Pandemi Sonrası Yatan Erişkin Hastalarda Solunum Yolu Virüslerinin Tekli ve Eşzamanlı Enfeksiyonlarına İlişkin Klinik Sonuçlar

Year 2025, Volume: 8 Issue: 3, 388 - 395, 22.10.2025

Özlem Güler , Melih Berkay Esgin , Müge Toygar Deniz , Birsen Mutlu , Aynur Karadenizli , Sila Akhan

https://doi.org/10.53446/actamednicomedia.1779267

Abstract

Amaç: Pandemi sonrası dönemde, SARS-CoV-2 diğer solunum virüsleriyle birlikte dolaşmaya devam etmektedir. Bu çalışma, pandemi sonrası tek ve eşzamanlı enfeksiyonların epidemiyolojisini değerlendirmek ve ana prognostik sonuç olarak yoğun bakım ünitesi (YBÜ) gereksinimlerini değerlendirmek amacıyla yapılmıştır.
Yöntem: Bu retrospektif kohort çalışması, Mayıs 2023 ile Ocak 2024 tarihleri arasında bir üçüncü basamak sağlık merkezinde gerçekleştirilmiştir. Hastanede yatan solunum semptomları olan ve laboratuvar tarafından doğrulanmış viral enfeksiyonları olan yetişkin hastalar çalışmaya katılmıştır. Klinik özellikler, viral dağılım ve YBÜ yatışının öngörücüleri analiz edilmiştir.
Bulgular: Toplam 231 hastanın %51,9’unda SARS-CoV-2, %16,9’unda influenza ve %12,6’sında rinovirüs/enterovirüs saptanmıştır. Viral ko-enfeksiyonlar olguların %6,1’inde tespit edilmiştir. Hastaların %18,2’sinde YBÜ yatışı gerekmiş olup virüs türüne göre veya tek enfeksiyon ile ko-enfeksiyonlar arasında anlamlı fark bulunmamıştır. Çok değişkenli analizde, diabetes mellitus (aOR: 2,63; %95 CI: 1,03-6,70), kronik böbrek hastalığı (aOR: 3,89; %95 CI: 1,41-10,69), konjestif kalp yetmezliği (aOR: 6,12; %95 CI: 2,23-16,77), serebrovasküler olay (aOR: 4,06; %95 CI: 1,22-13,50) ve metastatik solid tümörler (aOR: 10,27; %95 CI: 2,09-50,39) yoğun bakım ünitesi yatışı ile bağımsız olarak ilişkili bulunmuştur.
Sonuç: Pandemi sonrası dönemde hastanede yatan yetişkinlerde SARS-CoV-2 baskın solunum virüsü olmaya devam etmektedir. Viral ko-enfeksiyonlar nadirdir ve YBÜ yatış riskinin artmasıyla ilişkili değildir; ancak kardiyovasküler, metabolik ve onkolojik komorbiditeler ciddi klinik sonuçlarla bağımsız olarak ilişkilidir.

Keywords

Solunum Yolu Enfeksiyonları , Virüsler , Koenfeksiyon , SARS-CoV-2 Virüsü , Grip , Yoğun Bakım Üniteleri

Ethical Statement

Yazarlar, derginin yazar kılavuzunda belirtilen etik politikalarının uygulandığını ve ilgili etik inceleme kurulunun onayını aldıklarını teyit ederler. Bu çalışma, 2013 yılında revize edilen Dünya Tıp Birliği'nin Helsinki Bildirgesi'ne ve Kocaeli Üniversitesi Tıp Fakültesi Etik Kurulu'nun protokollerine uygun olarak insanlarla ilgili deneyler için gerçekleştirilmiştir. Projeye 2024/140 numarası verilmiş ve GOKAEK-2024/05.17 koduyla onaylanmıştır.

Supporting Institution

Yazarlar, bu araştırmanın kamu, ticari veya kar amacı gütmeyen kuruluşların herhangi bir finansman kurumundan herhangi bir mali destek almadığını beyan ederler.

Thanks

Meslektaşımız ve dostumuz Emel Azak'ın ani vefatı bizi derinden etkilemeye devam ediyor. Onun anısını saygıyla anıyor ve takdir ediyoruz. Ayrıca, verilerin istatistiksel analizini gerçekleştiren Kocaeli Üniversitesi Tıp Fakültesi Biyoistatistik ve Tıbbi Bilişim Anabilim Dalı'ndan Doç. Dr. Sibel Balcı'ya da teşekkürlerimizi sunuyoruz.

Clinical Outcomes of Single and Co-infected Respiratory Viral Infections in Hospitalized Adults After the Pandemic

Abstract

Objective: In the post-pandemic era, SARS-CoV-2 continues to circulate alongside other respiratory viruses. This study aimed to evaluate the epidemiology of single and co-infections after the pandemic and to assess intensive care unit (ICU) requirements as the main prognostic outcome.
Methods: This retrospective cohort study was conducted between May 2023 and January 2024 at a tertiary care center. Adult hospitalized patients with respiratory symptoms and laboratory-confirmed viral infections were included in the study. The clinical characteristics, viral distribution, and predictors of ICU admission were analyzed.
Results: Among 231 patients, SARS-CoV-2 (51.9%), influenza (16.9%), and rhinovirus/enterovirus (12.6%) were the most frequently detected viruses. Viral co-infections were identified in 6.1% of the cases. ICU admission was required in 18.2% of the patients, with no significant difference by virus type or between single and co-infections. In multivariable analysis, diabetes mellitus (aOR: 2.63; 95% CI: 1.03-6.70), chronic kidney disease (aOR: 3.89; 95% CI: 1.41-10.69), congestive heart failure (aOR: 6.12; 95% CI: 2.23-16.77), cerebrovascular accident (aOR: 4.06; 95% CI: 1.22-13.50), and metastatic solid tumors (aOR: 10.27; 95% CI: 2.09-50.39) were independently associated with ICU admission.
Conclusion: SARS-CoV-2 remains the predominant respiratory virus in hospitalized adults in the post-pandemic era. Viral co-infections were uncommon and not associated with an increased risk of ICU admission, whereas comorbidities such as cardiovascular, metabolic, and oncological conditions were associated with severe outcomes.

Keywords

Respiratory Tract Infections , Viruses , Coinfection , SARS-CoV-2 Virus , Influenza , Intensive Care Units

Ethical Statement

The authors confirm that the ethical policies of the journal, as noted on the journal’s author guidelines page, have been adhered to and appropriate ethical review committee approval has been received. This study was conducted in accordance with the Declaration of Helsinki of the World Medical Association, revised in 2013, for experiments involving humans, and with the protocols of the Ethics Committee of Kocaeli University Faculty of Medicine. The project was assigned number 2024/140 and received approval under the code GOKAEK-2024/05.17.

Supporting Institution

The authors declare that this research did not receive any financial support from any funding agency in public, commercial, or not-for-profit organizations.

Thanks

The abrupt passing of our colleague and friend Emel Azak continues to affect us. We respectfully remember and acknowledge her memory. We also acknowledge Associate Professor Dr. Sibel Balcı from Kocaeli University, Faculty of Medicine, Department of Biostatistics and Medical Informatics, Kocaeli, Turkey, for statistical analysis of the data.

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