Hafif COVID-19 Enfeksiyonundan İyileşen Hastalarda Ortostatik Hipotansiyon ve Kardiyak Fonksiyonun Değerlendirilmesi

Yıl 2025, Cilt: 5 Sayı: 2, 11 - 19, 31.07.2025

Ümmü Taş , Sedat Taş

https://doi.org/10.71255/maunsbd.1684291

https://izlik.org/JA26ZB79DB

Öz

Amaç: Bu çalışmanın amacı, hafif düzeyde COVID-19 enfeksiyonu geçirmiş ve iyileşmiş bireylerde ortostatik hipotansiyon (OH) sıklığını ve ekokardiyografik parametreleri, yaş ve cinsiyet açısından eşleştirilmiş bir kontrol grubuyla karşılaştırmaktır. Araştırma, hafif COVID-19 enfeksiyonunun kalp fonksiyonları ve kardiyovasküler otonomik yanıt üzerindeki olası etkilerini incelemeyi ve hastalığın uzun dönem kardiyovasküler sonuçlarını değerlendirmeyi hedeflemektedir.
Gereç ve Yöntemler: Bu kesitsel çalışma, 15 Mart 2021 ile 30 Mayıs 2021 tarihleri arasında kardiyoloji polikliniğine devam eden semptomları olan, laboratuvar testleriyle hafif COVID-19 enfeksiyonu geçirdiği doğrulanan 80 hastayı kapsamaktadır. Ayrıca, yaş ve cinsiyet açısından eşleştirilmiş 80 sağlıklı birey kontrol grubu olarak dahil edilmiştir. Katılımcıların boy, kilo ve bel çevresi gibi antropometrik ölçümleri kaydedilmiş; kan basıncı, oturur/yatar pozisyonda ve ayakta pozisyonda ölçülmüştür. Ortostatik hipotansiyon, ayakta durma sonrası üç dakika içinde sistolik kan basıncında ≥20 mmHg veya diyastolik kan basıncında ≥10 mmHg düşüş olarak tanımlanmıştır. Tüm katılımcılar, 12 derivasyonlu elektrokardiyografi (EKG) ve transtorasik ekokardiyografi ile değerlendirilmiştir. Ortostatik hipotansiyon sıklığı ve ekokardiyografik bulgular, uygun istatistiksel yöntemler kullanılarak iki grup arasında karşılaştırılmıştır.
Bulgular: COVID-19 sonrası persistan semptomları olan hastalarda, kontrol grubuna kıyasla ortostatik hipotansiyon sıklığı (%16.7’ye karşı %3.7, p=0.008) ve istirahat kalp hızı (p<0.001) anlamlı derecede yüksek bulunmuştur. Ekokardiyografik parametreler, COVID-19 grubunda daha yüksek olmasına rağmen, bu farklar istatistiksel olarak anlamlı bulunmamıştır. Ayrıca, ekokardiyografik bulgular ile yaş, beden kitle indeksi, cinsiyet veya ortostatik hipotansiyon arasında anlamlı bir ilişki saptanmamıştır.
Sonuç: Hafif COVID-19 enfeksiyonundan iyileşen bireylerde, ortostatik hipotansiyon gibi kardiyak anormallikler sık görülmekte olup bu durum, kardiyovasküler otonomik disfonksiyonun bir göstergesi olabilir. Bu bulgular, persistan semptomları olan post-COVID-19 hastalarında kapsamlı bir kardiyovasküler değerlendirmenin önemini vurgulamaktadır.

Anahtar Kelimeler

Ortostatik hipotansiyon , COVID-19 , otonomik disfonksiyon , ekokardiyografi , kardiyovasküler komplikasyonlar

Evaluation of Orthostatic Hypotension and Cardiac Function in Patients Recovered from Mild COVID-19 Infection

https://izlik.org/JA26ZB79DB

Öz

Objective: The purpose of this study was to evaluate the prevalence of orthostatic hypotension (OH) and echocardiographic metrics in individuals who have recovered from mild COVID-19 infection in comparison to a matched control cohort. This investigation seeks to explore the possible implications of mild COVID-19 on cardiac functionality and the autonomic cardiovascular response, as well as to examine the enduring cardiovascular ramifications of the illness.
Materials and Methods: This cross-sectional study encompassed a cohort of 80 patients with laboratory-confirmed mild COVID-19 infections who presented with ongoing symptoms at the cardiology outpatient clinic during the period from March 15 to May 30, 2021. Additionally, 80 healthy controls matched for age and sex were included in the study. Comprehensive anthropometric measurements, such as height, weight, and waist circumference, were recorded, while blood pressure was assessed in both sitting/supine and standing positions. Orthostatic hypotension (OH) was defined as a decline of ≥20 mmHg in systolic blood pressure or ≥10 mmHg in diastolic blood pressure occurring within three minutes of standing. All participants underwent a thorough evaluation, which included 12-lead electrocardiography (ECG) and transthoracic echocardiography. The occurrence of orthostatic hypotension and the echocardiographic findings were meticulously analyzed and compared between the two groups using appropriate statistical methodologies.
Results: Patients experiencing persistent symptoms following COVID-19 showed a notably higher prevalence of orthostatic hypotension (OH) at 16.2% compared to 3.7% in the control group (p=0.008) and had elevated resting heart rates (p<0.001). Although echocardiographic measures were all observed to be higher in the COVID-19 cohort, these differences did not reach statistical significance. Additionally, no meaningful correlations were identified between echocardiographic results and the variables of age, body mass index (BMI), sex, or OH.
Conclusion: Individuals recovering from mild COVID-19 often display cardiac abnormalities, including orthostatic hypotension, which may indicate the presence of cardiovascular autonomic dysfunction. These findings underscore the importance of performing a comprehensive cardiovascular evaluation for post-COVID-19 patients who are experiencing persistent symptoms.

Anahtar Kelimeler

Orthostatic hypotension , COVID-19 , autonomic dysfunction , echocardiography , cardiovascular complications

Kaynakça

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