Diet and Immune System

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Can diet help ‘boost’ our immune system to fight COVID-19?

While it is true that poor nutrition can hamper your ability to fight off illness and infection, it is misleading to think that a special food, nutrient or supplement can “boost” your immune system. There are many products being heavily promoted as “immune boosters”, however immunology is complex and there are no supplements or natural health products approved to treat or protect against the COVID-19 virus.

Alongside a healthy sleep pattern, regular physical activity and stress management strategies, now more than ever is a good time to develop a healthy eating routine.

A Balanced Diet

Following the key points below for a healthy balanced and varied diet with adequate energy and protein intake is important to best support your immune system and overall heart health.

  • Aim for 5 – 7 portions of fruit and vegetables per day (aim to include at every meal)
  • Choose brown and wholegrain versions of carbohydrates
  • Include 2 servings of lean protein per day e.g. fish, lean red meat and poultry, peas, beans, lentils and eggs)
  • Stay hydrated with water as your main fluid source
  • Limit high sugar/fat/salt foods to a few times per week

Below, we will take you through some of the key nutrients found in a balanced diet one and highlight the role they pay in supporting your immune system to work properly.

Click the image to download the Healthy Ireland Food Pyramid.
Click the image to download the Healthy Ireland Food Pyramid.

7 key nutrients for a healthy immune system

Protein is important for many bodily functions such as healing and repair and maintaining healthy muscle mass. It also has a role in the formation of antibodies that fight infection and disease.  Protein foods can be animal based such as meat, fish, poultry, eggs and dairy or plant based such as peas, beans, lentils, tofu and nuts. Vary your protein sources, choose lean meats and poultry and limit processed red meats to keep your diet low in saturated fat. Include fish twice a week one of which is oily such as salmon, mackerel, trout or sardines (tinned or fresh).

1

This vitamin is ace at supporting your immune system! It helps maintain the structure of the cells in the skin, respiratory tract and gut. It acts as an anti-oxidant which is kind of like anti-rust protection for our bodies cells, keeping them strong and ready to fight infection. Beta-carotene which is converted to vitamin A in the body is found in leafy greens, yellow and orange vegetables like pumpkin and carrots.

2

Vitamin E is also a powerful anti-oxidant and is found in green leafy vegetables such as spinach and broccoli. It is also found in avocados and vegetable oils such as sunflower and rapeseed oil and nuts and seeds including: almonds, hazelnuts and pumpkin. Why not try adding a handful of nuts or seeds to your cereal or using rapeseed oil in cooking and salad dressings.

3

Habitual vitamin C supplementation may help with the common cold by reducing severity and duration (>200mg/day) however we don’t know if this transfers to viruses. The recommended daily allowance (RDA) of vitamin C for most adults is 80mg which is easily achieved through a balanced diet. Foods rich in vitamin C include bell peppers, citrus fruits, broccoli, Brussels sprouts and berries. Fresh and frozen are equally as nutritious. While vitamin C supplementation up to 1000mg/day won’t do you any harm, excess consumption can result in stomach pain and diarrhoea.

4

Vitamin D works with calcium and phosphorus for healthy bones, muscles and teeth. Vitamin D also helps to regulate our immune responses and a recent review of the research found that vitamin D supplements can help protect against acute respiratory infections, particularly among people who are deficient.

This is one vitamin where supplementation is recommended, although we can make vitamin D in the skin through direct sunlight, in Ireland the sunlight isn’t strong enough between March and October. We can get some vitamin D from diet as it is found in foods such as eggs, salmon and fortified milk but typically we don’t consume enough of these foods to meet our needs. Taking a 10 micrograms per day supplement is recommended for adults and children over the age of one year. With the social isolation precautions our time outdoors may be restricted a bit more and so supplementation is more important than ever.

5

Zinc helps the immune system to work properly and plays a role in wound healing. The immune system works well when we consume the recommended daily allowance of zinc which is 10mg / day. It is rare to be deficient in zinc as it is present in a wide range of foods including; lean meat, poultry, seafood, milk, whole grain products, fortified breakfast cereals, beans, seeds and nuts.

