Long COVID inflammation could impact heart: Study

New research led by the University of Queensland has shed light on why many long COVID patients experience ongoing cardiovascular symptoms. 
 
Published in Nature Microbiology this week, the study analysed the blood of 50 patients from across Australia, comparing those who had either suffered long COVID for more than a year, had recovered from COVID-19, or had never had the virus.
 
Ultimately, it found this group had higher levels of inflammatory markers compared with those without symptoms of long COVID, and those who had not had COVID-19 at all. 
 
The study’s release comes at a time when around 65 million people globally are continuing to suffer from long-COVID, with many experiencing symptoms such as chest pain and heart palpitations.
 
University of Queensland Associate Professor Kirsty Short said the team had set out to find the cause of persistent palpitations and chest pain which are both common in patients living with long COVID.
  
‘We discovered elevated levels of cytokines, proteins which help control inflammation in the body, in the blood samples of people at about 18 months post-infection with SARS-CoV-2,’ she said.
 
Associate Professor Short said the study demonstrates the raised inflammatory proteins directly affected heart muscle cells, which in turn likely explained the heart-related symptoms. 
 
Dr Ken McCroary, a Western Sydney GP and RACGP Expert Committee – Quality Care member told newsGP he was ‘really proud to read this groundbreaking Australian research’.  
 
He said though it is early days and causative pathways are yet to be proven, the findings are significant for people with long COVID. 
 
 ’These inflammatory changes sound really quite significant,’ he said.
 
‘Having some validation, may ease the suffering.
 
‘Sometimes it is just helping [patients] make some lifestyle choices and decisions, which hopefully leads to less impairment and suffering, rather than actually having fixes for everything.’  
 
Dr McCroary said the research is another step forward in showing that long COVID is real, and that the scientific and health communities are working to learn more.  
 
‘I still have colleagues that struggle with long COVID and accepting it as a real syndrome,’ he said.
  
‘Apart from helping our patients, I think it will help those of us that may still have some doubts, or misunderstandings, or misconceptions about the reality of these symptoms and reality of the ongoing suffering that these people have.’ 
 
Dr McCroary envisages further research will follow to look at the effects of long COVID on other body systems too, including the lungs, kidneys, and the brain.
 
However, he said ‘the new norm for Australians, is multimorbidity, chronic health’, and in turn the risk of developing long COVID is higher in people who already have health vulnerabilities. 
 
‘Long COVID often is predated on premorbid function as well, so if you’ve already got chronic health disease, whether it’s anxiety, diabetes or something else, you’re more likely to get long COVID as well, that just contributes to their burden,’ Dr McCroary said.
 
‘Unfortunately, the health system and Medicare is disincentivised to provide quality time with our patients.
 
‘It’s all about faster throughput, it’s like a no-win situation for those with chronic health issues, which is unfortunately, becoming the majority [of Australians].’
 
While Associate Professor Short admitted ‘it’s only early days’, they say they are also curious about how the findings could be applied to other symptoms of long COVID, such as neurological disease or respiratory disease.
 
‘These results require validation in additional patient cohorts, including those infected with more recent SARS-CoV-2 strains,’ she said.
 
Despite these limitations, this work offers some important new insights into this complex disease, and hopefully offers opportunities to improve the diagnosis, treatment and understanding of long COVID.’
 
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