COVID-19 can have lingering effects on the body, and in some people, it may affect the heart. Long-term COVID-19 heart complications can include heart failure, an irregular heartbeat, coronary artery disease (CAD), and heart attacks.

The COVID-19 pandemic caused over 6.8 million deaths from at least 753 million cases worldwide, according to the World Health Organization (WHO) at the time of writing.

However, the disease is still fairly recent. Medical researchers continue to learn more about its long-term effects on people’s respiratory, nervous, and digestive systems.

This article explains the effects of COVID-19 on the heart, how to recognize symptoms, how common heart failure can be after COVID-19, and the outlook for those who develop heart failure after having the disease.

Coronavirus data

All data and statistics are based on publicly available data at the time of publication. Some information may be out of date. Visit our coronavirus hub for the most recent information on COVID-19.

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While COVID-19 most directly affects the lungs, the heart needs a steady supply of oxygen to function properly. Lung damage can stop oxygen from getting to the heart muscle, affecting how it pumps oxygen around the body.

Another factor contributing to heart damage is inflammation.

When the immune system fights off a viral infection, it triggers inflammation. However, COVID-19 can cause too much inflammation in some people, which can cause even more damage or interfere with the electrical signals that regulate how it pumps. Additionally, inflammation may cause blood clots throughout the body, including in the heart.

Some researchers are also investigating whether COVID-19 damages heart cells directly, but research is ongoing.

It is important to note that not all people with the virus will have heart damage — in fact, most will not. However, those with certain preexisting chronic health conditions might face a greater risk of developing heart problems after getting COVID-19. These include:

  • cardiomyopathy
  • CAD
  • diabetes
  • heart failure
  • hypertension
  • obesity
  • stroke
  • vasculitis

There are no specific symptoms that indicate that a person has heart damage after having COVID-19. However, people who have experienced damage to their bodies may have long-term COVID-19 symptoms. These appear differently for different individuals.

According to the Centers for Disease Control and Prevention (CDC), COVID-19 can cause the following long-term respiratory and heart symptoms:

  • breathlessness
  • coughing
  • chest pain
  • heart palpitations

A range of other symptoms may accompany these, including:

  • extreme tiredness
  • symptoms that worsen from exertion
  • brain fog
  • headache
  • sleep difficulties
  • dizziness and lightheadedness
  • depression
  • anxiety
  • altered smell and taste
  • diarrhea
  • stomach pains
  • painful joints or muscles

Heart failure after COVID-19 is relatively uncommon. However, because SARS-CoV-2, the virus that causes the disease, is so new, researchers are still investigating the condition.

A large 2022 study used data from 1,628,424 people with confirmed COVID-19. The researchers found that over the whole sample, 1.1% of participants with COVID-19 experienced heart failure, framing it as a rare complication.

The researchers concluded that the risk of heart failure increased by 90% for people within the 9 months after developing COVID-19. They also reported that this risk had a direct relation with high blood pressure and older age.

Another study using a sample of 153,760 participants found that the risk of heart failure was 72% higher in people who had confirmed COVID-19. This was even when symptoms were severe enough to warrant hospital admission.

A different 2022 study within one United Kingdom health center compared the mortality rate of heart failure among people who stayed in a hospital with COVID-19 and those in the hospital for other conditions.

The study found that within 367 days of discharge, people who left the hospital after a COVID-19 admission had a heart failure risk of 2.3% compared with 1.5% in non-COVID-19 patients. These individuals also had a mortality rate of 3.3% compared with 2.6% in non-COVID-19 patients — or an increased mortality risk of 27%

However, according to a 2021 study, 11% of people who had acute heart failure before their COVID-19 diagnosis died within 30 days.

It is important to be aware of potential symptoms of heart failure if an individual has had COVID-19 previously. These include the following symptoms:

  • breathlessness that affects a person’s daily activities
  • the heart beating faster than usual
  • unexpected and rapid weight gain
  • swelling in the ankles, legs, and feet
  • mental confusion, memory lapses, or experience cognition problems
  • constant coughing or wheezing

While these are not signs that heart failure has links to COVID-19, it is important to follow up on any signs of heart failure. They can progress to life threatening events such as stroke and heart attack.

COVID-19 can damage the heart and increases a person’s risk for heart failure, even if symptoms are not severe enough to warrant hospital admission. It can also increase the risk of serious complications for people who already lived with heart failure before contracting SARS-CoV-2, the virus that causes the disease.

Those who notice palpitations, breathlessness, and increased fatigue should consult a healthcare professional to rule out heart failure or other serious post-COVID heart conditions.