6

Selenium is involved in the normal function of the immune system. Good sources include Brazil nuts (5-6 Brazil nuts provide an adults daily needs) fish and seafood, brown rice, baked beans, sunflower seeds and oats are also good sources.

7

Most importantly, please remember that correct and frequent hand washing is your first line of defense and to continue to physically distance yourself as much as possible to break the chain of transmission. For more information check out the HSE website.

I have just been told I have heart failure, what does this mean?

Updated March 31

If you have just been told you have heart failure you are probably particularly worried, given the global pandemic of coronavirus. Because of this you have probably been given a diagnosis in hospital and promptly discharged home, back to the care of your GP due to pressure on medical staff to make beds available, but also to reduce this risk of you catching the virus. The specialist team of nurses and health care providers that you would usually see have most likely been redeployed.

So what does this mean for you?

Firstly, heart failure sounds scary – often when people are told they have heart failure they think that their heart is just going to stop. Heart failure is a chronic disease the same as diabetes – it cannot be cured but it can be managed.

Think of your heart as two pumps one side the right side pumping blood into the lungs to become oxygenated, the left side of the heart then pumping this blood around the rest of the body. Heart failure is a pump failure. Your heart is failing to pump as efficiently as it used to. It can be right, left or both sides that fail. It can fail for many reasons as is discussed on our heart failure page.

Having a pump that is not working as efficiently as it used to leads to a build-up of fluid – a lot of managing heart failure is managing fluid. This fluid can build up in the lungs, around the stomach or in the legs, causing the following symptoms.

Symptoms:

Breathlessness, particularly on exertion, waking up breathless at night or needing to increase the amount of pillows that you sleep. Swelling in your feet and legs. Bloating and reduced appetite.

What can you do?

Remember you will be seen for follow-up and possible further investigations when the coronavirus has gone or is under control. Until then, there are things you can do at home yourself.

  • Stay at home and follow advice around coronavirus, you are not more likely to catch the virus, but if you do you are more likely to develop complications.
  • Restrict your fluid intake to 2 litres in 24 hours (unless you have been specifically told differently by a medical professional) 2 litres is enough to keep your kidneys happy but not too much that will put extra pressure on your heart.
  • Don’t use salt of any kind including low salt. Salt is a magnet for fluid and works against medication that tries to help you get rid of this extra fluid. (water tablets or diuretics such as Furosemide).
  • Check your weight first thing every morning, go to the toilet and record your weight. Make sure you’re wearing the same thing every time you weigh yourself. You are looking at what your weight is doing, not what it is. If it increases by 3lb overnight or a total of 5lb (or 2kg) in 1 week you need to speak to your GP. A weight increase indicates a build-up of fluid and is a very strong indicator your heart is not pumping as well. This may mean you need to have your medication adjusted. Often you will see your weight start to increase before you have or notice any symptoms with heart failure.
  • Take your medication often people with heart failure are prescribed water tablets or diuretics such as Furosemide or Bumetanide. It is important that you take them, if you need to leave the house or go on a long journey and are worried about finding a toilet take them later in in the day. This is ok as long as you remember to take them and that water tablets will be in your system for around 6 hours. They start working after 30 minutes and are more potent the first couple of hours. This means if you take your tablets at bedtime you will get a very poor night’s sleep.

If you experience any of the following worsening of symptoms, you should contact your GP or attend your local emergency department.

See Croí’s health page for more information on heart failure.

The Croí Health Team is here as always if you need support. Contact us by email at healthteam@croi.ie or call 091-544310.

Advice From Croí, the Heart & Stroke Charity COVID-19 and People Living with Heart Disease

The coronavirus pandemic has caused great alarm and distress across the country. Understandably, many of those living with heart disease are anxious and concerned.

While people of all ages can be infected by this new virus, it presents a greater risk for people over the age of 60 years of age and those who have underlying medical conditions, chief among them is heart disease, high blood pressure and diabetes.

It’s well established that many virus infections can affect the heart, and coronavirus is no different. Viruses are known to cause inflammation of the heart muscle. While in a healthy patient this may not lead to an adverse outcome, the situation for those living with heart disease is different. If these individuals become infected with coronavirus they are at greater risk of adverse cardiac events and the outcomes may be poor.

