Evaluation of cardiac problems in follow-up in patients with mild COVID-19 infection

Aim: Although the findings of respiratory system involvement of Covid-19 infection are at the forefront, its effects on the cardiovascular system should also be carefully evaluated. Covid-19 infection can cause cardiac problems such as acute coronary syndrome, myocarditis, myopericarditis, acute heart failure, arrhythmia and sudden cardiac death. Cardiovascular complications and outcomes are not well known in the group of patients with mild or asymptomatic Covid infection, especially in the outpatient group without hospitalization. This group, which has outpatients, cannot be adequately investigated in terms of cardiac problems. We observe that patients with Covid-19 infection frequently apply to cardiology outpatient clinics with symptoms such as palpitations and shortness of breath, which may suggest arrhythmia and heart failure, or experience unexpected serious cardiac problems. In our thesis, it was aimed to investigate the long-term effect of Covid-19, which may cause myocardial involvement and predisposition to arrhythmia, in the patient group who have mild or asymptomatic infections, which constitute the majority of the population. Material and Method: Patients who applied to the cardiology outpatient clinic with various complaints and were learned to have had mild covid within the last 1 year (at the earliest 3 months ago) were included in the study. A total of 60 patients over the age of 18 were included in the study. The patients' times of covid exposure, symptoms, drugs used during covid infection, medical problems encountered after infection, vaccination, type and numbers were recorded. In order to determine the structural and functional cardiopulmonary involvement in patients with cardiopulmonary symptoms, electrocardiography (ECG), posteroanterior lung (PAAC) radiographs were taken, two-dimensional (2D) transthoracic echocardiography (ECHO) and strain ECHO were performed, routine diagnostic biochemical tests (complete blood count, Crp, troponin, BNP, D-dimer etc.) were measured. Results: Patients with mild Covid-19 infection applied to our cardiology outpatient clinic with complaints of chest pain (70%) and palpitation (63.3%), most commonly dyspnea (83.3%). No pathology was observed in the biochemical parameters measured in our study group. Five (8.3%) patients had right bundle branch block (RBBB), 6 patients had fragmented QRS and 3 (5%) patients had ST/T wave changes, but these patients were similar in symptoms to other patients and did not have arrhythmias. No impairment was observed in TPE (T-peak Tend) duration and cardiac electrophysiological balance index (ICEB), which are important in terms of arrhythmia susceptibility. In 2D ECHO, left and right ventricle dimensions and functions were within normal limits. No serious valve pathology was observed. Strain measurements, which can show myocardial involvement at an early stage, were within normal limits as 21.27 ± 1.88. Conclusion: In our study, no cardiac arrhythmia, myocardial and pericardial pathology were found in terms of cardiovascular complications in the chronic period follow-up of patients with mild covid-19 infection.