COVID-19 GEÇİRMİŞ HASTALARDA ARTERYEL SERTLİĞİN HASTALIK CİDDİYETİ İLE İLİŞKİSİ

Year 2024, , 328 - 333, 18.07.2024

Lütfullah Candan , Merih Kutlu , Mürsel Şahin

https://doi.org/10.18229/kocatepetip.1390586

Abstract

AMAÇ: COVID-19 ile ilişkili hedef organ hasarının patogenezinde endotel disfonksiyonu önemli rol oynamaktadır. Güçlü inflamatuvar hasara bağlı kardiyovasküler (KV) komplikasyonlar yoğun bakımda yatan COVID-19 hastalarında, hastalığı ayakta geçirenlere göre daha sık görülmektedir. Bu çalışmayı COVID-19 geçirmiş hastalarda infeksiyon ciddiyeti ile arteryel sertlik arasındaki ilişkinin, gelecekteki KV olayların bir öngördürücüsü olup olmadığını araştırmayı amaçladık.
GEREÇ VE YÖNTEM: Hastalar COVID-19 şiddetine göre yoğun bakımda yatan (ağır grup) ve hastalığı ayakta geçiren (hafif grup) olmak üzere iki gruba ayrıldı. Çalışmaya kontrol grubu olarak COVID-19 geçirmemiş hastalar alındı. Hastaların enfekte iken bakılan biyokimyasal parametreleri ise retrospektif olarak hastane veri tabanından elde edildi. Tüm grupların arteryel sertlik ve ekokardiyografik ölçümleri COVID-19 infeksiyonu sonrası ilk 1 ay içinde yapıldı.
BULGULAR: Çalışmaya 27’si kontrol, 32’si hafif ve 25’i ağır hastalık grubunda olmak üzere toplam 84 hasta alındı. Tüm popülasyonun yaş ortalaması 48.68±12.9 olup 58’i (%69) erkekti. AS ölçümlerinde elde edilen ortalama pulse wave velosite değerleri kontrol grubunda 8.02 m/s, hafif hastalık grubunda 8.07 m/s, ağır hastalık grubunda ise 8.75 m/s idi. Yoğun bakımda tedavi gören ağır hasta grubunun AS değerleri, kontrol ve hafif hasta grubuna göre daha yüksek olarak izlendi (sırasıyla p=0.007, p=0.008). Ancak hafif hastalık geçirenlerle kontrol grubu arasında AS değeri açısından istatistiksel olarak anlamlı fark yoktu (p=0.681).
SONUÇ: Çalışmamızda COVID-19 infeksiyonunu ağır geçiren hastaların arteryel sertlik değerlerini daha yüksek bulduk. Bu sonuç abartılı ve kontrolsüz inflamasyona sekonder endotel hasarı ile açıklanabilir. Bu nedenle böyle hastalarda yüksek PWV değerleri, gelecekteki kardiyovasküler olayların bir öngördürücüsü olarak kullanılabilir.

Keywords

COVID-19, Arteryel Sertlik, Endotel Hasarı, İnflamasyon.

THE RELATIONSHIP BETWEEN ARTERIAL STIFFNESS AND DISEASE SEVERITY IN PATIENTS WHO HAVE HAD COVID-19

Abstract

OBJECTIVE: Endothelial dysfunction plays an important role in the pathogenesis of target organ damage associated with COVID-19. In patients with COVID-19, cardiovascular (CV) complications due to strong inflammatory damage are more frequently observed in intensive care units patients compared to outpatients. In this study, we aimed to investigate whether the relationship between the severity of COVID-19 infection and arterial stiffness (AS) could be a predictor of future CV events, in patients who had COVID-19 infection.
MATERIAL AND METHODS: Patients were divided into two groups as those admitted to the intensive care unit (severe group) and outpatients (mild group), based on the COVID-19 severity. Patients without COVID-19 were included in the study as a control group. The biochemical parameters of the patients were obtained retrospectively from the hospital database. AS and echocardiographic measurements for all groups were performed within the first month after COVID-19 infection.
RESULTS: A total of 84 patients, 27 of whom were in the control, 32 in the mild disease and 25 in the severe disease groups, were included in the study. The mean age of the study population was 48.68±12.9 years, and 58 (69%) were male. The mean pulse wave velocity values obtained in AS measurements were 8.02 m/s in the control group, 8.07 m/s in the mild disease group and 8.75 m/s in the severe disease group. AS value of patients with severe disease who were treated in intensive care unit was significantly higher compared to controls and those with mild disease (p=0.007, p=0.008, respectively). However, there was no statistically significant difference in AS values between the patients with mild disease and control group (p=0.681).
CONCLUSIONS: In our study, we found higher arterial stiffness values in patients who had severe COVID-19 infection. This result may be explained by endothelial damage secondary to exaggerated and uncontrolled inflammation. Therefore, high pulse wave velocity values in such patients may be used as a predictor of future cardiovascular events.

Keywords

COVID-19, Arterial stiffness, Endothelial damage, Inflammation.

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