“It is normal to feel concerned about COVID-19, especially if you are living with heart disease. While it is normal to feel anxious about how this condition might affect you, the first thing to know is that you are at no greater risk of developing COVID-19 than anyone else. However, if you do contract the virus you have a higher chance of developing complications,” says Croí Director of Programmes, Irene Gibson.

With the number of cases in Ireland increasing on a daily basis, hospitals are likely to experience an unprecedented increase in-patient admissions. Consequently, in anticipation some hospitals are cancelling clinics and limiting non-urgent activity to urgent and emergency cases so as to reduce the strain on staffing and beds.

It is important to remember that our hospitals will continue to treat heart patients, but the current pressures may result in delays, cancellations of appointments and disruption of services.

 

How do I reduce my risk of contracting the COVID-19 virus:

For those living with heart disease, prevention is key. Currently, there is no vaccine to prevent COVID-19 and the best way to prevent illness is to avoid being exposed to this virus.

Coronavirus is spread by droplet infection – coughing and sneezing – or by close contact with someone who has the virus. As this is a new illness, we do not know how easily the virus spreads from person to person. Spread is most likely from those who have symptoms. It is very important therefore to limit close contact.

“Croí’s advice is to be extra vigilant and follow the advice of the HSE. Be aware of the symptoms of coranavirus and be extra vigilant in taking the recommended precautionary measures. Everyone has a role to play in reducing the spread of this virus and if we all take collective responsibility we will minimise the risk for everyone,” says Croí CEO, Neil Johnson.

 

Key things to remember are:

  • Stay at home as much as possible and limit your social contact, particularly with people who are unwell.
  • Wash your hands regularly with soap and hot water – do this for at least 20 seconds at each wash.
  • When you cough or sneeze, cover your mouth and nose with a tissue or your sleeve (not your hands). Immediately after use, put your used tissues in the bin and then wash your hands.
  • Do not touch your eyes, nose or mouth if your hands are not clean.
  • Do not share objects that touch your mouth, for example bottles or cups.
  • Do you best to follow all your medical advice on how to keep your condition well controlled.
  • Stay in regular contact with family, friends or neighbours as you may need to ask for help if you become sick.
  • Maintain a healthy diet – unless you have been advised to adhere to a specially prescribed diet, you should continue to try and eat a wide variety of foods that are rich in vitamins, minerals, fibre and other essential nutrients.
  • Try and engage in some form of exercise everyday – even if it is only walking up and down the stairs if you are able.

 

For Family and Caregivers:

  • Know what medications are prescribed – maintain a list.
  • Watch for new symptoms.
  • Prepare a plan to make sure food and other supplies are available when needed.
  • Consider options and have a plan for what would happen if you become ill.

 

International heart specialists are offering the following advice and opinion for specific heart conditions, says Croí

  • Individuals who are immunosuppressed, such as heart transplant patients or cancer patients who also have heart disease and pregnant women with underlying cardiac conditions are probably the most vulnerable to this virus and need to be extra vigilant.
  • There is no evidence to-date that the virus infects implanted devices such as pacemakers and cardioverter defibrillators or causes infective endocarditis (infection) in those with heart valve disease.
  • Individuals with Brugada Syndrome (heart rhythm disorder), need to be mindful of developing high temperatures (above 39 degrees Celsius) and should treat accordingly.
  • Individuals who have previously suffered from myocarditis or pericarditis are not at any higher risk of developing the same condition with COVID-19.
  • To-date there is no evidence that the coronavirus directly infects the heart however the infection caused by the virus may worsen heart function and exacerbate symptoms in patients with heart failure.
  • For the general population, wearing a mask is only recommended if you are experiencing symptoms or caring for someone with symptoms. If you have a heart condition, wearing a mask may make breathing more difficult so you should consult your doctor for advice on this.
  • All those with heart conditions who are on medications should take all their medications exactly as prescribed. Do not make any changes without firstly contacting your doctor or nurse.

Despite all the focus on coronavirus, the usual amount of heart attacks and strokes will continue to occur in our community. It’s important therefore to remind people not to delay if they are experiencing signs or symptoms of heart attack or stroke. If you do experience chest pains or stroke symptoms, please do not delay in calling 999 or 112. The emergency departments are still open for heart and stroke patients in all hospitals.

