Student Contributors: Monalisha Chakraborty, Arundhati Bose, BSc Biotechnology, Sem-IV

COVID-19 pandemic has immensely affected our lives. The doctors and scientists are working hard to decipher the mechanism of action of this virus. What has been elucidated so far is that the novel coronavirus mainly attacks the lungs resulting in Acute Respiratory Distress Syndrome. But it has not been clear so far how this virus affects the heart. Let us try to solve the puzzle here.

It has been reported that approximately 30% of patients developed heart damage following COVID-19 infection. While some of the patients already have a history of heart disease, the rest do not! So, some very mysterious connection is there between the novel coronavirus and the heart and this code yet to be cracked!

It is not new to the scientists and doctors that viral infection can interfere with the flow of blood to the heart and thus causing irregular heartbeat and even heart failure in severe cases. But the question remains unclear—why SARS-CoV-2 mediated incidence of heart damage is occurring more frequently in comparison with other heart diseases?

The virus is possibly attacking the heart directly. Maybe the virus is being circulated by the bloodstream and entering the heart. Heart cells are having surface proteins called Angiotensin-converting Enzyme 2 (ACE2), like the lung cells. ACE2 are the gateways for the virus to enter heart cells. ACE2 is normally having a protective “Anti-inflammatory” function; which helps to keep immune cells from inflicting more damage to the body’s cells. So, ACE2 controls the cytokine storm initiated by the virus-entry and also helps the virus to enter heart cells.

Now, the virus shows it’s true color! Once entered, it kicks out ACE2 protein and thus can damage host cells Directly or Indirectly, by preventing the body from ACE2 mediated anti-inflammatory protection. Now, this is obvious that inflamed, and damaged by the virus, the heart muscle will slowly stop functioning properly.

It’s really hard to decipher whether having more ACE2 is harmful or helpful in this context. The matter gets more complicated when the “game-changer” anti-COVID19 drug “hydroxychloroquine” could cause heart damage.  

Thus, it’s a challenge for all of us to find out a way to save our hearts. The situation becomes more challenging when the infected person is not diagnosed with any heart disease previously, thus becomes more vulnerable to the virus-induced heart damage. It is widely known that ACE-inhibitors and Angiotensin Receptor blockers are routinely used for the treatment of heart disease and also to control the blood pressure of an individual. But can we depend upon these drugs while infected with the virus as the upper mentioned medication acts as a double-aged sword; On one hand it can save the heart and lung from the virus-induced damage and on the other hand it can increase the chance of the infection. There is where we are helpless as more researches should be carried out to find out a solution.