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Experts say that heart problems associated with long COVID can cause shortness of breath. Morsa Images/Getty Images
  • In a new study, researchers reported that 35 percent of participants with long COVID experienced breathing difficulties a year after contracting the virus.
  • They said that this condition can be caused by heart problems as well as lung issues.
  • Cardiac issues are common among people with long COVID.
  • They said that the heart problems can persist long after the disease has abated, but they can also clear up on their own.

Symptoms such as coughing and breathing difficulties may make COVID-19 seem like it’s mostly a lung disease.

However, people who contract the novel coronavirus may suffer long-term damage to their heart as well, a study published today suggests.

More than one-third of people with no history of heart or lung disease who were hospitalized with COVID-19 continued to have shortness of breath a year after being discharged from the hospital, researchers from Belgium reported.

Their analysis showed that abnormal heart function was independently associated with persistent shortness of breath, known as dyspnea.

“Both lung and heart issues can cause shortness of breath,” Dr. Saurabh Rajpal, a cardiologist at The Ohio State University Wexner Medical Center, told Healthline. “This study is reminder that we cannot take this virus lightly and need to study its long-term effects on the heart.”

The findings were based on spirometry breath tests and chest computed tomography (CT) scans to assess lung function, along with cardiac ultrasound and a new imaging technique called myocardial work that provides more precise information on heart function.

The research “could help to explain why some patients with long COVID still experience breathlessness one year later and indicate that it might be linked to a decrease in heart performance,” Dr. Maria-Luiza Luchian, a study author and a cardiologist at the University Hospital Brussels, said in a press release.

The research was presented at EuroEcho 2021, a scientific congress of the European Society of Cardiology. It hasn’t been peer-reviewed or published yet.

The study included 66 participants without previous heart or lung disease who were hospitalized with COVID-19 between March and April 2020 at University Hospital Brussels.

Researchers found that 23 participants (35 percent) had shortness of breath a year after their diagnosis.

“When looking in detail at heart function by cardiac ultrasound, we observed subtle abnormalities that might explain the continued breathlessness,” said Luchian.

“Myocardial work could be a new echocardiographic tool for early identification of heart function abnormalities in patients with long COVID-19, who might need more frequent and long-term cardiac surveillance.

“Future studies including different COVID-19 variants and the impact of vaccination are needed to confirm our results on the long-term evolution and possible cardiac consequences of this disease.”

Dr. Eric Wisotzky, the director of our COVID Recovery Program at MedStar Health, told Healthline that shortness of breath is the one of the most common symptoms of long-term COVID-19 and that cardiac issues are “a relatively common concern among survivors.”

Heart palpitations and chest pain are some of symptoms of long-haul COVID-19 related specifically to the heart, not lung, he said. COVID-19 related diagnostic testing, however, more commonly focuses on lung issues.

“Heart-related conditions might be more common than we think because there’s not always a work-up,” said Wisotzky.

Rajpal said that COVID-19 can cause heart problems throughout the course of the disease.

“The effects we have seen on the heart with COVID-19 is more than we have seen with other viruses,” he said.

During the acute stage of an infection when people are most seriously ill, the coronavirus has been associated with myocarditis, an inflammation of the heart muscle, in about 1 to 3 percent of patients.

More people — up to one-third — have detectable levels of troponin, a biomarker for damage to heart muscle cells, Rajpal said. Risk of worsening heart function and heart attack also rises.

In the subacute phase — the period after active infection — COVID-19 can reportedly cause both myocarditis and pericarditis, which is swelling around the heart.

People can also can experience tachycardia, which can cause accelerated heart rate and dizziness, long after their infection with the coronavirus has passed, said Rajpul.

Wisotzky notes that conditions such as myocarditis and pericarditis can eventually clear up on their own.

“Cardiologists always harp on us that even for those who do present evidence of heart injury due to COVID-19, most don’t need any particular treatment and most do get better,” he said.

The study also found that significant numbers of the COVID-19 patients studied had lingering ground glass opacities — cloudy areas in the lungs that show up on CT scans — and pulmonary fibrosis at 6-month and 12-month followups, respectively.

These were not associated with shortness of breath, however.