“While the Croí Heart & Stroke Centre is not currently running face to face classes or programmes, our health team are here as always to answer your questions so please don’t hesitate to reach out to us or visit our website for support resources,” says Irene Gibson, Director of Programmes.

 

You can contact the Croí Health Team on 091-544310 Monday – Friday from 9:00am – 5:30pm or you can email us at healthteam@croi.ie.

The Croí website (www.croi.ie) is regularly updated with the latest advice on COVID-19, along with practical guides and tips to help you achieve a healthy lifestyle.  

COVID-19: Advice for individuals living with Heart Failure

This advice is based on information from the Heart Failure Patient Council of the Global Heart Hub. Croí is a member of the Global Heart Hub.

Covid-19 presents the world with an unprecedented public health challenge. Its rapid spread has caused significant alarm and disruption across the globe. Understandably, those living with heart disease and heart failure are anxious and concerned.

It is well established that many virus infections can affect the heart, and experts suspect that coronavirus is no different. Viruses are known to induce inflammation of the myocardium (heart muscle). While in a healthy patient this may not lead to an adverse outcome, the situation for those living with heart disease and heart failure is different. Evidence suggests that if these individuals become infected with coronavirus they are at greater risk of adverse cardiac events and the outcomes may be poor.

COVID-19 is a new illness that can affect your lungs and airways. It’s caused by a virus called coronavirus. With the number of cases around the world increasing on a daily basis, hospitals are experiencing an unprecedented increase inpatient admissions. Consequently, hospitals are cancelling clinics and l non-urgent activity.  Only urgent and emergency cases are being treated to reduce the strain on staffing and beds, and prevent vulnerable patients being exposed to the COVID-19 virus unnecessarily.

It is important to remember that hospitals will continue to treat heart patients, but the current pressures may result in delays, cancellations of appointments and disruption of services. The decisions on who will be treated will be based on clinical need, with those in most need of treatment being prioritised.

For further information on COVID-19 virus and symptoms see Croí’s advice here.

 

Staying well

For those living with Heart Failure:

  • Take all your medicines as advised by your doctor or nurse.
  • Do your best to follow all your medical advice on how to keep your condition well controlled.
  • Continue to self-monitor your condition and record your weight on a daily basis (first thing after you get out of bed in the morning).
  • Stay in regular contact with family, friends or neighbours as you may need to ask for help if you become sick.
  • Maintain a healthy diet – unless you have been advised to adhere to a specially prescribed diet, you should continue to try and eat a wide variety of foods that are rich in vitamins, minerals, fibre and other essential nutrients.

For Family and Caregivers:

  • Know what medications are prescribed and make sure supplies are secure.
  • Watch for new symptoms.
  • Prepare a plan to make sure food and other supplies are available when needed.
  • Consider options and have a plan for what would happen if you become ill.

 

What should I do if I experience gradual or persistent worsening symptoms of Heart Failure, such as my weight increasing or my legs swelling?

Self-monitoring of your condition on a daily basis is very important. It is equally important that you take your daily medicines as prescribed by your doctor.

If you experience any of the following worsening of symptoms, you should contact your GP, if available your Heart Failure Nurse or your local Heart Failure Clinic for advice and review of your medication. Due to the outbreak of COVID-19 many hospital staff have been redeployed. If you are unable to contact you heart failure nurse or team please contact your GP or local emergency department if you are concerned.

Worsening symptoms to look out for:

  • Weight increase greater than 3lb overnight or 5 lb (2kg) in a week .
  • Increased swelling in the legs or abdomen.
  • Increased shortness of breath on exertion, lying down or in bed at night.

If you have very sudden or very severe symptoms call for an ambulance so that you can be taken to hospital for treatment as soon as possible.

 

STAY CALM!

It is perfectly understandable that people may be feeling anxious or concerned about what might happen to them or their loved ones over the coming months. However, we must remind ourselves that this crisis will end. Only seek information from reliable sources – there is a huge amount of ‘fake news’ and false rumours which do nothing more than cause unnecessary anxiety and distress.

