In Wuhan City, Hubei Province, China, there has been a flurry of pneumonia cases. On January 9, 2020, China’s health authorities announced that it was a new strain of coronavirus. The COVID-19 Pandemic was caused by the SARS-CoV-2 coronavirus, which spread in Greece from February 26, 2020 onwards, affecting our everyday life at a socio-economic and health level. Infection with the COVID-19 virus has various clinical manifestations from asymptomatic to catastrophic respiratory and cardiac failure. In the heart, COVID-19 can cause: inflammation (myocarditis and/or myopericarditis), arrhythmias, thromboembolic and ischemic events, heart failure, cardiogenic shock and sudden death. We must emphasize that the risk of the above cardiac complications is much greater in patients with pre-existing cardiovascular disease, such as arterial hypertension, coronary heart disease, valvular diseases with or without prosthetic valves, arrhythmias such as atrial fibrillation and heart failure. Therefore, prevention is the key to dealing with the COVID-19 pandemic.
What are mRNA vaccines and how do they work?
Nowadays, mRNA vaccines (as a whole) are the most modern, fast and effective way of vaccination, especially in times of great need such as the pandemic. Data from 10 years of experimental and clinical studies show that these vaccines are safe. Specifically, mRNA vaccines are: non-infectious, do not interact with body cells and do not cause mutations. After the production of the defense they are destroyed and eliminated directly through physiological processes, without invading the interior (nucleus) of the cells and without interacting with our genetic material (DNA). On the contrary, according to recent data, the COVID-19 virus interacts with our DNA at a rate of 10-20%.
Cases of an inflammatory reaction of the heart in the form of myocarditis and/or myo-pericarditis have been described in the first days after the 2nd dose of mRNA COVID-19 vaccine, mainly in adolescents and young adults. The latter complications usually manifest themselves asymptomatically or with mild symptoms, such as palpitations, shortness of breath or discomfort, and are treated symptomatically (antipyretic – anti-inflammatory) and with rest. Usually patients return to their daily lives after the symptoms have completely subsided. However, the return to exercise and sports activities needs special attention. We emphasize that patients with prosthetic valves constitute a special population group that have a greater thromboembolic risk. Therefore, patients with prosthetic valves require special attention and may need stricter monitoring and/or hospitalization with individualized anticoagulation.
Should we be vaccinated?
Studies show that the risk of the above heart complications due to COVID-19 is much higher, even multiple times compared to that of the mRNA vaccine, and therefore the probability of their occurrence is much higher if we are not vaccinated after all. The researchers observed that per million population fully (and with the 2nd dose) vaccinated could avoid: 11,000 new cases, 560 hospitalizations, 138 intensive care unit admissions and 6 deaths due to virosis from COVID-19, as opposed to approximately 40-45 cases of myo/pericarditis due to mRNA vaccination. Therefore, in any case the risk of heart attack from mRNA vaccines is much smaller compared to the risk caused by the disease itself.
Unfortunately, the official statistical data to date (09/21) (CoVid19.gov.gr) show that as a country we are low in terms of the percentage of the population per municipality who are vaccinated. The image shows the vaccination rates against COVID-19 in our country until August 4, 2021 by Municipality.
In conclusion, we emphasize that the presence of cardiovascular complications due to COVID-19 is a poor prognostic factor and therefore rapid and correct treatment limits the risk. Maintaining general preventive measures and vaccination are currently the ONLY means of prevention. Finally, clinical studies with drugs against COVID-19 are underway with promising initial results.