Two years and six months have passed since the first confirmed case of COVID-19 in Korea. There are 600 million confirmed cases worldwide, of which 6 million, or 1%, have died from COVID-19. Korea, which had a relatively good medical environment and quick response, had more than 20 million confirmed cases as of August 2022, but the mortality rate was 0.12%, lower than the global average. This is low even when compared to the COVID-19-related mortality rates in countries such as the United States (1.1%), France (0.4%), Germany (0.5%), the United Kingdom (0.8%), and Japan (0.2%). If you look at the death rate alone, Corona 19 can be considered as a mild disease that passes for a while, like the seasonal flu. However, the frequent mutations incapacitate the vaccine’s effect, and it can spread quickly due to its strong contagious power, and unexpected immune system reactions cause various organ damage and sometimes uncontrollably worsen the body’s functions, which can lead to death. can’t just see
As numerous studies related to COVID-19 have been conducted in a short period of less than three years and various clinical experiences have been accumulated, we have found that the mortality rate is higher in the elderly 60 years and older, obesity, chronic diseases and immunocompromised conditions than in the healthy young age group. . A recent large-scale study found that 11% of patients infected with COVID-19 had underlying heart disease, and the risk of developing a fatal disease was three times higher than those without heart disease.
In addition to this, research results show that even patients without prior heart disease are 1.5 times more likely to be diagnosed with various heart diseases such as arrhythmias, myocarditis, pericarditis (pericarditis), and coronary artery disease following COVID-19 infection. In particular, the higher the severity at the time of infection, the greater the risk increased significantly by 5 to 20 times.
The impact of COVID-19 on heart disease has been explained by various mechanisms. First, there are cases where the corona virus invades through the respiratory system and indirectly causes damage to the myocardium or blood vessels, causing an inflammatory response throughout the body. The second is when the coronavirus directly promotes the inflammatory response of the myocardium and vascular endothelium, causing myocarditis or myocardial infarction. Third, there is also heart disease that accompanies damage to various organ functions, such as dominoes, due to excessive activation of uncontrolled immune response. Finally, a temporary decrease in heart function, called ‘stress cardiomyopathy’, may occur as a result of a stress response following a sudden change in physical condition following infection with COVID-19.
Although the contagiousness and fatality rate of COVID-19 have decreased compared to the early days of the pandemic by using various therapeutic agents along with vaccination, it is still considered a fearful disease for people with heart disease. The following rules should be followed to prevent the progression to a fatal course, including complications of the heart due to COVID-19. First, preventive measures such as wearing a mask and washing hands should be thoroughly taken to prevent infection with COVID-19, and sufficient vaccinations should be followed according to the guidelines. Currently, the target of the 4th vaccination in Korea is ‘adults over 50 years of age, those with immunocompromised and underlying diseases over 18 years of age, inpatients and workers in nursing hospitals and mental health promotion facilities, residents and workers in facilities vulnerable to infection (disabled people, living facilities for the homeless) ‘If you have heart disease, it is included in the subject of the fourth vaccination, so it is recommended that you receive an additional vaccination if 4 months have passed since the third vaccination. Next, it is important to maintain stable heart health by thoroughly managing heart disease on a daily basis. Even if a stressful situation occurs due to COVID-19 infection, if our body’s immune system overcomes the fight once morest the virus and the heart can withstand it well until it recovers once more, it can be prevented from worsening into a fatal state. It is also necessary to regularly consult with the attending physician to maintain an optimal heart condition, and to train the body to develop tolerance through steady exercise and management. Lastly, even if you do not currently have heart disease, if you are included in the high-risk group for COVID-19 infection and heart disease, such as the elderly, diabetes, family history of heart disease, etc. good to do
Since the heart is an important organ that cannot be rested even for a moment, a fatal situation can occur when there is a problem, and for people with heart disease, Corona 19 infection, which comes like a cold, can take everything away, so you should always be alert. It is important to minimize the risk of COVID-19 infection by thoroughly following the infection rules to prevent post-mortem visits, and to minimize the worsening of the condition through appropriate measures to get tested as soon as possible if there are suspicious symptoms. This is the secret to overcoming heart disease and maintaining a healthy and happy life.
[김효수 대한심장학회 이사장(서울대 의대 순환기내과)]
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