In the wake of the Delta and Omicron surges of the past year, physicians are finding that 10% to 30% of patients who have had COVID-19 are experiencing an array of life-altering, long-term conditions referred to as long-haul COVID. These include heart disease and cardiovascular-related symptoms, such as a fast heartbeat, shortness of breath, brain fog and chronic fatigue.
Research published this past winter in Nature Medicine called for better guidance on evaluation and treatment of patients with long COVID and cardiac involvement, and the American College of Cardiology answered soon thereafter with new guidance from experts.
Among those on the front lines of treating these patients is Dr. J. Jeffrey Marshall, interventional cardiologist at Northside and president of the Georgia chapter of the American College of Cardiology. Dr. Marshall believes the new guidance will help him and other physicians as they diagnose and treat patients with long COVID and cardiac involvement – and ultimately help them get back to living full lives.
“There are two different types of long COVID with cardiac involvement – one with symptoms but no objective findings of heart damage, and the other type is a syndrome with evidence of heart damage and cardiovascular symptoms,” Dr. Marshall explains.
Physicians diagnose long COVID when these conditions persist for three months or more after infection. It can occur even in patients who had mild or moderate cases of the virus.
Long COVID has hit close to home for Dr. Marshall. His long-time medical assistant, Ashley Morris, a healthy 42-year-old who contracted COVID-19 in fall 2021, was hospitalized for 12 days with serious complications. Seven months later, she cannot climb stairs and can tolerate only a few minutes of exercise. She has returned to work but has to sit most of the time, which is challenging for a medical assistant. Shortness of breath and bronchial spasms still plague her.
“My prognosis is unclear,” Morris says. “I hope my symptoms will get better over time…. For now, I do what I can. I listen to my doctor (Dr. Allison Dupont, one of Dr. Marshall’s partners). I certainly don’t take life for granted. Life is short. This puts things in perspective.”
But Ashley is one of the more fortunate patients with long COVID and cardiac symptoms. Others do not fare as well and cannot work or care for themselves, Dr. Marshall notes.
He advises people who have had COVID-19 and have symptoms, such as a fast heartbeat and chronic fatigue, that persist for more than three months to see their primary care physician for evaluation. The doctor may order tests, such as blood work, an electrocardiogram (EKG) and echocardiogram, or refer the patient directly to a cardiologist for testing and treatment, which may include cardiac rehabilitation and medication.
Learn more about Northside Hospital Heart Institute and cardiovascular care at Northside.