DEAR DR. ROACH: I read your recent column on long-haul effects in COVID compared to the flu. About 14 years ago, a young neighbor caught some kind of virus. His wife said he was never the same after that. He was in his mid-40s. There were several fundraisers in the area to try to raise money for the young family. He needed a heart transplant and was put on a waiting list. His cardiologist wrote an article for the local paper explaining that many people suffer heart damage from the flu and other viruses. The doctor was trying to explain that not everyone with heart disease made poor health decisions such as smoking.
He unfortunately passed away before he received a transplant. Was the doctor’s statement correct? This was long before COVID. — D.T.
ANSWER: Most of the time, when we think about heart disease, we mean coronary artery disease, the type of heart disease with blockages in the arteries supplying blood to the heart. However, another major form of heart disease is congestive heart failure. This is a disease targeting the muscle part of the heart. Sometimes the underlying problem is an inability of the heart to squeeze properly, and sometimes it’s an inability for the heart to relax properly. Risk factors for CHF include high blood pressure, previous heart attacks, drinking excess alcohol and viruses.
Over 20 viruses have been shown to damage the heart muscle and cause CHF, including influenza viruses. As of this writing, it is not clear if SARS-CoV-2, the virus associated with COVID-19, inflames the heart muscle to produce the kind of muscle damage that causes the symptom complex we call congestive heart failure. It may be proven with more study.
CHF is usually treated by medication. Very severe cases from any cause are sometimes treated by heart transplant, but it is sadly too often the case that a donor heart is not available in time. Your neighbor’s doctor was absolutely correct. Making assumptions about what caused a person to get a particular disease is not wise.
DEAR DR. ROACH: It’s been publicized that we should not wash N95 or KN95 COVID masks because that would compromise one of the protective layers inside. What about the ubiquitous light-blue pleated (expandable) masks that are worn by so many people? Is it OK to wash them without compromising their effectiveness? — A.F.
ANSWER: Surgical masks are quite effective for everyday use, but when there is a high risk of exposure, physicians still wear a certified N95 mask. KN95 masks are a reasonable alternative as long as they are approved by the Food and Drug Administration. (The FDA revoked the emergency use authorization for KN95 masks when certain N95 masks were no longer in short supply. See tinyurl.com/FDAmasksCOVID for more information and the complete list.)
The Centers for Disease Control and Prevention does not recommend washing surgical masks. High-quality surgical face masks are available online for about 15 cents each.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
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