Cosgun, Muharrem Said

Objectives: Myocardial injury is closely associated with the poor prognosis of patients infected with coronavirus disease 2019 (COVID-19). Early diagnosis of cardiovascular complications that develop during the process of COVID-19 is crucial. R-wave peak time (RWPT) is an electrocardiographic parameter in which myocardial involvement caused by various situations is shown. This study was designed to assess the predictive value of RWPT in patients infected with COVID-19 who developed a myocardial injury. Methodology: A total of 138 patients diagnosed with COVID-19 were enrolled in this prospective study. The patients were classified according to their troponin values ― study group (SG, n= 52) with high troponin and control group (CG, n= 86) without elevated troponin. All data obtained from patients were compared. Results: QRS duration (101 ± 5 ms vs. 99 ± 6 ms, p= .013) and RWPT (43 ± 6 ms vs. 38 ± 5 ms, p<0.001) were significantly longer in SG than in the CG. In multivariate analysis, C-reactive protein (OR: 1.109, 95% CI: 1.058–1.163; p<0.001), ejection fraction (OR: .844, 95% CI: .765–.931; p=0.001), and RWPT (OR: 1.211, 95% CI: 1.096–1.339; p<0.001) were independent predictors of myocardial injury in COVID-19-infected individuals. The ROC analysis revealed a cut-off value of RWPT for myocardial injury of 40.5 ms, with a sensitivity of 63.5% and a specificity of 62.8% (AUC: 0.730, 95% CI: 0.641–0.819, p<0.001). Conclusion: RWPT is a significant predictor of myocardial injury and may benefit in better identifying patients with myocardial injury in COVID-19.

Cosgun, Muharrem Said

Objectives: This study aimed to examine the relationship between cardiologists’ smoking habits and their attitudes toward smoking cessation management. Methodology: This cross-sectional study collected data from cardiologists actively working at 56 different centres in 2021. A questionnaire was sent to cardiologists via e-mail. Participation was voluntary. Results: A total of 218 cardiologists, 183 (83.9%) nonsmokers and 35 (16.1%) smokers, were included in the study. The median age of the participants was 46 years (range: 31−69 years), and 75.7% (n = 165) were male. There were no statistically significant differences between the smokers and nonsmokers in terms of demographic characteristics. More nonsmoking than smoking cardiologists advised their patients to quit smoking (71% vs. 37.1%; p < 0.001). However, there were no statistically significant differences between the two groups in terms of pharmacological therapy (34.9% vs. 28.6%; p = 0.464), psychological support (23% vs. 17.1%; p = 0.447), or electronic cigarette recommendations (3.3% vs. 8.6%; p = 0.149), and most participants made no relevant recommendations (66.1%, 78%, and 95.9%, respectively). Conclusion: Cardiologists’ smoking habits directly affect their attitudes toward smoking cessation management. The significant benefits of quitting smoking for cardiovascular disease prevention require that cardiologists make stronger recommendations for smoking cessation therapies and counseling to their patients.

Cosgun, Muharrem Said

Objectives: The presence of cardiac involvement is accepted as an indicator of morbidity and mortality in Coronavirus disease 2019 (COVID-19) patients. Therefore, this study investigates data on cardiovascular involvement and clinical outcomes between the first wave with wild virus and mutation-dominant second wave of the COVID-19 outbreak. Methodology: This was a single centre, retrospective study using and the data was collected from confirmed COVID-19 patients. Patients' demographic and clinical characteristics, cardiovascular involvement, and the factors associated with mortality were analysed. All these data were compared between first (wild virus) and second-wave (mutant viruses) patients. Results: The study included 476 positive inpatients confirmed by a real-time polymerase chain reaction. Although the length of hospital stay was similar, the duration of intensive care units (ICUs) was longer in the second wave (6.3 ± 3.2 vs. 7.5 ± 3.5; p=0.020). The rate of severe illness (12.9 vs. 20.3%; p=0.037) and critical illness referral to ICUs (4.3 vs. 9.7%; p=0.031) was higher in the second wave than in the first. In addition, the incidence of myocardial damage was significantly higher in the second wave (4.3 vs. 10.7%; p=0.046). Conclusion: In the present study, myocardial injury, development of critical illness, and referral to the ICUs increased in correlation with the disease severity in the second wave compared to the first. Variant viruses and possibly the burden of the crowd on healthcare contribute to this situation. Therefore, epidemiological data are required to guide situational awareness as long as the pandemic remains.