Dr. Pamela Marcovitz with a patient.

Sindhu Koshy, M.D., a cardiologist affiliated with Henry Ford Health System, says that her female patients tended to fall into bad health habits during the pandemic.

As COVID receded and patients started to return in normal numbers to the Beaumont Ministrelli Women’s Heart Center, Pamela Marcovitz, M.D., a cardiologist and the center’s medical director, began to observe the pandemic’s impact on her patients. 

From a cardiac perspective, she found that some patients’ lifestyles improved during the lockdown. They had more free time and couldn’t eat in restaurants, so they began cooking with healthy ingredients, which had a positive impact on their heart health.

“Restaurants tend to use a lot of salt. By eating at home their blood pressure was controlled better,” Marcovitz says. “Sometimes they used the extra time to exercise more. So, they had better cholesterol levels and blood pressure. Some lost weight — usually 5-10 pounds but one woman lost 38.”

Dr. Sindhu Koshy
Dr. Sindhu Koshy

But other patients responded differently — eating more restaurant carryouts and binge watching television. These patients didn’t do as well, she reports.

Sindhu Koshy, M.D., a cardiologist affiliated with Henry Ford Health System, says that her female patients tended to fall into bad health habits during the pandemic.

“They were not exercising and were eating more junk food,” she explains. “The pandemic took a higher toll on women because many had to supervise their children doing virtual schoolwork, as well as do their own work and handle household chores. It took a toll on their mental health, so they didn’t feel they could do as much exercise.”

Post-COVID Heart Patients

Both Marcovitz and Koshy provided follow-up care to their regular cardiac patients after recovery from the virus, as well as new patients who experienced first-time cardiac symptoms after COVID. 

“Many patients had complications [after having the coronavirus] including myocarditis, and some had reduced heart function,” Marcovitz says. “Some have prolonged symptoms of fatigue and shortness of breath.”

Koshy explains, “Anecdotally, there seem to be more women experiencing post-COVID fatigue and shortness of breath. Their brain fog and fatigue seem to last longer but most improve within three months.

“The younger patients — under 60 — tend to be the long haulers. Younger people who hadn’t been vaccinated yet were more likely to experience severe complications.”

Sometimes it just takes time, Marcovitz says. “We use exercise to build tolerance. Patients need to hydrate while exercising and their heart rate and blood pressure must be monitored. Some people put off routine checks of their blood pressure and cholesterol because of the pandemic and may need medical or other intervention for coronary blockages.” 

In addition, some patients cut back on cardiac rehabilitation out of concern for COVID transmission or because these outpatient programs were temporarily halted. As an alternative to in-person rehabilitation, some patients were given exercises to do at home, including video instruction, she says.

Post-COVID patients have an increased risk of developing clots in their legs and lungs or having a stroke. This could be because they were immobilized during their bout with COVID, which can lead to clots, Marcovitz says, or because their lifestyle or work life became more sedentary during the pandemic. 

Treating POTS

Both cardiologists have tested and treated for Postural Orthostatic Tachycardia Syndrome (POTS) — a condition which some patients developed after COVID. POTS is a condition which affects blood flow, causing rapid heart palpitations, fainting and lightheadedness as well as chronic fatigue and brain fog. 

“POTS is a condition of the autonomic nervous system, not primarily a cardiac problem,” Marcovitz says. “It can be very debilitating and last a long time. POTS affects mostly women between 13 and 50 years of age. We are seeing more of it in the last year.

Any severe illness, surgery or extreme weight loss can trigger it, she explains. Symptoms can occur when individuals stand up after sitting or reclining, or among those who stand for a long time as part of their jobs.

Treatments include core and leg exercises, increased intake of fluids and greater salt intake to lower adrenalin levels that control heart rate. Compression stockings or pantyhose can also help. She adds that some medications, including beta blockers, are available to treat it. “This is a common reason why people are coming to us now,” notes Marcovitz. 

Koshy has treated more cardiac patients with POTS or POTS-like symptoms after COVID as well. Many are severely dehydrated. “People who exercise are more likely to notice it. COVID can affect any or every system in the body,” she says.