damage cannot be completely ruled out. It is possible that the damage is very mild and even the high-sensitivity troponin test, which is currently recognized to be more sensitive, cannot detect it.

Therefore, if we experience a series of uncomfortable symptoms such as difficulty breathing, fatigue, palpitations, etc. after being infected with the new coronavirus, it is best to go to the hospital for further examination to rule out infection of the heart or lungs.

Regarding the diagnosis of myocarditis, the three most important clinical examination indicators are: ① electrocardiogram; ② cardiac ultrasound; ③ myocardial markers

However, there is no need to worry too much, as the damage to myocardial cells can be relieved by itself through later treatment and rest.

Even if there are symptoms of myocarditis, most myocarditis can be completely cured through proper treatment.

If you have carefully read the pathogenesis of myocarditis mentioned above, you will know that myocarditis is not caused by exercise.

But why do some people suddenly develop myocarditis after exercise?

Myocarditis is actually divided into mild, moderate and severe grades. In the early stages of the disease, you may not have any discomfort symptoms, but in fact your myocardial cells are in a severely damaged state and your heart is not functioning well.

Especially after fighting the new coronavirus, our bodies need strict bed rest to allow myocardial cells to fully recover, which is also an important guarantee for recovery.

In this case, if we fail to recognize that we have serious myocardial damage and exercise rashly, it will increase the burden on the myocardium , making it overwhelmed when it is already severely damaged. This may induce myocarditis or even sudden death.

In short, it is not that exercise after infection with the new coronavirus causes myocarditis, but that you already have myocarditis and exercise causes the condition to worsen.

Therefore, I hope everyone can give their bodies enough time to recover, and don’t rush to resume exercise~

01

Why is the incidence of myocarditis higher in young patients?

Because young people have stronger immune systems.

The pathogenesis of myocarditis is that our own immune system mistakenly attacks our myocardial cells. Since young people have stronger immune systems, they are more likely to kill and destroy our own myocardial cells , resulting in a higher incidence and mortality rate of myocarditis in young and middle-aged people than in the elderly.

02

It has been two weeks since the test results turned negative, but I still have cough and chest tightness. Is it necessary to go to the hospital?

If the coughing symptoms still recur after 2 weeks of recovery, it is recommended that you go to the hospital for two very important examinations:

① CT of the lungs;

② Routine blood test.

These two tests can help doctors determine whether the patient has bacterial pneumonia. If so, antibiotic treatment can actually quickly control the patient's condition.

03

How long does it take to resume exercise after being infected with the new coronavirus?

The specific recovery time needs to be judged based on your own medical condition and physical condition.

👉 Patients diagnosed with myocarditis: Try to stay in bed for at least one month, and do not engage in any strenuous physical activities within 3 to 6 months.

👉 Patients with myocardial damage: Strict restrictions are required on exercise. If shortness of breath and fatigue occur after exercise, or existing respiratory symptoms such as cough and fever worsen, then you need to stop exercising immediately.

👉Ordinary patients: No matter what type of exercise you do, you must adhere to one principle: while completing the exercise, your body will not experience persistent fatigue and discomfort, and will not aggravate the original symptoms.

Exercise recovery can be divided into 5 stages.

① Within 1 to 2 weeks after recovering from COVID-19 infection: Try not to do any exercise that consumes a lot of physical energy. Instead, do some stretching muscle recovery exercises. This will not consume too much physical energy, but can also help to stretch your muscles.

② The second stage: Start doing some daily physical activities, such as taking a walk, doing some daily chores, etc.

③ The third stage: You can perform local resistance activities, such as dumbbell training, leg raising and other local resistance exercises.

④ Stage 4: Moderate-intensity exercise activities, such as aerobic exercises such as cycling, jogging or swimming.

⑤ Stage 5: Return to normal intensity of exercise that was acceptable before infection, such as playing football, basketball, etc.

Notice!

Each time we enter a stage, we need to observe our body for at least one week to determine whether the above-mentioned discomforts occur.

Once discomfort occurs, we need to immediately stop the current stage of exercise, return to the previous stage, wait for the body to recover, and then continue to start advanced recovery exercise.

04

After the test turns negative, if I keep coughing and expectorating, and have difficulty breathing when going upstairs, can I take medicine?

If you still have symptoms of coughing and wheezing two weeks after the test turned negative, you may have symptoms of pneumonia or heart damage.

However, whether it is a decline in lung function or heart function, it is clinically dangerous. It is recommended that if such a situation occurs, go to the hospital for treatment in time and do not take medicine on your own.

If after a series of tests such as electrocardiogram, lung CT scan, and blood routine examination, no heart or lung infection is found, then there is no need to worry too much. It should be just a viral infection and the body will recover after some time.

05

After the test results turned negative, why do I still sweat at night when I sleep?

Whether it is nucleic acid or antigen negative, it only means that the virus in our body has not replicated in large quantities, which means that most of the viruses have been killed by us.

However, the viruses remaining in the body may cause secondary bacterial infections because the viruses destroy part of our body's immunity, especially our lungs, which may lead to secondary bacterial infections and cause heart damage.

When our organs are damaged, patients may experience a variety of symptoms, including night sweats. If the symptoms of night sweats are severe, it is recommended to go to the hospital for further examination in time.

But if this night sweating only occurs during the fever period of viral infection, especially when the fever subsides, the night sweating will be relieved, then there is no need to worry about this situation.

06

What should people who have had heart stents installed pay attention to if they become positive?

① If your heart disease worsens after being infected with the new coronavirus, such as angina pectoris, tightness in the heart, and other symptoms of heart failure, it is recommended that you go to the hospital for treatment in time.

Because the new coronavirus may cause damage to the heart. For patients with underlying heart disease, coronary heart disease, or heart stents, infection with the new coronavirus is likely to aggravate the original heart disease or induce heart failure.

② Patients who are taking heart disease-related drugs, especially coronary heart disease drugs, if they need to use drugs related to the treatment of the new coronavirus, it is recommended that they first consult a professional cardiologist to see if any adjustments are needed based on their actual medication situation.

This is because the medications used by patients with coronary heart disease may be contraindicated or interact with some of the medications used to treat COVID-19.

That’s all for today!

Although myocarditis is a very serious heart disease

But the incidence rate is not as high as people think.

And with proper treatment

Most cases of myocarditis can be completely cured!

So we don't need to panic too much

Instead, you should pay more attention to your own physical condition.

Get some rest so your body can heal soon!

Welcome to forward and share!