How to deal with myocarditis caused by new coronavirus infection

 Recently, the first wave of new coronavirus infections in many places across the country has gradually turned negative. However, the discussion about sudden death caused by strenuous exercise in the short term after recovery has caused people to fall into a new round of worries.

Can infection with the new Coronavirus cause viral myocarditis? What should I pay attention to after suffering from viral myocarditis? 

How long can I exercise after recovery? 

Myocarditis is a rare complication of new coronavirus infection. 

In April of this year, the "Circulation" magazine published a research report, which analyzed more than 56,000 hospitalized patients with new coronavirus infection in 23 hospitals in Europe and the United States from February 2020 to April 2021. The results showed that, among every 1000 infected persons, 2.4 people were clearly or probably suffering from acute myocarditis, and 4.1 people were suspected of having acute myocarditis. Therefore, myocarditis is considered to be a relatively rare cardiovascular complication after COVID-19 infection.

"Myocarditis refers to myocardial localized or diffuse acute or chronic inflammatory lesions. Fulminant myocarditis is the most serious type of myocarditis. It has a sudden onset and extremely rapid progression, which can lead to malignant arrhythmia and heart failure. It can cause sudden death." Chen Yang, a  Cardiovascular expert at Sichuan Provincial People's Hospital, introduced that winter and spring are the seasons of high incidence of myocarditis. People with long-term fatigue are high-risk groups of myocarditis.

"Many factors can cause myocarditis, such as infection, autoimmune factors, etc. Among the myocarditis caused by infectious factors such as viruses, bacteria, spirochetes, etc., viral myocarditis is the most common, such as hepatitis virus, influenza virus, etc. It may cause viral myocarditis." Chen Yang said that from a clinical point of view, infection with the new coronavirus may indeed cause myocarditis, but the probability and severity of fulminant myocarditis still need to be revealed by more research.

After suffering from myocarditis, what problems should be paid attention to? 

Studies have shown that, unlike general viral myocarditis, there are more risk factors for myocardial damage after infection with the new coronavirus, such as advanced age, male sex, underlying cardiovascular disease, obesity, diabetes, hypertension, immunosuppression, and patients with severe systemic diseases. Myocarditis is more likely to occur after infection with the new coronavirus.

In this regard, Zhang Ran, a  Cardiovascular expert at the General Hospital of the Chinese People's Liberation Army, reminded that people with the above risk factors need to take personal protection and try to avoid infection with the new coronavirus; if they are unfortunately infected, they need to be highly vigilant for the occurrence of viral myocarditis; In addition, we must adhere to the standard treatment of chronic underlying diseases.

Viral Myocarditis Symptoms 

"The symptoms of viral myocarditis vary greatly from person to person. Mild cases have no subjective symptoms, and severe cases can manifest as severe arrhythmia, heart failure, cardiogenic shock and even sudden death." Zhang Ran said that after being infected with the new coronavirus, About 2 weeks after prodromal symptoms of infection such as fatigue, muscle soreness, nasal congestion, runny nose, sore throat, cough, etc., if symptoms such as chest tightness or chest pain, dyspnea, palpitations, dizziness, and extreme fatigue suddenly appear, you need to be alert to the possibility of viral myocarditis up.

"When the above symptoms appear, you should see a doctor in time. Patients diagnosed with viral myocarditis, whether mild or moderate, are recommended to be hospitalized." Zhang Ran emphasized.

Exercise after recovery needs to be cautious. 

Most patients with viral myocarditis can recover by themselves, and some patients may have sequelae such as arrhythmia and heart enlargement if the disease persists. Zhang Ran warned that patients who develop myocarditis after being infected with the new coronavirus should pay attention to rest within 3 months after discharge, avoid heavy physical labor and strenuous exercise, follow up regularly in outpatient clinics, and review the heart by rechecking electrocardiogram, dynamic electrocardiogram, and echocardiography according to the condition. 

Structural and functional recovery.

"What needs to be reminded is that after being infected with the new coronavirus, even if the results of the antigen test or nucleic acid test have turned negative, it is still not recommended to engage in any form of strenuous exercise within 2 weeks. After a period of time after being infected with the new coronavirus, the human body is still in immune dysfunction Excessive exercise will lead to fatigue, reduce the body's immunity, and easily induce viral myocarditis." Zhang Ran said, especially those with cardiovascular diseases and other basic diseases, frail people and the elderly, need to rest for 3 hours after "Yangkang" Only after more than a month can you gradually resume exercise under the guidance of a doctor.