Mechnical AV and Corona Virus Risks- March 2020

[drivetopless]

This may be a dumb question, but I have not talked to my cardiologist about it and do not plan to go to his office any time soon because of the social distancing. With the Corona Virus, is someone with a mechanical heart valve,10 years post surgery, and otherwise in good health considered high risk? Let's assume mid 50s in age. Thought some of you might have talked to your docs and could share what you've learned. Is being on coumadin an issue if you contract the virus?

I'm still social distancing, but just wondered about increased risk a mechanical valve adds without any other risk factors present (diabetes, hbp, coronary artery disease, copd, etc).
Thanks!

 

[robojerry]

I would also very much like to know the answer to this. I've heard that if you're offered the flu jab every year (in the UK) then that is a good indication that you're high risk. I am, but at the same time I feel like my heart issue has been fixed and to certainly doesn't effect my day to day life. I'll contact my doctors I think, especially since my company has now said that anyone with underlying health conditions should be off for 12 weeks (I work in a customer facing role that is still, despite all the measures put in place, very busy). Again though, I don't feel like it's a "condition", and the only category it falls into is Chronic Heart Failure...

 

[Patrick7651]

This is also something I would like to know. I did contact my Cardioigist via one of his nurses. The response I received was pretty much the standard procedure being advised to the general public with a final caveat of “don’t leave your home unless you have to”. Of course I have been reading as much as I can regarding “high risk” patients. According to the CDC people on blood thinners are in that category. I don’t believe we are necessarily at higher risk to become infected, but are at more risk for complications. The articles I have read about the progression of Covid-19 describe what happens to the infected lungs. As it progresses the over reaction of our immune system actually destroys healthy tissue and causes fluids (blood) to enter the lungs more readily. Of course if you are on blood thinners the ability of your blood to clot is compromised. In a hospital situation this could be managed by countering the thinners but by doing so would increase stroke risk. I am not a medical professional but that is my take on being considered high risk if I am exposed to the Coronavirus.

 

[pellicle]

Hi

With the Corona Virus, is someone with a mechanical heart valve,10 years post surgery, and otherwise in good health considered high risk? Let's assume mid 50s in age.

recent discussion (with a very high "noise to signal" ratio) recently had these good points:

no, nothing like that ... between 2.5% and 3% ... but mainly the elderly.
Coronavirus Age, Sex, Demographics (COVID-19) - Worldometer

AGE​	DEATH RATE confirmed cases	DEATH RATE all cases
80+ years old​	21.9%​	14.8%​
70-79 years old​	​	8.0%​
60-69 years old​	​	3.6%​
50-59 years old​	​	1.3%​
40-49 years old​	​	0.4%​
30-39 years old​	​	0.2%​
20-29 years old​	​	0.2%​
10-19 years old​	​	0.2%​
0-9 years old	​	no fatalities​

I am an insulin dependent diabetic and have heart failure, so I already am. I think a lot will depend on people's own health conditions, and perhaps how densely populated your area is? I will still go out, fresh air is good! But not to crowded areas.

View attachment 887330

Just wanted to remark on this:

first I've ever heard about this and unable to find anything at all to support this claim

Here is a good "lay person" explanation
Here’s the Damage Coronavirus (COVID-19) Can Do to Your Lungs

and a more detailed one mentions something about it once

Pulmonary pathological features in coronavirus associated severe acute respiratory syndrome (SARS)
Focal haemorrhage was seen in some cases. Apart from one case with apical pleural adhesion, pleuritis was not apparent. Mild and small pulmonary thromboembolism was only noted in patient 7

not that it is a respiratory illness not a cardiovascular one.

So you should fit into the age related groups above. If you aren't a smoker I'd say you're skewed towards "better outcomes" than those above.

Be sensible about your precautions, life goes on. Its more about government shutting down the vectors of intercontinental transport (which they finally now have), because the virus does not spontaneously generate, so if someone doesn't carry it to you its not going to get to you

 

[Astro]

Hopefully warfarin does not effect the severity of covid 19 infection. I can see that it may be an additional complication for those who develop severe illness.

Covid 19 is a respiratory illness but also attacks the heart. The Chinese data shows that 12% of covid patients have a raised troponin level which shows that heart is affected. Their data also showed that heart failure and arrhythmia are common causes of death in those who had severe illness. Early research indicates that covid enters cells via ACE2 receptors. ACE2 receptors are located in lungs, heart and lining of blood vessels. Unfortunately, it is not just a respiratory illness.

Bottom line: we should view ourselves to be at risk, particularly those approaching surgery or recently recovering from surgery. Take no unnecessary risks, keep safe.

 

[Astro]

Sorry if my above post is rather confronting. The big majority of patients, including those with heart disease, do recover from covid 19. However, there is increased risk and we should take this seriously.

 

[pellicle]

Sorry if my above post is rather confronting.

?
seemed rational and logical to me

 

[gerrychuck]

That all lines up with what I have found as well. Great summary Astro.

 

[vitdoc]

There can be a hemorrhagic component to the disease. One local case here of a 34y male who died started with coughing up blood. I suspect that in the severe cases anticoagulation would be discontinued until things improved. Hence possible issues with mechanical valves. There has been some discussion that the disease in it’s severe form my have an anticoagulant component. Key word is severe.