How to avoid suffering from myocarditis after “Yangkang”?

  Recently, several provinces have released survey data, and the positive infection rate of the new crown in some places exceeds 60%. On December 29, 2022, Tang Xuefeng, Secretary of the Party Committee and Researcher of the Sichuan Provincial Center for Disease Control and Prevention, said in an interview, “We completed two online questionnaires from December 17th to 19th and from December 25th to 28th. 480,000 people and more than 230,000 people participated in the survey.” Tang Xuefeng said that according to the comprehensive judgment of the survey results, the overall infection incidence of residents in Sichuan Province has exceeded 80%.
  The first wave of people infected with the new crown who suffered the peak of infection in many places has gradually turned negative and gradually returned to normal work and life. At the same time, the physical condition after “Yang Kang” has also been widely concerned and hotly discussed. Related topics such as “Be careful of viral myocarditis after Yang passed”, “Fu Yang”, “brain fog after ‘Yang Kang'” and other related topics rushed to the hot searches.
  ”There is no need to be too fearful and anxious. Under the premise of a huge infection base, various symptoms will appear due to differences in individual physique.” Guo Wei, deputy chief physician of the Department of Infectious Diseases, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, told reporters. However, “Yangkang” does not mean that you can be unscrupulous. Even after “Yang Kang”, rest for at least 2 to 3 weeks, and avoid strenuous exercise during this period. At the same time, strengthen personal protection, improve your own immunity, and try to avoid multiple infections.
New crown infection may induce myocarditis

  Myocarditis is a nonischemic, inflammatory disease of the heart muscle that reduces the heart’s ability to pump blood. This inflammation can cause the heart to beat quickly or irregularly, which can lead to arrhythmias.
  A study published in the “Chinese Journal of Internal Medicine” on November 1, 2022 showed that the number of patients with myocarditis, the number of new cases, and the number of deaths in 2019 in China were 234,900, 275,100, and 13,100, respectively, compared with 1990 Year-on-year increases of 85.62%, 47.51% and 50.22% respectively. The morbidity and fatality rates were 16.94/100,000 and 0.92/100,000, respectively, a decrease of 6.06% and 16.04% compared to 1990.
  ”Compared with 1990, the overall burden of myocarditis in China in 2019 showed a downward trend, and the burden of myocarditis in men was higher than that in women, and more attention should be paid to the burden of myocarditis in the elderly population in China,” the above study wrote.

  ”After being infected with the new crown virus, the symptoms of some people may last for about two weeks.” Zhao Lan said that for the vast majority of people, the sense of smell and taste can generally recover within three months after being infected with the new crown virus.

