Coronavirus FAQ
Coronavirus & Heart Disease
8 April 2020
Below is a list of common questions about coronavirus (COVID-19) and how it can impact your heart. This information has been provided by three world-leading cardiologists; Professors Jason Kovacic, Bob Graham and Diane Fatkin from the Victor Chang Cardiac Research Institute. You can also watch our latest videos on COVID-19.
Update 25 Nov 2021: Information from this article was accurate at the time of publishing and reflected the rules/advice announced by governing bodies at that time.
If you have heart disease, are you at increased risk of contracting COVID-19?
At the present time, we believe that the great majority of people with cardiovascular disease or heart disease are not at any specific increased risk of contracting coronavirus (COVID-19). This includes people with a prior heart attack, people with congestive heart failure, people with prior stents and it would even extend to people with other forms of cardiovascular risk features such as high cholesterol or high blood pressure. We believe that the overwhelming majority of these patients are at no specific increased risk of contracting COVID-19.
However, we do believe that diabetes places people at somewhat increased risk for COVID-19, although it doesn't appear to be a dramatically increased risk. One specific patient population that is potentially at increased risk of contracting COVID-19, are those that are taking immunosuppression medications. This would certainly include patients that have had a prior heart transplant or other cardiac patients that are taking medication such as prednisone, methotrexate or other immune-suppressing agents. This group of people needs to be very careful and exercise strict adherence to all of the measures that are in place to protect people from getting COVID-19, including social distancing, hand hygiene and other measures.
How does COVID-19 affect the heart?
COVID-19 affects the heart in at least two major ways that we're aware of. The first is it can apparently cause a direct infection of the heart. This is known as myocarditis, with ‘myo’ meaning muscle and ‘carditis’ meaning cardiac inflammation or inflammation of the heart. So myocarditis is a direct viral infection of the heart. Viruses can infect our body in many different ways and we've all had these infections ranging from a stuffy nose, bronchitis, gastroenteritis, hepatitis and other infections affecting many parts of the body. And the heart is no different. Most viral infections of the heart pass, and the virus is gone from the body within a few weeks. In rare cases, viral infections of the heart can result in more serious damage. This appears to be the case with the COVID-19 – for most people, there is minimal or no involvement of the heart, but in a few cases this myocarditis appears to be more serious.
The second way COVID-19 may affect the heart is related to our immune system. Normally when we get a viral infection or any type of infection, the body has an inflammatory response and there's a release of a lot of hormones and molecules into the bloodstream. The surge in the release of those hormones and other messengers with COVID-19 can cause the heart function to be reduced. Finally, there may be some increased oxygen demand placed on the heart that may cause additional strain and it can mimic, in some respects, a heart attack. But this third possible mechanism is a little bit unclear at the present time.
Specifically, what forms of cardiac disease puts you at higher risk of requiring hospitalization, if infected with COVID-19?
The great majority of people with cardiac disease are not at increased risk of getting the infection. However, if they do get the infection, the problem is that they appear to be at increased risk of having a more significant or severe infection. So if you do have any form of cardiovascular disease and you find yourself presenting with some of the symptoms of COVID-19, it is important that you seek medical care early. For heart transplant patients or people that are receiving immune-suppressing drugs, again, those patients are at more risk of getting the infection and potentially getting a more severe infection. So it's very important that all of these patients and people with different cardiovascular diseases practice very careful social distancing and hygiene measures to avoid getting the infection in the first place.
My child has congenital heart disease (CHD). What should I do?
Thankfully, COVID-19 tends to affect adults and older people, far more so than children. However, children with congenital heart disease should be particularly careful, and their parents should also be particularly careful about avoiding any infection in the first instance. We would stress the importance that in these families, the entire family needs to be taking extra precautions with hand washing, social distancing, and all the measures that are in place to avoid getting the infection in the first place. That is certainly the most important thing to do, and if any signs of infection were to develop then medical care should be sought early.
Is there a coronavirus (COVID-19) vaccine available?
On February 21, 2021, Australia rolled out its first COVID-19 vaccinations. The first people receiving the vaccines will be priority groups who are at a higher risk from COVID-19, including quarantine, frontline healthcare workers, and aged and disability care residents and staff. Visit our FAQs on COVID-19 Vaccines & Heart Disease for more information.
If a coronavirus treatment is found, how soon could it be available at hospitals in Australia?
