Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
The Social, Psychological and Clinical Implications of the COVID-19 Pandemic in Cardiovascular Patients Using Angiotensin Converting Enzyme Inhibitor or Angiotensin Receptor Blocker
Anjiotensin Dönüştürücü Enzim İnhibitörü ya da Anjiotensin Reseptör Blokörü Kullanan Kardiyovasküler Hastalarda COVID-19 Pandemisinin Sosyal, Psikolojik ve Klinik Etkileri
Meltem Refiker EGEa, Ayşenur Feyza PAÇb, Seçil SAYINc, Yeşim AKINd, Burcu DEMİRKANe
aDepartment of Cardiology, Yüksek İhtisas University Faculty of Medicine, Ankara, TURKEY
bDepartment of Pediatric Cardiology, Yüksek İhtisas University Faculty of Medicine, Ankara, TURKEY
cClinic of Pediatric Cardiology, Ankara City Hospital, Ankara, TURKEY
dDepartment of Cardiology, Karabük University Faculty of Medicine, Ankara, TURKEY
eClinic of Cardiology, Ankara City Hospital, Ankara, TURKEY
Turkiye Klinikleri J Med Sci. 2021;41(2):150-7
doi: 10.5336/medsci.2020-80852
Article Language: EN
Full Text
ABSTRACT
 Objective: The heart expresses angiotensin converting enzyme (ACE)-2 that makes it vulnerable to severe acute respiratory syndrome-coronavirus-2. Besides ACE inhibitors/angiotensin receptor blockers (ARBs) are used for cardiovascular diseases. Although no significant increase in the risk of coronavirus disease-2019 (COVID-19) infection and no increase in the severity of disease in patients receving ACE inhibitor/ARB therapy were shown, it has been noticed that some patients have tendency to stop the use of these agents. The aim of this study is to determine the behavior attitude of the cardiovascular outpatients during pandemic who use ACE inhibitor/ARB and to asses the impact of COVID19 on them. Material and Methods: One hundred outpatients were included. A survey questioning the social, psychological and the clinical implications of COVID-19 was applied to volunteers. To measure the anxiety and despair levels, Beck scorings were used. Results: A small number of patients stopped using ACE inhibitors/ARBs. Severe hopelessness and severe anxiety levels were seen in a few patient. Gender, fear of getting sick, thinking to have enough information about COVID-19 and accessibilty to cardiovascular drugs were the factors affecting the Beck scores. Social distancing and cleaning hands are stated as the best measures for protection. Most of the patients preferred primary health clinics for routine controls and a few patient had knowledge about tele-medicine. Conclusion: Although a confusion has occured in the public about the use of ACE inhibitors/ARBs, drug release rates were found to be low. The anxiety and disparity levels are subsantially not severe. But it is still important to continue informing patients about the precautions and the use of tele-medicine.

Keywords: COVID-19; angiotensin converting enzyme inhbitor; angiotensin receptor blockers; Beck scores; precautions
ÖZET
 Amaç: Anjiotensin dönüştürücü enzim [angiotensin converting enzyme (ACE-2)] ekspresyonu, kalbi şiddetli akut solunum sendromu-koronavirüs-2'ye karşı duyarlı yapmaktadır. Bunun yanında birçok kardiyovasküler hastalıkta ACE inhibitörleri/anjiotensin reseptör blokörleri (ARB) kullanılmaktadır. ACE inhibitörü/ARB tedavisi alan hastalarda artmış koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)] riski ya da hastalığın ciddiyetinde bir artış görülmese de bazı hastaların bu ajanların kullanımını bırakmaya eğilimleri olduğu farkedilmiştir. Bu çalışmanın amacı, pandemi döneminde kardiyoloji polikliniğine başvuran ACE inhibitörü ve ARB kullanan kardiyovasküler hastaların davranış paternlerini belirlemek ve COVID-19'un bu hastalar üzerindeki etkilerini araştırmaktır. Gereç ve Yöntemler: Çalışmaya 100 gönüllü hasta dâhil edildi. Hastalara COVID-19'un sosyal, psikolojik ve klinik etkilerini sorgulayan önceden hazırlanmış bir anket uygulandı. Hastaların anksiyete ve umutsuzluk seviyelerini değerlendirmek için Beck ölçekleri kullanıldı. Bulgular: Çok az hastanın ACE inhibitörü/ARB kullanımını bıraktığı görüldü. Ciddi anksiyete ve umutsuzluk çok az hastada saptandı. Beck skorlarını etkileyen en önemli faktörlerin cinsiyet, hastalanma korkusu, COVID-19 hakkındaki bilgi düzeyi ve pandemi süresinde kardiyovasküler ilaçları temin edebilme durumu olduğu saptandı. Hastaların COVID-19'dan korunmada, sosyal mesafeyi koruma ve el yıkamayı en önemli önlemler olarak düşündükleri tespit edildi. Bu dönemde rutin kontroller için çoğu hastanın sağlık ocaklarını tercih ettiği ve çok az hastanın tele-tıp uygulaması hakkında bilgi sahibi olduğu tesbit edildi. Sonuç: Toplamda ACE inhibitörleri/ARB'lerin kullanımı açısından bir kafa karışıklığı yaşansa da çok az hastanın bu grup ilaçları bıraktığı görülmüştür. Hastalarda anksiyete ve umutsuzluk seviyeleri ciddi düzeyde değildir. Ancak hastalıktan korunmada alınacak tedbirler ve tele-tıp kullanımı konusunda hastaların halen bilgilendirilmesi gerekmektedir.

Anahtar Kelimeler: COVID-19; anjiotensin dönüştürücü enzim inhbitorleri; anjiotensin reseptör blokörler; Beck skoru; önlemler
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