Young people are more likely to suffer a heart attack after COVID-19: a cardiologist has given advice on how to proceed in the first months after infection.

Delfi rytas spoke with cardiologist Rokas Šerpytis, a physician at the Santara Clinics of Vilnius University Hospital, about the possible connection between myocarditis and the vaccine and what we know about the effects of the virus on the cardiovascular system.

– The Israeli government has identified 62 cases of myocarditis. In total, more than 5 million people have been vaccinated. people. We know that Israel is one of the first to vaccinate its society. So far, a study from the country has not confirmed a link between heart inflammation and the vaccine. However, what is your opinion, as a cardiologist, about how the vaccine might be associated with this disease?

– Evaluating the published data, myocarditis was detected in 60 people. Compared with last year and the year before, the incidence of myocarditis is not higher. And 5 million people have been vaccinated.

Otherwise, the incidence of myocarditis in the population is 10 to 20 cases per 100,000 inhabitants. What they say is that the frequency is 1 in 100,000. population, that is, 10 times less. Okay, maybe we can think that [tai įvyko] for two months. We divide by 12 and get a number that will be even less.

I think there is no clear connection. Everyone is more attentive to some side effects and that fixes it. Since 5 million people in the entire population have been vaccinated, it is automatically some kind of disease that those people suffer from. They live their lives and sometimes get myocarditis. It is not more common than usual.

– As you mentioned, 1 in 100,000 people suffered from myocarditis. vaccinated individuals. Still, it is an interesting fact that among men between the ages of 18 and 30 there were 1 in 20 thousand, which is 5 times more often. Why might such a disease be more common in young men? In general, when it comes to myocarditis, is this inflammation more common in this particular age group and gender?

– These are more common in younger and more active people, who are more likely to develop viral infections that can complicate myocarditis. This is the causal link: they are more active, come out more frequently, become more infected with these viruses, and develop myocarditis.

As I mentioned earlier, 1 in 20 thousand, that is, multiply by 5 – 5 out of 100 thousand. – significantly less than usual. There is no connection.

– By eliminating you, the majority of health professionals, the Israeli government itself has emphasized that, even if some possible link between certain disorders and the vaccine is confirmed, the benefits of vaccines far outweigh the potential risks. Probably, attention should be paid here to the damage done to the human body by the virus itself. What we know today about how the virus affects the cardiovascular system. Do we have new data?

– Very good question, because we are talking about several cases per 100,000 inhabitants. In reality, if a person develops a COVID-19 infection, one in five people is diagnosed with heart damage, an increase in troponin.

Of those who suffer an infection after an MRI, an MRI test is done every second. Here we are talking about every second and some cases for every 100,000 inhabitants are incomparable things.

Another thing is that having a COVID-19 infection greatly increases the chances of clots forming. A prothrombotic condition develops that can cause a person to develop a type of thrombosis in the body, a myocardial infarction, or a pulmonary embolism in a few months.

In the past, younger people with myocardial infarction used to go to the hospital, but these were quite rare cases. Now every week we admit one to several 35-year-olds who have no risk factors for cardiac resuscitation with myocardial infarction or pulmonary artery thromboembolism. The benefit-risk balance is simply unmatched.

If there are 4 in 1 million cases of blood clots after vaccination, then women using contraceptives alone have a risk of thrombosis of 500 to 1,000 per million, and those who have relapsed with COVID-19 infection may have up to 100,000. for a million. They are incomparable things.

– We will probably see later how the statistics on cardiovascular diseases have changed. But I understand that already in your daily work you see trends in the health consequences of COVID-19, the number of patients is increasing. What symptoms would you advise paying attention to, especially in young people, which are not risk factors?

– COVID-19 infection notably increased household mortality during the first and second waves. During the first wave, mortality at home increased to 40 percent and in the second wave to 90 percent. These are real and very large numbers in Lithuania.

If you do get infected, you need to take care of yourself. Months after COVID-19 you should be at rest: drink plenty of fluids and avoid strenuous exercise.