Already many heart patients are slow to respond to changes in their health or they are dismissing new symptoms because they do not wish to burden their doctor or local hospital. Despite the Covid-19 crisis, doctors and emergency rooms are still there to help heart patients so do not ignore worrying symptoms or delay in contacting them if you are unwell. Keep up to date with your local health information notices on how best to contact your GP or Heart Failure Nurse.  The Heart Failure Patient Council of the Global Heart Hub are being advised by medical and public health experts and we will keep you updated on any changes in information that could affect those living with Heart Failure.

 

See Croí’s health page for more information on heart failure.

The Croí Health Team is here as always if you need support. Contact us by email at healthteam@croi.ie or call 091-544310.

Aerobic Workout at Home

Aerobic Exercise

Exercises to get your heart rate rising!

Here is a video of a sample aerobic exercise session that includes a warm up, main phase and cool down.

Aerobic exercise describes any exercise that uses your arms and legs for a continuous period of time such as walking, cycling, swimming or a cardio exercise class. Aerobic exercise strengthens our heart and lungs. This type of exercise has consistently been shown to positively affect our cardiovascular health; improving blood pressure, blood sugar control, cholesterol levels and body weight. It is also associated with a whole host of other health benefits including a significant reduction in the risk of bowel and breast cancer.

In order to avail of these health outcomes it is important that you adhere to what we refer to in exercise as the FITT guidelines:

Frequency (How many days per week do I need to engage in this type of exercise)

      • 5-7 days/week

Intensity (How hard do I need to be working when I’m exercising)

      • Moderate

Time (How long should I exercise for)

      • 30-60 minutes per session. This is a target. If you are currently inactive, begin with 10 minutes and build up.

Type (Examples of aerobic exercise)

      • Regular, purposeful exercise that involves major muscle groups and is continuous and rhythmic in nature (i.e. walking, cycling).

These guidelines tell you how many days a week you should be doing aerobic exercise and also how long each aerobic session should last. Most importantly the guidelines state that your aerobic exercise should be of a moderate intensity. A rule of thumb is that you can say a sentence but perhaps not engage in a full conversation when you are completing your aerobic exercise.

The 30-60 minutes duration of an aerobic session does not include a warm up and cool down. These are important components of your aerobic exercise session. You should start slow and gradually build up the intensity of the warm up phase to ensure your heart and muscles are fully prepared for the main conditioning phase (moderate intensity). Similarly, it is very important to cool down after the conditioning phase. This involves gradually reducing the intensity of your efforts until your breathing and heart rate are almost at a pre-exercise level. See the above diagram for guidance on timings and intensities for a full aerobic exercise session.

Disclaimer for online videos: Performing these exercises is at your own risk. Croí cannot be held responsible or liable for any injury or harm incurred while exercising using the online resources provided on our website. Those unaccustomed to exercise or with special health considerations should consult their medical practitioner before performing any exercise.

Need some help or have a question?

The Croí Health Team is here as always if you need support. Contact us by email at healthteam@croi.ie or call 091-544310.

See more home workout videos below!

COVID-19: Advice for individuals with Heart Valve Disease

People living with moderate or severe heart valve disease are at increased risk of complications if affected by COVID-19. Those at greatest risk are individuals with severe disease, significant ongoing symptoms or awaiting valve surgery.

It is important to remember that hospitals will continue to treat heart patients, but the current pressures may result in delays, cancellations of appointments and disruption of services.

This advice is based on information from the Heart Valve Disease Patient Council of the Global Heart Hub. Croí is a member of the Global Heart Hub.

What should I do if I am due to have heart valve surgery or have a heart valve procedure?

If you are due to have surgery you should continue to prepare for it unless told otherwise by your clinician. If your surgery is rescheduled for a later date you should monitor your symptoms closely. If your symptoms get worse and you begin to feel unwell you should report this to your GP, call your hospital medical team or in severe cases, call the emergency services.

 

What should I do if I have recently had heart valve surgery or a heart valve procedure?

Patients who have recently had a procedure have an increased risk of infections due to cuts/incisions which may be exposed to germs. The normal risk of infection for heart valve disease patients is low, but in the current situation you should take every extra measure to limit your risk of infection. If you do begin to feel unwell you should contact your hospital medical team or call the emergency services.

