Is there a higher risk of heart damage from HCQ+AZ or from COVID-19?

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I simply ask the question, and leave it to the reader to decide.
Highly esteemed and heavily published Yale School of Public Health professor of epidemiology Dr. Harvey Risch, in conjunction with cardiologists from around the world, calculate the odds of a fatal arrhythmia caused by hydroxychloroquine+Azithromycin at 9 per 100,000. That compares to a 5,000-15,000 per 100,000 chance of an elderly or high-risk patient dying of untreated ("go home and isolate") COVID-19.
https://www.covid-19forum.org/index.php?topic=169.msg202#msg202

"The totality of any or fatal cardiac arrhythmia events among more than 15,000 patients
treated with hydroxychloroquine or hydroxychloroquine+azithromycin is zero."
https://earlycovidcare.org/wp-content/uploads/2021/09/Evidence-Brief-Risch-v6.pdf

40:50 mark - 3,000 electro physiologists were asked "if any had seen any cardiac arrhythmias from hydroxychloroquine with Azithromycin used in synergy in the outpatient setting, and in the entire country with 3,000 electro physiologists the answer was zero (while they did see a bunch in the ICU setting)."



Judging from the articles that follow would it seem like there is a greater chance of suffering heart problems by not taking HCQ+Z+AZ early and instead allowing COVID-19 to run its course for even a little while, as compared to beating it back with HCQ+Z+AZ in the EARLY OUTpatient setting? Perhaps particularly for the earliest possible mitigation immediately upon the initial symptoms or clinical suspicion of COVID-19.

https://www.webmd.com/lung/news/20200729/recovered-covid-patients-often-have-heart-damage

"Recovered COVID Patients Often Have Heart Damage

By Carolyn Crist

July 30, 2020 -- A large number of patients who recover from the coronavirus may have heart damage weeks or months after they feel better, according to two new studies in JAMA Cardiology.

Released Monday, the studies reinforce the idea that COVID-19 attacks more than the lungs — it can damage other organs, too, even in people who were healthy before they contracted the virus.

In one study, researchers [SM1] from Germany analyzed MRI scans in 100 people between ages 45 to 53 who recovered from the coronavirus. Compared to scans of similar patients who didn’t have the virus, 78 had lingering heart damage and structural changes to their hearts. In addition, 76 of those patients had a biomarker usually found in heart attack patients, and 60 had heart inflammation.

Of the 100 patients recently recovered from COVID-19, 67 (67%) recovered at home, while 33 (33%) required hospitalization.

None of the patients had heart problems before the virus or experienced heart symptoms while they had COVID-19. They were “mostly healthy” before they got sick, the researchers said.

“The patients and ourselves were both surprised by the intensity and prevalence of these findings, and that they were still very pronounced even though the original illness had been by then already a few weeks away,” Valentina Puntmann, MD, a cardiologist at the University Hospital Frankfurt and a co-author of the study, told UPI.

“We found evidence of ongoing inflammation within the heart muscle, as well as of the heart’s lining in a considerable majority of patients,” she said.

In the other study, another team of researchers from Germany analyzed autopsy reports for 39 people between ages 78 to 89 who died from COVID-19 at the beginning of the pandemic. They found that the virus infected the heart in 16 -- or 41% -- of the patients.

“We see signs of viral replication in those that are heavily infected,” Dirk Westermann, MD, a cardiologist at the University Heart and Vascular Centre in Hamburg and a co-author of the study, told STAT.

“We don’t know the long-term consequences of the changes in gene expression yet,” he said. “I know from other diseases that it’s obviously not good to have that increased level of inflammation.”

Doctors have documented heart damage among COVID-19 patients worldwide. Boston Red Sox pitcher Eduardo Rodriguez announced on Sunday that he wouldn’t start the season because he’s dealing with heart inflammation after contracting the coronavirus. He’s waiting for additional MRI results to determine whether he can play, according to WEEI.

“Back when I got COVID, I felt it all. I felt all the symptoms and everything,” he told the radio station. “Right now, I don’t feel all the symptoms. I got surprised when I got that from my heart because I don’t feel any symptoms from that. I didn’t feel anything from my chest.

Of the 100 patients recently recovered from COVID-19, 67 (67%) recovered at home, while 33 (33%) required hospitalization.
https://www.webmd.com/lung/news/20200729/recovered-covid-patients-often-have-heart-damage
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https://www.upi.com/Health_News/2020/07/27/Three-quarters-of-adults-with-COVID-19-have-heart-damage-after-recovery/5451595856303/

"Three-quarters of adults with COVID-19 have heart damage after recovery
By Brian P. Dunleavy

July 27 (UPI) -- Seventy-eight percent of people diagnosed with COVID-19 showed evidence of heart damage caused by the disease weeks after they have recovered, according to a study published Monday by JAMA Cardiology.

Of 100 participants in the study, 78 had evidence of heart damage on magnetic resonance imaging, or MRI, according to the researchers.

None of the 100 patients included in the analysis had experienced heart symptoms related to the new coronavirus and "were mostly healthy ... prior to their illness," the researchers said.

"The patients and ourselves were both surprised by the intensity and prevalence of these findings, and that they were still very pronounced even though the original illness had been by then already a few weeks away," study co-author Dr. Valentina Puntmann told UPI.

"We found evidence of ongoing inflammation within the heart muscle, as well as of the heart's lining in a considerable majority of patients," said Puntmann, a consultant physician, cardiologist and clinical pharmacologist at University Hospital Frankfurt in Germany.

The researchers said the MRI findings were consistent with two potentially serious heart conditions: myocarditis and pericarditis, according to the researchers.

Myocarditis is inflammation of the heart muscle, and it can reduce the heart's ability to pump, potentially causing irregular heartbeats, Puntmann said.

Pericarditis causes inflammation of the protective tissues surrounding the heart and can cause pain, she said.

The 100 study participants, 45 to 53 years old, had recovered from COVID-19. Participants' underwent MRI evaluation two to three months after being diagnosed with the virus, researchers said.

Sixty percent of the participants had evidence of ongoing heart inflammation on their MRIs that was independent of preexisting conditions or the course of their COVID-19 infection, according to the researchers.

RELATED COVID-19 increases death risk for cancer patients 16-fold, study says

Two-thirds of the participants recovered from COVID-19 at home, and 18% never had symptoms of the virus, the researchers said. Roughly half had mild to moderate symptoms of the coronavirus, they said.

"While we do not yet have the direct evidence for [long-term] consequences yet, such as the development of heart failure, which can be directly attributed to COVID-19, it is quite possible that in a few years this burden will be enormous based on what we know from other viral conditions," Puntmann said.

Although the participants in Puntmann's study recovered from the virus, a separate analysis, also published Monday by JAMA Cardiology found evidence of infection in the hearts of 16 of 39 -- or 41% -- patients who died from the disease.

The findings were made after autopsies of the patients, who were between 78 and 89 years old.

"[COVID-19] can infect the heart and, in severe cases, the virus seems to replicate within it," study co-author Dirk Westermann, a cardiologist at University Medical Center Hamburg-Eppendorf, also in Germany, told UPI.

"We need long-term follow-up studies of COVID-19 survivors to see whether [the virus] impacts cardiac function over the long-term," he said."
https://www.upi.com/Health_News/2020/07/27/Three-quarters-of-adults-with-COVID-19-have-heart-damage-after-recovery/5451595856303/

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