With regard to drugs, studies are still being carried out on the advisability of using coagulants and in what doses. We can’t say that yet.

Increased inflammation has been seen in people with low omega-3 levels, increasing the risk of thrombosis. Several studies are currently underway to evaluate omega-3 use after COVID-19 infection and whether that reduction in inflammation can help prevent thrombosis.

It is water, calm and you can take omega-3 supplements up to 2 grams a day.

– For a long time, there was not much talk about vaccines: both influenza and tick-borne encephalitis. We probably don’t even know what its side effects are. Now there are many doubts in the world: both about Vaxzevria and about the Johnsson & Johnsson vaccine, here are the questions about Pfizer. Are side effects affecting blood clotting common when it comes to antiviral vaccines? Is there something new in it, or have we just become more interested in those vaccines?

– You see, they don’t cause that thrombosis, what are we trying to talk about. The percentage is very low and is not higher than any other year. Only people are more interested.

It goes without saying that everyone sees this as a new vaccine, that the research is not great, but the COVID-19 infection has greatly accelerated medical progress – the vaccine has developed much faster and there has been much collaboration. higher between different institutions. If there are any side effects, they are noticeable much faster.

Yes, all vaccines have some side effects, but they happen early, in the first few days, and that’s it. The person is then protected from a threatening illness that can often lead to death. The benefit-risk balance is even incomparable.

– With regard to cardiovascular diseases in Lithuania and in the world, the statistics are certainly not very encouraging yet. Can you predict how a COVID-19 pandemic will affect the cardiovascular disease situation? Is it possible to have much sadder consequences?

– We see this as an increase in mortality from cardiovascular diseases, in part because people cannot always see medical professionals on time. This is observed not only in Lithuania, but also around the world. COVID-19 infection exacerbates chronic illnesses, which sometimes become acute. Often times, it is not perfectly healthy people who end up in the hospital, but rather those who have some kind of disease that has not been diagnosed.

Certainly, there are not many cases in which drugs are prescribed and cause a side effect simply because there is, let’s say, some oncological process that a person suffers, but it is not diagnosed. And when the CT scan is done, we see that there are already metastases everywhere and it only accelerates what would have come out in the near future.

Yes, we see it and those chronic diseases are greater, the greater the number of complications of those chronic diseases.

People who have high blood pressure, diabetes, or high cholesterol just shouldn’t stop taking these drugs or combine them. And if there are any problems, COVID-19 infection often causes very strong pressure fluctuations, higher heart rate, impaired glucose, insomnia, which in turn causes harm, you should consult a family doctor or other specialist to help you get through that period after Infection.

– The effects of vaccines are unquestionable: we see not only in theory but also in practice that the vaccine helps to overcome this pandemic. But there are still people who doubt them. What would be your advice for those who still have doubts, get vaccinated or not?

– It is very important to vaccinate as many people as possible so that we can acquire collective immunity as soon as possible so that the disease does not spread or new cases occur.

Clearly, what I would like to note is that everyone thinks the vaccine is a miracle cure and that we will all be healthy. Probably now, as it was, there will be no more. We will live with it for a long time. This is war. Now we are all used to it, but it used to be a great tragedy. Everyone was looking if there were 1-2 cases, and now 10-20 people die every day, everyone is used to it.

Be that as it may, this is a war. And each war lasts at least 4 years. Probably, one should not think that everything will end now and prepare not for the sprint but for the marathon all the time. It seems that the work will be much longer than we think.

Everyone thinks that year, year, and everything will pass soon. And we’re going for the second year, we can already see that ending, but we can’t say exactly where it will go and how. The world is big. Suppose that the countries in Africa, which are less prosperous, have significantly fewer vaccinated people.

What we see in India, where the climate is warm, and what is the prevalence of a pandemic everywhere, then those varieties can occur. It’s important to keep them to a minimum and get vaccinated as soon as possible, and then keep people on the vaccine and prevent them from getting infected and getting sick.