 

How do I reduce my risk of contracting the COVID-19 virus:

There is currently no vaccine to prevent COVID-19 and the best way to prevent illness is to avoid being exposed to this virus. As you are at higher risk of a more serious illness if you contract coronavirus you are being advised to stay at home as much as possible and to limit your social contact.

We strongly urge you to take extra care in ensuring you follow all of the recommended precautions.

You need to be extra vigilant, be aware of your symptoms and take the recommended precautionary measures by physically distancing.

 

What are the symptoms of COVID-19?

For further information on COVID-19 virus and symptoms see Croí’s advice here.

If you are experiencing any of these symptoms and feel you need medical help, you should follow the guidelines issued by your health authority on how best to seek medical help.

Any heart valve patient with progressive or new onset symptoms, particularly syncope (fainting, ‘passing out’ or collapse) should contact their doctor immediately.

See Croí’s health page for more information on heart valve disease.

The Croí Health Team is here as always if you need support. Contact us by email at healthteam@croi.ie or call 091-544310.

Stretch at Home

Stretching

Increase your flexibility and range of motion

As well as requiring our muscles to be strong, we also need them to be supple and stretchy. Supple muscles are less likely to become injured and more likely to facilitate easier execution of activities of daily living such as bending, reaching, lifting and turning.

This is a much neglected type of exercise largely due to peoples’ perceptions that it does not do much. Yet it holds the key to enhancing our aerobic fitness and muscle strength as well as being a standalone type of exercise with its own unique set of physical outcomes listed above. Stretching exercises can help address any muscle imbalances that can occur over the years from poor posture or other bad habits such as excessive sedentary behaviour. This in turn optimises our efforts in the other two types of exercise  (Aerobic & Resistance).

For effective muscle stretching please follow the FITT guidelines below.

Frequency (How many days per week do I need to engage in stretching)

    • ≥2-3 days a week

Intensity (How hard do I need to be working when I’m stretching)

    • Stretch to the point of feeling tightness or slight discomfort

Time (How long should I hold each stretch for)

    • 10-30 seconds. For older adults (>65 years of age) holding a stretch for 30-60 seconds can give greater benefits

Type (Examples of stretching exercises)

    • Watch the video for a complete series of muscle stretching exercises for each of the major muscle groups.

To avoid injury, it is important that you do these stretches when your muscles are warm (i.e. at the end of an aerobic or muscle strengthening session). See pg. 7 of our Resistance Training at Home booklet for cool down stretches.

Disclaimer for online videos: Performing these exercises is at your own risk. Croí cannot be held responsible or liable for any injury or harm incurred while exercising using the online resources provided on our website. Those unaccustomed to exercise or with special health considerations should consult their medical practitioner before performing any exercise.

Need some help or have a question?

The Croí Health Team is here as always if you need support. Contact us by email at healthteam@croi.ie or call 091-544310.

See more home workout videos below!

Resistance Training at Home

Exercises to help gain muscle strength

To begin strengthening your muscles you need to engage in resistance training. This involves performing a series of exercises where you lift a weight that you are unaccustomed to for a specific amount of repetitions. This type of training can provide significant functional benefits and improvements in overall health and well-being. These improvements include: increased bone density, improved muscle mass and joint function, reduced potential for injury, increased metabolism and improved cardiac function.

As with aerobic exercise there is a set FITT guideline to bring about the above physical outcomes.

Frequency (How many days per week do I need to engage in muscle strengthening exercise)

    • 2-3 days/week

Intensity (How hard do I need to be working when I’m doing my muscle strengthening exercise)

    • Moderate* intensity

Time (How long should a muscle strengthening session last for)

    • Approx. 30-40 minutes – complete 8-10 exercises per set and aim to complete 2-4 sets.

Type (Examples of muscle strengthening exercise)

*It is important that you perform your muscle strengthening exercises at a moderate intensity. In this instance, moderate intensity refers to the amount of times you can lift a weight during an exercise. Ideally you want to select a weight for each exercise that you can lift 12 times. If you can easily perform 15 repetitions of an exercise, the weight is low intensity and not enough of a challenge to strengthen your muscles. Likewise if you struggle to perform 8 repetitions, the weight is high intensity and not appropriate.  You can download our Resistance Training at home booklet which will explain this is a little more detail.