  In a study released in September 2021 by the US Centers for Disease Control and Prevention (CDC) that included data from more than 900 hospitals, a total of more than 36 million patients were included, of which 4.0% were diagnosed between March 2020 and January 2021. Diagnosed with COVID-19 infection, 0.01% were diagnosed with myocarditis between March 2020 and February 2021.
  The results of the study showed that between March 2020 and January 2021, the risk of myocarditis in patients with new crowns was nearly 16 times that of patients without new crowns. In addition, in the study cohort, about 40% of patients with myocarditis had a history of new coronary infection. “These findings suggest an association between COVID-19 infection and myocarditis, although a causal relationship cannot be inferred from observational data.” The study points to COVID-19 infection as a risk factor for myocarditis, with risk varying by age group.
  A number of infection doctors told reporters that myocarditis is not only caused by the new coronavirus, but all respiratory pathogens may be induced. Because of the large number of infected people across the country in this epidemic, even though the incidence of myocarditis itself is very low, some related cases can still be seen.
  Zhao Lan, deputy chief physician of the infection department of a tertiary hospital in Xi’an, told reporters that clinically, the probability of myocarditis after infection with the new crown is much lower than the probability of severe disease. Before the epidemic of the new coronavirus, viral infections such as influenza virus, adenovirus, and Coxsackie virus existed all the time. These infections may induce myocarditis, but the probability is very low.
  ”According to the data published so far, after infection with the Omicron strain, the proportion of myocarditis diagnosed is 2‰ to 3‰. When the base of infected patients is large, the problem of myocardial injury should be taken seriously.” Department of Cardiovascular Medicine, Guangdong Provincial People’s Hospital Xue Yumei, deputy director and chief physician, talked about it at an expert interview meeting on December 30.
  ”During the recent diagnosis and treatment process, many patients have been found to have symptoms such as rapid heart rate after ‘Yangkang’. After checking troponin and other indicators, it was found that there was mild damage to the myocardium.” Guo Wei said that some patients used to sleep quietly at night. The resting heart rate is 50-70 beats/min. After being infected with the new crown, this value rises to 80-100 beats/min. Among the COVID-19 patients treated by Guo Wei, those with the aforementioned symptoms were not finally diagnosed with myocarditis, but experienced chest tightness, rapid heart rate, and palpitations during the recovery period.
  A chief physician of the Department of Critical Care Medicine of a tertiary hospital in Wuhan told reporters that the diagnosis of myocarditis cannot be determined by a single indicator. In addition to blood tests, imaging tests are also needed to confirm the diagnosis. Many people have found that some indicators such as myocardial enzymes have increased, which does not mean that they have myocarditis. However, when symptoms such as rapid heart rate, shortness of breath, and chest tightness appear in the body, attention should be paid.
  ”After ‘Yangkang’, you should pay attention to your daily heart rate changes.” In Guo Wei’s view, if the heartbeat is significantly faster, especially for a long time, you need to seek medical treatment in time. The problem involving the heart is more urgent than pneumonia in the lungs. If it is really serious, arrhythmia, myocardial ischemia, or even sudden death may suddenly occur, and it should not be taken lightly.
  ”After being infected with the new crown, the probability of developing heart failure is very low. Generally, for patients with mild symptoms, if they take more rest in daily life, the myocardial damage will recover.” Guo Wei added.
  On December 29, 2022, the official website of the Beijing Health and Medical Commission released the “Guidelines for Health Management of Patients with Novel Coronavirus Infection During the Recovery Period (First Edition)”. Symptoms, at this time, it is recommended to pay more attention to rest, adjust the daily routine, and maintain adequate sleep. At the same time, you should strengthen your own nutrition, eat more foods rich in protein and vitamins, and improve the body’s disease resistance. If the symptoms of palpitations are obvious, and the beats per minute continue to exceed 100 but less than 60 beats, or irregular beats occur, you need to be alert to the occurrence of viral myocarditis. It is recommended to go to the hospital for examination in time to find out the cause and take measures.

Can the new crown cause kidney damage?

  ”The season of high incidence of respiratory and intestinal infectious diseases is also the season of high incidence of myocarditis. The incidence of patients covers all ages. Young people who are usually healthy and have no underlying diseases may also have the possibility of myocarditis.” Zhao Lan said that myocarditis is also mild. In severe and severe cases, mild viral myocarditis is mostly just a high value of myocardial injury markers, and there are slight changes in the electrocardiogram, but there are no obvious symptoms of myocarditis. In severe cases, such as fulminant myocarditis, sudden death may occur in severe cases, but it is rare.
  According to a report by CNR.com on December 31, 2022, the team of Professor Yu Bo, Dean of the Cardiovascular Hospital and Director of the Cardiology Department of the Second Affiliated Hospital of Harbin Medical University, implemented ECMO technology and successfully treated two patients with sudden fulminant myocarditis due to new coronavirus infection. .
  ”From a medical point of view, the pathogenesis of fulminant myocarditis is still not very clear, and it may also be related to the patient’s specific constitution and infection with the new crown, which is a small probability event.” Zhao Lan said. During the onset of fulminant myocarditis, the heart rate is extremely fast, and symptoms such as severe fatigue, chest tightness, and chest pain may occur. The gold standard for diagnosing myocarditis is myocardial biopsy, but many cases of fulminant myocarditis are urgent, and the disease progresses rapidly within a day or two or even a few hours. Once the patient develops severe heart failure, ECMO is needed urgently for supportive treatment.
  ”Symptoms such as chest tightness and shortness of breath in some patients infected with the new coronavirus do not necessarily mean that there is a heart problem, but may also be related to respiratory symptoms, personal depression, and anxiety.” Zhao Lan said.
  In addition to myocarditis, “Yangkang” people also developed symptoms such as persistent cough, loss of sense of smell and taste. “Most of the new crown patients hospitalized in the hospital are seriously ill, and most of the patients who go to the general outpatient clinic are mildly ill, and the latter have symptoms such as persistent dry cough.” Guo Wei said that the number of people who came to the hospital for CT scans has increased a lot recently. From the CT results of the hospital From the point of view, except for the CT results of patients with persistent cough that showed scattered small lesions in the lungs, most outpatients did not have obvious pneumonia. “If you have a persistent cough accompanied by coughing up sputum and yellow-green sputum, you need to go to the hospital for timely examination.” Guo Wei suggested.

