Since the beginning of the pandemic, COVID-19 has been associated with heart problems. However, it was not known whether these problems were caused by the virus attacking the heart or by an inflammatory response to the viral infection elsewhere in the body.
Researchers at Washington University in St. Louis have tried to answer this question and have discovered the cause of heart damage and impaired blood pumping function in COVID-19 patients. They concluded that the heart damage in COVID-19 patients is due to the virus invading and replicating inside heart muscle cells.
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The researchers used stem cells to engineer tissue that models human infection and the contraction of heart tissue. By studying these models, they determined that viral infection not only kills heart muscle cells, but destroys the muscle fiber units responsible for muscle contraction.
They also showed that this cell death and loss of heart muscle fibers can occur even in the absence of inflammation.
“Early in the pandemic, we had evidence that this coronavirus could cause heart failure or heart damage in generally healthy people, which was alarming to the cardiologist community,” explained study lead author Kory J. Lavine.
The debate was limited around whether this was due to a direct heart infection or a systemic inflammatory response that occurs due to lung infection. The results were published in the journal JACC: Basic to Translational Science.
“Our study is unique because it definitely shows that, in COVID-19 patients who developed heart failure, the virus infects the heart, specifically the cells of the heart muscle,” said the doctor.
Other viral infections have long been associated with damage to the heart, but SARS-CoV-2, the virus that causes COVID-19, is unique in its effect on the heart, especially on responding immune cells to infection, scientists emphasize.
The researchers were able to validate their findings by studying tissue from four COVID-19 patients with infection-associated heart lesions, but more research is needed as this type of tissue is very difficult to obtain.