COVID-19 AND EFFECTS ON THE CARDIOVASCULAR SYSTEM

Yıl 2024, Cilt: 25 Sayı: 2, 260 - 269, 29.04.2024

Fatma Yekta Urkmez Esra Polat

https://doi.org/10.18229/kocatepetip.1100443

Öz

Coronavirus Disease 2019 (COVID-19), which emerged at the end of 2019 and became a global pandemic, is not only a respiratory disease, but also affects other systems. The most important reason for this is the ability of the virus to bind to the angiotensin converting enzyme-2 (ACE2) receptor.The cardiovascular system is one of the main systems that are directly or indirectly affected by COVID-19. Regardless of respiratory symptoms, patients can be diagnosed with COVID-19 by applying to the hospital with complaints such as chest pain and palpitation. Also in the course of COVID-19 cardiological such as arrhythmia, acute coronary syndrome, myocarditis, heart failure; vascular effect patterns such as venous thromboembolism may also be seen. Worse outcomes are generally encountered when cardiovascular system involvement accompanies the course of COVID-19. Another aspect of the relationship between SARS-CoV-2 infection and the cardiovascular system is that the underlying cardiovascular system diseases adversely affect the prognosis of COVID-19. In the presence of conditions such as underlying hypertension, coronary artery disease, and heart failure, patients' exposure to COVID-19 results much worse. Unfortunately, it is reported that this cardiovascular system involvement is also observed in the "Prolonged COVID-19" period, which continues after the COVID-19. The frequency and duration of symptoms and signs vary in prolonged cases of COVID-19. Prolonged COVID-19 is characterized as alarming because of its widespread monitoring and long duration. In addition, after the introduction of mRNA vaccines, there has been an increase in vaccine-related myocarditis and pericarditis cases, especially in young men. However, this increase is at a very low rate compared to myocarditis and pericarditis cases due to the disease, and it has been determined that it is much safer in terms of mortality. In this review, it is aimed to evaluate the effect of COVID-19 and COVID-19 vaccines on the cardiovascular system and to present a holistic perspective to the clinicians who follow these patients.

Anahtar Kelimeler

SARS-CoV-2, Prolonged COVID-19, Cardiovascular system, mRNA vaccines, Myocarditis

COVID-19 VE KARDİYOVASKÜLER SİSTEME ETKİLERİ

Öz

2019 yılının sonunda çıkan ve global bir pandemi haline gelen Coronavirüs Hastalığı 2019 (COVID-19) sadece solunum sistemini tutan bir hastalık olmayıp diğer sistemleri de etkilemektedir. Bunun en önemli nedeni virüsün, anjiotensin dönüştürücü enzim-2 (ACE2) reseptörüne bağlanabilme özelliğidir. Kardiyovasküler sistem COVID-19’dan doğrudan veya dolaylı yollarla etkilenen sistemlerin başlıcalarından biridir. Hastalar respiratuar semptomlardan bağımsız olarak göğüs ağrısı, çarpıntı gibi şikayetlerle hastaneye başvurarak COVID-19 tanısı alabilmektedir. Ayrıca COVID-19 seyrinde aritmi, akut koroner sendrom, myokardit, kalp yetmezliği gibi kardiyolojik; venöz tromboemboli gibi vasküler etki paternleri de görülebilmektedir. COVID-19 seyrine kardiyovasküler sistem tutulumu eşlik ettiğinde genellikle daha kötü sonlanımlarla karşılaşılmaktadır. SARS-CoV-2 enfeksiyonu ile kardiyovasküler sistem ilişkisinin bir diğer açısı da altta yatan kardiyovasküler sistem hastalıklarının COVID-19 prognozunu olumsuz yönde etkilemesidir. Altta yatan hipertansiyon, koroner arter hastalığı, kalp yetmezliği gibi durumlar varlığında hastaların COVID-19’dan etkilenimi çok daha kötü sonuçlanmaktadır. Ne yazık ki bu kardiyovasküler sistem etkileniminin COVID-19’un ardından devam eden “Uzamış COVID-19” döneminde de izlendiği bildirilmektedir. Uzamış COVID-19 vakalarında semptom ve bulguların sıklığı ve süresi değişkenlik göstermektedir. Yaygın olarak izlenmesi ve uzun sürmesi nedeniyle uzamış COVID-19 endişe verici olarak nitelendirilmektedir. Bunların yanı sıra mRNA aşılarının kullanıma girmesinin ardından, özellikle genç erkeklerde aşı ile ilişkili myokardit ve perikardit vakalarında artış saptanmıştır. Ancak bu artışın hastalığa bağlı olarak ortaya çıkan myokardit ve perikardit vakalarına göre oldukça düşük bir oranda olup mortalite açısından ise çok daha güvenli olduğu tespit edilmiştir. Bu derlemede, COVID-19’un ve COVID-19 aşılarının kardiyovasküler sistem üzerine olan etkisinin değerlendirilmesi ve bu hastaların takibini yapan klinisyenlere bütüncül bir bakış açısının sunulması hedeflenmiştir.

Anahtar Kelimeler

SARS-CoV-2, Uzamış COVID-19, Kardiyovasküler sistem, mRNA aşıları, Myokardit

Kaynakça

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