Please read page 8 of our Resistance Training at Home booklet for important general instructions for resistance training at home.

Disclaimer for online videos: Performing these exercises is at your own risk. Croí cannot be held responsible or liable for any injury or harm incurred while exercising using the online resources provided on our website. Those unaccustomed to exercise or with special health considerations should consult their medical practitioner before performing any exercise.

Need some help or have a question?

The Croí Health Team is here as always if you need support. Contact us by email at healthteam@croi.ie or call 091-544310.

See more home workout videos below!

FAQs: COVID-19

FAQ

Here are some of the frequently asked questions that our Croí team have covered this week in relation to COVID-19. We will keep this page updated regularly. The Croí Health Team are following National & International best practice guidelines and the advice of the HSE. Learn more at www.hse.ie.

1. Why are older adults and people with chronic health conditions at higher risk of more serious illness if they catch coronavirus COVID-19?

As we age our immune systems grow weaker, which makes it more challenging for older adults to fight off infectious diseases.  Chronic health conditions are more common as we get older. These conditions like heart disease, stroke, lung disease, diabetes, cancer or high blood pressure might mean your immune system isn’t as strong as others when exposed to viruses.

If you have a heart condition the virus could affect your heart in several ways. It is mainly associated with the lungs but if your diseased heart has to work harder to get oxygenated blood throughout the body, it may cause an extra strain. This can worsen problems for people with heart failure, where the heart is already struggling to pump blood efficiently.

2. I’ve heard that high blood pressure or my blood pressure medications could cause more severe Covid-19 infection – should I stop taking my blood pressure tablets?

It is always important to take any heart medication your doctor has prescribed, and even more so when you are at risk of being exposed to the COVID-19 virus. By taking your medication, you can better protect your heart, which can help protect you against complications of COVID-19 if you do get it.

It has been suggested, especially on social media sites, that commonly used medications (see list below) used to treat high blood pressure and certain heart conditions may increase the risk of infection and the severity of COVID-19. Because of this, patients taking these drugs for their high blood pressure and their doctors have become increasingly concerned, and, in some cases, have stopped taking their medications.

It is important to highlight that this information is speculation and does not have a sound scientific basis or evidence to support it. Best practice guidelines from the European Society of Cardiology Council on Hypertension strongly recommend that physicians and patients should continue treatment with their usual anti-hypertensive therapy.

Blood pressure medications:

  • Angiotensin converting enzyme inhibitors (ACE-i)
    • common examples include Capoten (captopril), Tritace (ramapril), Coversyl (perindopril), Vasotec (enalapril) Prinivil, Zestril (lisinopril) Lotensin (benazepril)
  • Angiotensin Receptor Blockers (ARBs)
    • common examples include Atacand (candesartan), Teveten (eprosartan), Micardis (telmisartan), Diovan (valsartan), Cozaar (losartan), Benicar (olmesartan)

3. I have a chronic heart condition… What can I do to reduce my risk?

For heart and stroke patients, prevention is key. If you are in an at-risk group or caring for someone in an at-risk group, you should follow the HSE general advice on how to protect yourself from coronavirus.

Cocooning is now recommended for all individuals aged 70 and over or those who have underlying medical conditions, visit the cocooning section of our website to see if you fall into this category. If you are not advised to cocoon you should still stay at home as much as possible, only leaving the house when needed such as to attend medical appointments or for food shopping. For further information, see our COVID-19 advice page. In addition to the general advice, do your best to keep your condition well-controlled. That means:

  • Follow your doctor’s advice including taking medications as directed.
  • If possible, get a 90-day supply of your prescription medications so you don’t have to go regularly to the pharmacy to pick them up.
  • Have a plan for if you do get sick
    • Watch your health for new symptoms
    • Stay in touch with family, friends, neighbours as you may need to ask for help if you become sick
    • Have a backup plan for who can care for you if your caregiver gets sick
  • If you are family/caregiver
    • Know what medications are prescribed and make sure supplies are on hand
    • Have a backup plan to make sure food and other supplies needed are available
    • Determine who can take over if you become sick

Looking after your emotional health & well-being

2

It is normal to feel concerned about COVID-19. Being asked to avoid and reduce human contact, to socially distance ourselves and to self-isolate goes against human nature. It is the opposite of what humans want to do in a crisis. This can affect your mental and physical health. However, there are many things you can do to mind your mental health and it is important to stay positive and focus on what can you do rather than what you cannot.

