COVID-19 can cause serious cardiovascular complications including heart failure, heart attacks and blood clots that can lead to strokes, scientists have warned.
The researchers from the University of Virginia (UVA) in the US also cautioned that COVID-19 treatments can interact with medicines used to manage patients' existing cardiovascular conditions.
The article, published in the American Journal of Emergency Medicine, aims to serve as a guide for emergency-medicine doctors treating patients who may have or are known to have COVID-19.
The authors note that much attention has been paid to the breathing complications of COVID-19, but less has been said about the cardiovascular complications that can lead to death or lasting impairment.
"As we encounter more and more patients with COVID-19-related illness, we are increasing our understanding of its impact on the body in general and the cardiovascular system in particular," said William Brady, of UVA's Department of Emergency Medicine.
The researchers noted that heart failure is a particular concern in patients with COVID-19.
One study, the authors note, found that almost a quarter of COVID-19 patients -- 24 per cent -- were suffering acute heart failure when they were first diagnosed with the coronavirus.
The authors state that it remains unclear if the heart failure was the result of COVID-19 specifically or if the virus was worsening undiagnosed heart failure.
Of the patients with heart failure, nearly half were not known to have high blood pressure or cardiovascular disease, they said.
The report also noted that COVID-19, and other diseases that cause severe inflammation throughout the body, increase the risk that fatty plaque built up in the blood vessels will rupture, leading to heart attacks and stroke.
Influenza and certain other viruses have been associated with increased risk of plaque ruptures within the first week after the disease was diagnosed, the authors noted in their review of the available COVID-19 medical literature.
They also described potential drug interactions in COVID-19 patients.
For example, the highly publicised malaria drug hydroxychloroquine can interact with medications designed to regulate heart rhythm, in addition to causing heart damage and worsening cardiomyopathy, the authors said.
Remdesivir, an antiviral that is the only COVID-19 treatment authorised by the FDA, can cause low blood pressure and abnormal heart rhythm, they said.
It's important for doctors to bear these interactions in mind when treating patients with COVID-19, the authors noted.
"As we gain more experience with this new pathogen, we realise that its adverse impact extends beyond the respiratory system," Brady added.
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