Covid-19 and cardiovascular disease increase each other’s severity


AU Faculty of Medicine, Cardiovascular Surgery Faculty Member Prof. Dr. İlhan Gölbaşı said that four of the seven types of coronaviruses cause mild symptoms, while the remaining three (SARS, MERS, COVID-19) cause fatal diseases. Prof. Dr. Gölbaşı said, “Covid-19 is a fatal disease that spreads very rapidly and progresses with acute respiratory distress syndrome or pneumonia in symptomatic cases,” said Gölbaşı.

Stating that the disease is transmitted by airborne droplets from infected people during cough, sneezing or speech, Prof. Dr. Gölbaşı said, “In addition, it is transmitted to the mucous membranes after touching the infected surfaces. 3-7 days after the virus enters the body, it occurs with fever, cough, fatigue, muscle, head, abdominal pain, diarrhea and respiratory distress.”

‘ATTENTION TO HEART-VESSEL PATIENTS’

Stating that the patient’s previous respiratory disease, infection and cardiovascular disease are important in terms of getting sick and the development of vital complications, Prof. Dr. Gölbaşı said, “Covid-19 and the underlying cardiovascular disease mutually increase the severity of each other. Complications due to both diseases are exacerbated,” said Gölbaşı.

‘HEART, LUNGS, KIDNEY AND BLADDER CELLS’

Stating that Covid-19 enters cells at a high rate in the heart and lungs, Prof. Dr. Gölbaşı, “Lung type 2 alveolar cells, especially kidney cells, bladder urethelial cells. This shows that other organs other than the lungs also show disorders,” he said.

‘RAPID HEART RATE’

Stating that Covid-19 increases arrhythmia, Prof. Dr. Gölbaşı said, “The increase in heart rate is thought to develop as a result of hypokalemia (low potassium) that develops as a result of the interaction of the coronavirus with the system that regulates blood pressure and fluid balance. Hypokalemia increases sensitivity to various tachyarrhythmias (rapid heartbeat). In addition, it increases its severity in patients with previous arrhythmias. It has been shown that 16 percent of patients develop arrhythmia. In patients followed up in intensive care, this rate can rise up to 40 percent, “he said.

‘NEEDS OF INTENSIVE CARE IS 2-3 TIMES MORE THAN’

Stating that various cardiovascular risk factors also negatively affect the prognosis (prediction-estimation) of these patients, Prof. Dr. İlhan Gölbaşı said:

“In a meta-analysis of six studies published in China, involving 1527 patients with Covid-19, it was reported that it was 9.7 percent in diabetes, 16.4 percent in cardio-cerebrovascular patients, and 17.1 percent in hypertensive patients, respectively. More importantly, the presence of diabetes, cardiovascular disease and hypertension increases the development of serious disease or the need for intensive care 2-3 times. The high rate of hypertension in these patients is explained by the prevalence of hypertension in the elderly patient population and their vulnerability to infection. “

‘DEATH RATE IN HEART PATIENTS 10.5 PERCENT’

Noting that the mortality rate in Covid-19 cases in general is 2.3 percent, it is higher in hypertension, diabetes and cardiovascular patients and is seen as 6 percent, 7.3 percent and 10.5 percent, respectively. Dr. Gölbaşı said, “The incidence of cardiovascular diseases and their effects on clinical outcomes vary significantly in different geographical regions.”

‘HIGH RATE OF HEART ATTACK’

Noting that it was observed that Covid-19 infection caused damage to the heart as well as to the lungs. Dr. Gölbaşı said, “Studies have shown that severe / critical Covid-19 patients have a high level of effect on the immune system in the circulation. Consequently, severe systemic inflammation and multi-organ failure may develop. “It is thought that the risk of heart attack may increase. It can cause damage to the heart muscle due to serious drops in blood oxygen levels, mostly by holding the respiratory system.”

‘HEART FAILURE DEVELOPED IN 52 PERCENT OF THE PATIENTS LOST’

Prof. Dr. Gölbaşı said, “Due to these mechanisms, it has been observed that patients have significant increases in troponin (heart enzyme) level, which shows myocardial (heart muscle) damage. It is known that a significant increase in troponin develops in roughly 8-12 percent of positive cases. In the group with mild disease, this rate is 1-2 percent. Despite the increase in enzyme levels, ECG changes were not detected in the patients. In the studies, it was observed that 52 percent of the patients who died and 12 percent of those who were discharged developed heart failure.


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