Depends what the treatment is. In addition to the vaccines, alternative treatment options are being explored in clinical trials and if they are effective (which will probably take 2-3 months to know for sure), these could be available almost immediately, particularly if the treatment involves a drug that has already been approved for use in humans.
If someone has a pre-existing heart condition, should they get the flu shot this year?
Yes. In fact, those with and without a pre-existing heart condition should get a flu shot, and it is probably advisable to get this as soon as possible. This will reduce your chance of getting the flu so that if you develop symptoms then it is unlikely to merely be due to the common flu. It will also reduce your chance of getting both the flu and COVID-19 (it is just possible that if you have the common flu you might be more susceptible to contracting COVID-19).People with pre-existing heart disease should also get a “pneumovax” vaccination to reduce your chances of getting bacterial pneumonia. The only exceptions to these vaccinations are those people who are immunocompromised or are taking drugs that suppress the immune system (eg heart transplant patients). In such cases, you should consult your doctor before getting vaccinated.
Is the Victor Chang Cardiac Research Institute doing any research in the coronavirus (COVID-19) space?
The Institute is actively planning a number of studies in the COVID-19 space, including investigations into the risks of COVID-19 for patients with heart conditions; tracking patients with certain forms of heart disease, such as spontaneous coronary artery dissection or dilated cardiomyopathy (DCM) to see if they have more severe disease should they contract COVID-19; evaluating the risks of heart rhythm disturbances with certain potential treatments for COVID-19 that are currently being evaluated, and using stem cells to suppress overactivity of the immune system, which occurs in patients with COVID-19 who develop severe respiratory problems.
Should people with heart disease stay home and self-isolate entirely?
Not if they are symptom-free, haven’t been exposed to anyone who has COVID-19 or haven’t just returned to Australia, but they certainly should be very diligent in practicing social distancing, washing/sanitising their hands frequently and perhaps even wearing a mask, when they go out.
I have a heart condition, do I need to cancel my upcoming doctor’s appointment/surgery at the hospital?
Well, this depends on why you are visiting the doctor and whether you are sick or not. Keeping on top of your heart condition will help you to be in better shape if you do become COVID-19 positive, so it is important to see your heart doctor regularly and to take all your usual medication. Many doctors are now doing “telehealth” appointments, so you may be able to be reviewed without physically having to attend a clinic or hospital appointment. Telehealth is not possible if you need urgent medical attention or any heart tests, such as echocardiography. If in doubt, ring ahead and see what your doctor recommends. As always, if you do need to attend a doctor’s appointment, don’t forget your social distancing and scrupulous hand washing.
How do I best care for someone with a pre-existing heart condition at this time?
People with pre-existing heart conditions have an increased risk of getting complications of COVID-19 infection and so prevention is the way to go. Both you (the carer) and the person you are looking after need to keep away from people who are possible viral carriers. This involves staying at home, social distancing and lots of handwashing. You both need to try to stay fit and healthy with regular exercise and good food. Of course, it is important that people with heart disease take their usual medication and see their doctor regularly.
I have a heart condition, should I be wearing a face mask?
Face masks should definitely be worn if you are COVID-19 positive, in order to limit the spread of viral particles if you cough or sneeze. If you are well and do not carry the COVID-19 virus, face masks may be helpful to reduce the number of times you touch your face, especially in situations when your hands might have been in contact with a contaminated surface. So, you probably don’t need to wear a mask at home but it may be good practice when you go to the supermarket or to other public places such as the doctor’s surgery.
I have a heart condition, can I still exercise right now?
Yes, it is very important that we all stay healthy right now and keeping physically active is part of this. For people with heart conditions, we recommend regular moderate exercise such as walking briskly for 30 minutes, at least 5 times a week. The amount of exercise each person can comfortably do will depend on what the underlying heart problem is – listen to your body! We all feel better if we exercise outdoors and get lots of fresh air. However, social distancing needs to be kept in mind even when outdoors, and exercise in crowded places should be avoided if possible.
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For all media enquiries and interview requests, please contact:
Julia Timms
Head, Media & Communications
j.timms@victorchang.edu.au
0457 517 355
Acknowledgement of Country
The Victor Chang Cardiac Research Institute acknowledges Traditional Owners of Country throughout Australia and recognises the continuing connection to lands, waters and communities. We pay our respect to Aboriginal and Torres Strait Islander cultures; and to Elders past and present.
