Mustafa KARABACAK

COVİD-19 PANDEMİSİNİN KARDİYOVASKÜLER ETKİLERİ

Koronavirüs hastalığı-2019 (COVID-19), DSÖ tarafından Mart 2020 de Pandemi olarak kabul edildi ve etken “Ciddi Akut Solunumsal Sendrom-Koronavirüs-2” (SARS-CoV-2) olarak isimlendirildi. SARS-CoV2 enfeksiyonu, anjiyotensin dönüştürücü enzim 2'nin (ACE2) virüs yüzeyine diken proteinlerle bağlanmasıyla hücreye penetre olmaktadır. Çalışmalarda COVID-19 enfeksiyonuna, kardiyovasküler hastalıkların sıklıkla eşlik ettiği ve kötü prognozla ilişkili olduğu gösterilmiştir. COVİD-19 enfeksiyonu miyokardit, kalp yetmezliği, akut koroner sendromlar, aritmi, kardiyojenik şok gibi bazı kardiyovasküler komplikasyonlara neden olabilir. Bu olumsuz kardiyovasküler komplikasyonlar, ACE2 yolu ile doğrudan miyokardiyal hasar veya SARS CoV-2'nin dolaylı kardiyak etkileri nedeniyle ortaya çıkar. Özellikle hiperenflamasyona bağlı olarak gelişen sitokin fırtınası kalp hasarından sorumlu olabilir. COVID-19 ile enfekte olmuş hastaların % 25'inden fazlası miyokardiyal hasara sahiptir. Bu nedenle, COVID-19 ile enfekte olan hastalar, hastanede kaldıkları süre boyunca, mutlaka miyokardiyal hasar açısından değerlendirilmelidir.

CARDIOVASCULAR EFFECTS OF COVID-19 PANDEMIA

The coronavirus disease-2019 (COVID-19) has rapidly developed into a global pneumonia pandemic. SARS-CoV2 infection is occurred by attaching angiotensin converting enzyme 2 (ACE2)with spike proteins on the surface of virus. Cardiovascular diseases is most common comorbidity of COVID-19 patients and is closely related to poor prognosis. COVİD-19 infection may cause a some of cardiovascular complications such as myocardit, heart failure, acute coronary syndroms, arrhythmia, cardiojenic shock. These unfavourable cardiovascular complications occur due to the direct myocardial injury by ACE2 pathway or indirect cardiac effects of SARS CoV-2. Especially, Cytokine storm that develops especially due to hyper-inflammation may be responsible for cardiac damage. More than 25% of COVID-19 infected patient have myocardial injury .Thus, COVID-19 infected patients must be followed for myocardial injury during the hospital stay.

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