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Since the coronavirus arrived in Norway, more than 40 patients have been admitted for rehabilitation at the National Association for Heart and Lung Diseases (LHL) hospital in Gardermoen.
Patients have clearly shown how hard the coronavirus can hit, and some have had to learn a lot again.
In addition to rehabilitation, the hospital is participating in a study, which includes corona patients who have suffered a serious illness.
– So far we have found disability in both the lungs and the heart, says pulmonologist E claim C. Borna at Dagbladet hospital.
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The study will follow patients for a year and therefore will not be completed.
Around the world, there are several studies showing that coronary heart disease can have an effect on the heart.
– Studies from other countries show MRI images of the heart with changes and weakening of the pumping function of the heart muscle, says Borna.
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– worried
Cardiologist Mao Chen from Sichuan University in China tells Nature that about one-third of corona patients experience symptoms that affect the heart in the acute phase of the disease. One of the symptoms is cardiomyopathy, which stretches the heart muscle or makes it stiffer or thicker and affects the heart’s ability to pump blood. Some patients have also had blood clots.
– My biggest concern is the long-term effects, says Chen.
In some patients, the risk of cardiovascular disease is present “for a long time,” he says. However, Chen is aware that studies of these patients are still in their infancy and that it is too early to determine what consequences the coronavirus will have for patients in the long term.
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Many reasons
Cardiologist Wasim Zahid tells Dagbladet that the effect of COVID-19 on the heart may be due to a number of reasons.
– One is that covid-19 increases the risk of blood clots, so it is conceivable that patients have small blood clots in the coronary arteries around the heart that cause small heart attacks. The other is called myocarditis, which is a direct viral inflammation of the heart muscle cells that damages the muscle.
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The coronavirus primarily attacks the lungs, and this can also be a factor that weakens the heart muscle.
– The heart and lungs are closely related. If there is great resistance in the lungs, it puts extra pressure on the heart, which can contribute to injury.
Whether the injury will be chronic or something happens is too early to tell, Zahid emphasizes.
– But we are concerned if this will cause long-term damage. That is our job as cardiologists. That’s why it’s important to study this, he says.
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Chronically tired
For patients who have studied LHL, the consequences of the disability on the heart or lungs have been that they are not able to function as they physically want.
– Those who have it, get tired of it, says the pulmonologist Borna.
Chronic tiredness, in technical language called fatigue, is one of the most common side effects of COVID-19. However, residents do not believe that everyone who experiences fatigue after COVID-19 has heart problems.
– The main reason why many people are tired is probably that the body has a reaction. I don’t think everyone who is tired has heart problems. The explanation for this probably lies more in the central nervous system, he says.
Many tendon injuries
Many of the crown patients report the same tendon injuries:
– What recurs is shortness of breath, stabbing chest pain, and many are bothered by the feeling of stiffness in the lungs. They tire quickly, and several describe chronic fatigue, Borna says.
A study of 143 people who had been hospitalized in Rome found that 53 percent were still experiencing fatigue on average two months after crown symptoms appeared. 43 percent also had shortness of breath, writes Nature.
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Fatigue has also been shown to cause tendon damage in people who have only experienced mild symptoms. Many people struggle to focus for more than a few minutes at a time, while others find it difficult to just get out of bed in the morning.
According to Borna, many of the LHL Hospital patients are unsure why the body reacts the way it does.
– It is frustrating not being able to give the patient a good answer to all questions. Because we can’t pinpoint exactly what causes all the symptoms, since the virus is so new.
Early rehabilitation is important
In June, the LHL hospital had a peak of corona patients admitted for rehab, but during the summer the number dropped.
– Now he has started to recover and we currently have six or seven hospitalized patients, with more on the way, says Borna.
Borna believes the increase is related to the fact that many of the patients choose to go home after being hospitalized.
– Some are followed up by a municipal physiotherapist after their hospital stay, but never recover. Then they will come to us at a later date.
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However, according to Borna, it is clear that it is important to start rehabilitation quickly.
– Those who start rehabilitation early after illness have a better progression and recover faster. Those who start late have worse progression. From our patients, it appears that prior rehabilitation has a very effective effect.
Many people who start rehab late have been bothered by the aftermath of coronary heart disease for many months, Borna says.
– They often have various ailments, even months after being infected for the first time. You are chronically tired and remember poorly.
– Do you think that the problems some people experience will last?
– I do not expect it to happen, but so far we know too little about the sequelae of coronary infection to answer this.