  ”After being infected with the new crown virus, the symptoms of some people may last for about two weeks.” Zhao Lan said that for the vast majority of people, the sense of smell and taste can generally recover within three months after being infected with the new crown virus.
  A few days ago, the symptoms of “brain fog” after “Yangkang” rushed to the hot search. Wang Gongqiang, chief physician of the Neurology Department of the Affiliated Hospital of the Institute of Neurology of Anhui University of Traditional Chinese Medicine, said in an interview with the media that at present, there is no research that can clarify the causality between the new crown and “brain fog”. However, we can infer that the physical and mental fatigue caused by the infection of the new crown will also cause us to have symptoms of “brain fog” to a certain extent.
  Studies have shown that the new coronavirus mainly infects through the binding of its surface spike protein to the ACE2 receptor on human cells. In October 2021, a study in “Nature” mentioned that although the respiratory route dominates the new crown infection, the highest levels of ACE2 receptors were also found in the small intestine, testis, kidney, myocardium, colon and thyroid .
  Can COVID-19 Infection Cause Kidney Damage? The above-mentioned chief physician of the Department of Critical Care Medicine of the top three hospitals in Wuhan said that this is related to the severity of the patient’s own condition. If it is a mild new crown patient, the proportion of kidney damage is very low. “If it is a new crown patient with severe new crown or serious underlying disease, the probability of kidney injury is relatively high, and this ratio can reach 20% to 30%.”
  ”Checking for kidney damage mainly depends on whether some renal function indicators are elevated, and the relationship with urine protein indicators is not very close.” said the chief physician of the Department of Critical Care Medicine.
  The mutation of the new coronavirus continues. According to the forecast data of the US Centers for Disease Control and Prevention (CDC), from December 25 to 31, 2022, the proportion of XBB.1.5 of the Omicron variant branch will reach 40.5%, which is almost double that of 21.7% in the previous week.
  Jin Dongyan, a professor at the School of Biomedical Sciences of the Li Ka Shing Faculty of Medicine at the University of Hong Kong and an expert in virology, told reporters that the virus strain has only caused a slight increase in the number of confirmed cases in the United States, and the number of hospitalizations and deaths has not changed significantly. “Even XBB.1.5 has not changed the fact that the new crown has become an endemic epidemic in the United States.” Jin Dongyan emphasized.
  Li Tong, Chief Physician of the Respiratory and Infectious Diseases Department of Beijing You’an Hospital, once reminded the public that after a period of time after infection with BA.5, the level of protection will decline, and the risk of reinfection will increase when encountering a strain with strong immune escape ability. However, re-infection mainly occurs in some immunocompromised populations, and the risk of re-infection in a short period of time is relatively small for people with normal immune function, and the symptoms after infection are usually milder than the first time.
  Guo Wei suggested that in daily life, personal protection should still be actively done, and protective measures such as wearing masks in public places, maintaining social distance, and avoiding places where crowds gather are taken.