Firstly, being aware of your own emotions addressing how you think and feel, will help you in coping. Over the coming days, weeks and months people’s lives will change, but it is important to keep things in perspective as this will pass.

You may notice feeling

  • increased anxiety
  • feeling stressed
  • finding yourself excessively checking for symptoms, in yourself, or others
  • becoming irritable more easily
  • feeling insecure or unsettled
  • fearing that normal aches and pains might be the virus
  • having trouble sleeping
  • feeling helpless or a lack of control
  • having irrational thoughts

People with cardiovascular disease

People who have cardiovascular disease or who have experienced a stroke may be more likely to experience anxiety or stress in relation to the outbreak of COVID-19 virus. There are many reasons for this, such as the fact that you are in the at risk group for COVID-19 virus. You are at no greater risk of developing COVID-19 than anyone else. However, if you do contract the virus you have a higher chance of developing complications. 

Although the link between stress and the risk of heart disease and stroke is not well understood, we do know that stress can increase your blood pressure, impact on the blood clotting mechanism and result in people leading an unhealthy lifestyle. For example as a coping mechanism people are more likely to increase their caffeine intake, smoke, drink more alcohol and be less active when they are stressed.

If you have heart disease, being anxious or stressed may bring on symptoms like angina (chest pains).  If you do experience chest pains, please do not delay in calling 999 or 112. The emergency departments are still open for business as are all hospitals.

It isn’t possible to avoid stress completely but we can change the way we cope with it, particularly with of the outbreak of COVID-19 and the imposed control measures. 

Our top 5 recommendations for reducing stress and anxiety:

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1. Stay connected

Social support is proven to be an important factor in protecting our mental health against negative feelings. Stay in touch with friends and family using mobile technology such as WhatsApp, Skype and video calls. Telephone, text and email. Check in on elderly and vulnerable neighbours. Remember you don’t have to appear strong and try to cope with things on your own. Speaking to others and talking things through can reduce anxiety and worry.

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2. Limit your exposure to media

The constant stream of updates and news about COVID-19 can be overwhelming and cause increased anxiety. It can be difficult to separate facts from fiction. Use only trustworthy and reliable sources such the HSE and the Department of Health. Try to limit social media usage, set yourself times during the day to check for updates. If you are finding the COVID-19 coverage upsetting or too intense talk it through with a friend or family member. Remember much of the information online is driven by people’s personal opinion’s, beliefs and agendas and it may not be helpful for you to take these on as your own right now.

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3. Get a good night’s sleep

Sleep is closely linked to our mood and mental health, sleep disruption and poor quality sleep can negatively impact on your mood. Try to maintain regular sleep patterns it can be unhealthy to fall into bad habits such as going to bed later and getting up later. Changes to your sleep pattern now could impact on your mood in the weeks, months ahead. Try to maintain a routine scheduling daily activities throughout the day such as exercise and relaxing activities. If worrying feelings or thoughts are preventing you from achieving good quality sleep, try talking them through with someone.

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4. Maintain a healthy routine

Your normal daily routine may be affected by COVID-19, but trying to keep some structure will help. Pay attention to your needs and feelings during this time especially during times of stress. You may still be able to do some of the things you enjoy and find relaxing. For example this may include regular exercise, practicing relaxation techniques or reading a book. Try Chair Yoga with our incredible instructor, Vicky Harkin!

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5. Practice self-care

In times like this with the outbreak of COVID-19 we have a responsibility to ourselves to practice self-care. If we don’t practice self-care we will be of less use to ourselves and to others. Examples of self-care include:

  • cooking healthy nourishing meals
  • allowing yourself time to engage in the things you enjoy
  • taking time to relax
  • setting boundaries – such as saying no to visitors and reducing demands on yourself to prevent burn out
  • Practice mindfulness, meditation, walking or baking- small changes that you will be able to continue with post COVID-19

Try to keep things in perspective, things will get better.