Covid led to serious heart damage in “healthy” middle-aged patients who were more likely to die as a result, a major Scottish study found.

The virus led to impaired function of the right side of the heart and this was associated with an 86 per cent mortality rate. None of the patients had serious heart problems before they contracted the virus.

Around one in three showed evidence of Right Ventricular Dysfunction which affects the heart’s ability to pump blood to the lungs.

Doctors said there was now “no doubt” that Covid affects heart function after the ground-breaking study, which involved 10 intensive care units and 121 patients treated over September 2020 to March 2021, when the majority of people were not vaccinated.

This kind of knowledge is invaluable

Nearly half of ventilated patients in the study (47%) died because of Covid-19, a figure that is comparable to national and international death rates.

The majority of patients (66%) were men. 

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Doctors hope the findings will improve outcomes for patients most at risk of serious illness in future outbreaks of the virus or other pandemics.

Screening could be used to spot the early signs of heart damage with treatments administered at an earlier stage.

Dr Philip McCall, a consultant in cardiothoracic anaesthesia, who led the study said the condition is “difficult to spot unless you are looking for it”, adding: “That’s why the results of this study are so important.

“We now know that Covid-19 is a problem associated not just with ventilation, but can affect the heart.

The Herald:

(Dr Philip McCall and Dr Ben Shelley, heart specialists at NHS Golden Jubilee)

“A combination of factors create the perfect storm for Covid-19 to damage the right side of your heart, which ultimately can cause death.

“If you’re pumping blood to the lungs and the lungs become very sick, you have an additional problem because the lungs are not willing to receive blood.”

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He said the majority of patients were in their 50s and that whilst around one third of them had high blood pressure, none had “significant heart problems”. 

He added: “One patient in an intensive care bed looks very similar to another patient – you have to go looking for this with ultrasound to find out how well the heart is functioning.”

The left side of the heart pumps blood around the body while the right side pumps blood to the lungs.

“If you have sick lungs, such as if you have Covid, that puts a lot of back pressure on the right side of the heart,” said Dr McCall. “Imagine standing on a hose and watching the pressure build up.

“On top of that, the technique we use to try to treat sick lungs [such as ventilation] can add to that problem. We know that Covid can also cause blood clots in the lungs and legs.

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“Covid itself can also cause damage to the heart, with myocarditis. We know this from other work.”

However, Dr McCall said the damage to the right side of the heart was no worse than would be seen if a patient becomes seriously unwell with other respiratory illnesses such as flu or pneumonia. 

He also said further studies are needed to find out if patients are left with permanent heart damage.

Dr Ben Shelley, Consultant in Anaesthesia and Intensive Care at NHS Golden Jubilee, said: “The study has revealed that there is no doubt Covid-19 affects the heart and has a major impact on outcomes for the patient. 

“This kind of knowledge is invaluable, not only in combatting any future waves of Covid-19, but in planning for future pandemics to allow people to be treated more effectively.”

Another study led by the University of Glasgow found that one in eight people who were hospitalised with Covid between May 2020 and March 2021 were later diagnosed with myocarditis, or heart inflammation. Damage to the other organs such as the kidneys was also common.

Among the 159 patients enrolled in the study, risk factors for heart disease were common, including overweight or obesity, high blood pressure and pre-diabetes or diabetes. 

Researchers said it may be possible a healthy person hospitalised with Covid is likely to have a worse infection than someone with underlying health conditions.