Since a virus now known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in late 2019 and was declared a pandemic in March 2020, scientists have been racing to understand the virus and the new disease known as COVID-19. We have much to discover, but emerging evidence points to these facts.
What we know about the COVID-19 pandemic:
- A heart attack, stroke or cardiac arrest is still an emergency that requires immediate medical attention during the COVID-19 outbreak. Call 9-1-1 if you or someone with you experiences signs of a heart attack, stroke or cardiac arrest.
- About 8 out of 10 people who get COVID-19 will experience mild to moderate respiratory illness and will recover without requiring special treatment or hospitalization.1
- About 1 in 6 people who get COVID-19 will become seriously ill and develop difficulty breathing.2
- There is an increased risk of more serious complications from COVID-19 for people who:
• Have an underlying medical condition such as a heart condition, stroke, high blood pressure, diabetes, cancer, chronic lung disease, or a compromised immune system3,4
• Have risk factors such as pregnancy, smoking or vaping,5 or poor diet
• Are aged 65 and over.4
- People in an assisted-living facility, long-term care home or retirement home may be at increased risk for developing COVID-19-related complications.4
- Currently, nearly half of COVID-19 related deaths in Canada are related to outbreaks in long term care homes. Residents of long-term care facilities are particularly vulnerable due to communal living spaces, shared healthcare providers, external visitors and transfers from other healthcare facilities.6
- Cardiac and stroke emergency response teams remain available to care for people with new onset or worsening symptoms of stroke and heart conditions. Telemedicine (virtual visits with healthcare providers) is in place and is more important than ever to ensure ongoing care and management.7–9
While COVID-19 is typically considered a threat to the lungs, there is an additional threat to the heart.
- People with pre-existing heart conditions are particularly vulnerable and face a higher risk of dying from COVID-19.5
- Emerging data shows that people with heart conditions are four times more likely to die from the virus than patients with no underlying conditions.10
- Some COVID-19 patients also had other heart conditions:
• Up to 1 in 3 (15%-31%) had high blood pressure.11
• More than 1 in 3 (35%) had several underlying conditions, including high blood pressure, coronary heart disease and cardiomyopathy.12
- People with high blood pressure have nearly 2 ½ times higher chances of dying if they contract COVID-19, compared to those with no underlying conditions.12
- Like other respiratory syndromes such as influenza (flu), COVID-19 can cause injury to the heart, even in patients without a history of heart disease, resulting in poorer outcomes.13,14
- The mortality rate among patients who suffer a cardiac injury while in hospital for COVID-19 is 51% (1 in 2 people).14
What we know about COVID-19 and the brain:
- Emerging data shows that people who have had a stroke are three times more likely to die from the virus than patients with no underlying conditions.10
- Many of the risk factors associated with increased risk for stroke are also associated with increased risk of poorer outcomes with COVID-19, including age, high blood pressure and diabetes.5
- Stroke survivors who experience swallowing difficulties are at increased risk of food going into the lungs and causing infection (aspiration pneumonia). These people are at higher risk of poorer outcomes with COVID-19.
- People living with stroke and vascular cognitive impairment (including dementia) may be especially challenged during this time as they often depend on others to help with their daily needs. People with vascular cognitive impairment are at increased risk of social isolation, and caregivers may also experience increased difficulties.15
What we know about COVID-19, smoking and vaping:
- If ever there was a time to quit smoking and vaping, it is now.
- Any kind of tobacco smoking is harmful to the cardiovascular and respiratory systems.16 People with COVID-19 who have pre-existing cardiovascular and respiratory issues due to tobacco use or otherwise have poorer outcomes.17
- Smoking is most likely associated with a negative progression and adverse outcomes for COVID-19 patients.18
1. World Health Organization. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). 2020.
2. World Health Organization. Q&A on coronaviruses (COVID-19). https://www.who.int/news-room/q-a-detail/q-a-coronaviruses.
3. Zhou F, et al. The Lancet. 2020.
4. CDC. Coronavirus Disease 2019 (COVID-19). Centers for Disease Control and Prevention.
5. CDC. February 12–March 28, 2020. MMWR Morb Mortal Wkly Rep.
6. Public Health Agency of Canada. Guidance for infection prevention and control of COVID-19 for long-term care homes. 2020.
7. Portnoy J, et al. J Allergy Clin Immunol Pract. 2020.
8. Klein BC, et al. Neurology. 2020.
9. Meyer BC, et al. Lancet Neurol. 2008:787-795.
10. Chen R, et al. CHEST. 2020.
11. Clerkin K, et al. Circulation. 2020.
12. Lippi G, et al. Pol Arch Intern Med. 2020.
13. Guo T, et al. JAMA Cardiol. 2020.
14. Shi S, et al. JAMA Cardiol. 2020.
15. COVID-19 Updates. Ontario Neurodegenerative Disease Research Initiative (ONDRI).
16. World Health Organization, World Heart Federation, The International Tobacco Control Policy Evaluation Project (the ITC Project) 2012.
17. Guan W, et al. N Engl J Med. 2020.
18. Vardavas C, et al. Tob Induc Dis. 2020.