The disease caused by the novel coronavirus can harm other organs in the body -- including the heart -- and now two separate studies, published in the journal JAMA Cardiology on Monday, provide more insight into how Covid-19 may have a prolonged impact on heart health in those who have recovered from illness and may have caused cardiac infection in those who died.

"We've understood for a few months now that Covid-19 is not only a respiratory infection but a multi-system infection," said cardiologist Dr. Nieca Goldberg, medical director of the NYU Women's Heart Program and senior adviser for women's health strategy at NYU Langone Health in New York, who was not involved in either study.

"There is an acute inflammatory response, increased blood clotting and cardiac involvement. And the cardiac involvement can either be due to direct involvement of the heart muscle by the infection and its inflammatory response. It could be due to blood clots that are formed, causing an obstruction of arteries," Goldberg said.

"Sometimes people have very fast heart rates that can, over time, weaken the heart muscle, reduce the heart muscle function. So there are multiple ways during this infection that it can involve the heart."

Inflammation of the heart

One of the JAMA Cardiology studies found that, among 100 adults who recently recovered from Covid, 78% showed some type of cardiac involvement in MRI scans and 60% had ongoing inflammation in the heart.

The study included patients ages 45 to 53 who were from the University Hospital Frankfurt Covid-19 Registry in Germany. They were recruited for the study between April and June. Most of the patients -- 67-- recovered at home, with the severity of their illness ranging from some being asymptomatic to having moderate symptoms.

The researchers used cardiac magnetic resonance imaging, blood tests and biopsy of heart tissue. Those data were compared with a group of 50 healthy volunteers and 57 volunteers with some underlying health conditions or risk factors.

The MRI data revealed that people infected with coronavirus had some sort of heart involvement regardless of any preexisting conditions, the severity or course of their infection, the time from their original diagnosis or the presence of any specific heart-related symptoms.

The most common heart-related abnormality in the Covid-19 patients was myocardial inflammation or abnormal inflammation of the heart muscle, which can weaken it.

This type of inflammation, also called myocarditis, is usually caused by a viral infection, Goldberg said, adding that she was not surprised by these study results.

"What they're saying in this study is that you can identify myocardial involvement or heart involvement by magnetic resonance imaging," Goldberg said.

The study has some limitations. More research is needed to determine whether similar findings would emerge among a larger group of patients, those younger than 18 and those currently battling coronavirus infection inste

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