Alanya’da yatarak tedavi gören COVID-19 hastalarının geriye dönük analizi

Öz

Amaç: SARS-CoV-2’nin etkeni olduğu COVID-19 pandemisi dünya genelinde ciddi morbidite ve mortaliteye neden olmaktadır. Bu çalışmada XXXXX’de yatarak takip ettiğimiz COVID-19 olguları geriye dönük irdelendi. Yöntemler: Mart 2020-Mayıs 2021tarihleri arasında COVID-19 tanısı ile yatırılarak takip ettiğimiz hastalar retrospektif olarak tarandı. Gerçek-zamanlı polimeraz zincir reaksiyonu (RT-PCR) ile SARS CoV-2 viral nükleik asit testi pozitif olan hastalar çalışmaya dahil edildi. Çalışmaya dahil edilen olguların hastane bilgi yönetim sistemi üzerindeki kayıtları ve dosyaları retrospektif olarak tarandı. Hastaların demografik, klinik ve laboratuvar değerleri hazırlanan formlara işlendi. Hastalığın derecesi hafif, orta, ciddi ve kritik olarak sınıflandırıldı. Bulgular: Onaltı hafif/orta, 34 ciddi/kritik hasta çalışmaya dahil edildi. Hastaların ortalama yaşı 58±15.9 yıl olup %64’ü erkek idi. Hipertansiyon (%28) ve Diabetes mellitus (DM) (%28) en sık saptanan komorbid hastalıklardı. Ciddi ve kritik hastalarda ileri yaş, DM, solunum sıkıntısı, derin lenfopeni (<800), d-dimer yüksekliği, C-reaktif protein (CRP) normal sınırın >20 kat yüksekliği, prokalsitonin yüksekliği (>0.25ng/ml) istatiksel olarak (p<0.05) anlamlı bulundu. Hastaların 46’sında favipiravir, 18’inde deksametazon (6 mg/gün, 5-10 gün), 3’ünde IL-6 reseptör blokeri ve 2’sinde immün plazma tedavisi verildi. Hafif vakalar dışında tüm hastalara proflaktik veya tedavi dozunda düşük molekül ağırlıklı heparin verildi. Mortalite gelişen beş olgunun hepsi erkek ve 50 yaş ve üzerinde olup en az bir komorbidetesi vardı. Sonuçlar: Ciddi ve kritik seyreden olgularda ileri yaş, DM, derin lenfopeni, d-dimer yüksekliği, CRP’nin normal sınırın 20 kat yüksekliği ve prokalsitonin yüksekliği anlamlı bulundu. COVID-19 hastalarında antiibiyotik tedavisinin düzenlenmesinde prokalsitonin önemli bir biyobelirteçtir.

Anahtar Kelimeler

• Koronavirüs
• COVID-19
• SARS-COV-2
• Pandemi

Retrospective analysis of clinical features in hospitalized COVID-19 cases in Alanya

Abstract

Objective: COVID-19 pandemic caused by SARS-CoV-2 has resulted in serious morbidity and mortality around the world. In this study, COVID-19 patients hospitalized in xxxx were examined. Methods: A retrospective analysis was performed for COVID-19 patients hospitalized between March 2020 and May 2021. The definitive diagnosis was made by the detection of SARS-CoV-2 nucleic acid by RT-PCR. The demographic, clinic and laboratory values were obtained through the medical records. The degree of the illness was classified as mild, moderate, severe and critical. Results: Sixteen mild/moderate and 34 severe/critically ill patients were included. The mean age was 58±15.9 years, 64% being males. Hypertension (28%) and Diabetes mellitus (DM) (28%) were the most common comorbidities. Being elderly, DM, dyspnea, profound lymphopenia, elevated d-dimer level, CRP being 20 times higher than the upper limit of normal, and high procalcitonin levels were statistically significant (p<0.05) in severe and critically ill patients. Ninety two percent received favipravir. Eighteen received dexamethasone (6 mg/day, 5-10 days), 3 received IL-6 receptor blockers, and 2 received immune plasma treatment. All patients received low-molecular-weight heparin in prophylactic or therapeutic doses except mild cases. Five patients that had developed mortality were male gender, elderly and had at least one comorbidity. Conclusion: Severe and critically ill patients were significantly more likely to have old age, DM, elevated d-dimer level, profound lymphopenia, CRP being 20 times more than the upper limits of normal, and high levels of procalcitonin. Procalcitonin is an important biomarker to guide the need for antimicrobial chemotherapy in COVID-19 patients.

Keywords

• Coronavirus
• COVID-19
• SARS-CoV-2
• Pandemic

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