As a heart disease specialist, Dr. Akshay Pendyal has seen, firsthand, the effect that COVID-19 infection can have on patients with pre-existing heart conditions. Clinical outcomes are worse in COVID patients with cardiovascular disease and conditions such as hypertension, diabetes, and obesity, evidence shows.
"We have also learned that racial and ethnic minorities have been disproportionately affected by the COVID-19 pandemic" said Pendyal, a Novant Health cardiologist who works at the Movement Family Wellness Center on Freedom Drive in Charlotte, which serves many Hispanic and Black patients – two populations that have seen a "disparate impact."
The causes of this imbalance are due, in large part, to disparities in education, housing, healthy food, and access to healthcare. Known collectively as “social determinants of health,” these factors are critical to overall health and well-being.
Racial and ethnic disparities in these social determinants of health, in turn, contribute to higher rates of chronic conditions such as obesity, diabetes, and cardiovascular disease (CVD) among Black and Hispanic populations. And these chronic conditions are associated with more severe outcomes in COVID patients.
With this in mind, Pendyal answered some of the questions his heart patients ask most frequently:
What special risks does COVID present to people with heart disease or related conditions?
Patients with heart disease are at higher risk of getting really sick from the virus, to the point where they may require hospitalization or intensive care. By "heart disease," I mean common conditions such as high blood pressure, congestive heart failure (an inability of the heart to adequately pump blood), and coronary artery disease (or plaque buildup in the walls of the blood vessels).
What special precautions should heart patients take to prevent infection?
I tell all of the patients I see in my cardiology clinic to always wear a mask when leaving the house, to avoid large gatherings and to maintain social distancing, and to wash their hands frequently.
Should heart patients get the COVID vaccine?
Yes! I am advising my patients to get the vaccine and booster if they're eligible. Not only am I vaccinated, more than 9 billion doses have been safely administered around the world.
One thing I tell all of my patients is that the technology that forms the basis for the mRNA vaccines (Pfizer and Moderna) has been around for a while. It's been extensively studied by researchers across the world. This technology involves using your body's own defenses in preventing you from getting sick.
However, if you have concerns, please consult with your doctor about any specific questions related to your condition.
Is one vaccine preferred over another?
In line with the CDC’s recommendation to use mRNA vaccines over Johnson & Johnson, Novant Health is now exclusively offering Moderna and Pfizer COVID immunizations for the primary series. People who experienced an allergic reaction to an mRNA vaccine can, however, opt to receive a J&J booster at Novant Health.
The recommendation cited the risk of blood clots linked to J&J’s vaccine.

“I would emphasize that the adverse events the Centers for Disease Control and Prevention (CDC) includes in their latest report are incredibly rare and involve blood clotting. However, COVID-19 itself creates much higher risk of blood clots than the vaccine does. Despite these changes, J&J has been important tool and protected millions of people around the world from getting COVID,” said Dr. David Priest, Novant Health chief safety, quality and epidemiology officer.
Individuals who prefer or are only eligible for the J&J vaccine are encouraged to check NCDHHS or a retail pharmacy for availability.