COVID-19 TANISINI TAKİBEN BEHÇET HASTALIĞININ SEYRİ: GENİŞ BİR RETROSPEKTİF KOHORT ÇALIŞMASI

Abstract

Amaç: Behçet hastalığı mukokutanöz ve sistemik bulgularla seyredebilen kronik vaskülitik bir hastalıktır. Bu çalışmada Covid-19 enfeksiyonunun Behçet hastalığı semptomları ve seyri üzerine etkisini incelemeyi amaçladık. Gereç ve Yöntem: Üçüncü basamak bir Dermatoloji merkezinde takip edilen Behçet hastaları Covid-19 enfeksiyonu açısından sorgulandı. Daha önce PCR ile kanıtlanmış Covid-19 geçiren hastalarda Behçet hastalığı seyri ve aktivasyonu Behçet Hastalığı Aktivite İndeksi (BHAİ) ile retrospektif olarak değerlendirildi. Bulgular: Bu çalışma sürecinde poliklinik kontrolüne başvuran 449 Behçet hastasının 68'inin (%15,1) Covid-19 enfeksiyonu geçirme öyküsü mevcuttu. Hastaların yaş ortalaması 42,7±11,8 yıl olup, %63,2'si (n=43) kadındı. Behçet hastalarımızın çoğunda (n=48, %70,6) Behçet hastalığı sadece mukokutanöz tutulum ile seyrederken, bir kısmında (n=20, %29,4) çeşitli sistemik tutulumlar hastalık sürecinde gelişmişti. Bu hastaların büyük bir çoğunluğu (n=59, %86,8) enfeksiyon öncesinde sadece kolşisin tedavisi almaktaydı. Covid-19 enfeksiyonu öncesi BHAİ skorlama sistemine bakıldığında hastalarımızın %85,3'ü (n=58) remisyondaydı (BHAİ0), %14,7'si (n=10) ise halihazırda aktivasyondaydı (BHAİ-1-3). Covid-19 enfeksiyonunu takiben hastaların %39,7'sinde (n=27) aktivasyon veya hastalık şiddetinde artış görüldü (BHAİ-1-4). Behçet hastalarımızda enfeksiyonu takiben görülen hastalık aktivasyonu çoğunlukla mukokutanöz (n=21, %30,9) lezyonlar ile karakterizeydi. Hastaların %60,3'ünde (n=41) ise hastalık seyrinde herhangi bir değişiklik kaydedilmedi. Behçet hastalarında Covid-19 enfeksiyonu öncesi ve enfeksiyon sonrası BHAİ skorları karşılaştırıldığında anlamlı düzeyde (p<0,001 ve z=-4,691) Behçet hastalık şiddetinde artış tespit edildi. Sonuç: Covid-19 enfeksiyonu bazı hastalarda Behçet hastalığı semptomlarının aktivasyonuna, alevlenmesine ve hatta yeni organ tutulumuna yol açabilmektedir. Bu durum prospektif geniş serilerle doğrulanmalıdır.

Keywords

• Behçet hastalığı
• Covid-19
• hastalık aktivitesi

THE COURSE OF BEHÇET’S DISEASE FOLLOWING COVID-19 DIAGNOSIS: A LARGE RETROSPECTIVE COHORT STUDY

Abstract

Objective: Behçet’s disease (BD) is a chronic vasculitic disease with mucocutaneous and systemic involvements. This study aims to examine the effects of COVID-19 on the symptoms and course of BD. Material and Method: The BD patients who were followed up in our department with a history of COVID-19 were evaluated regarding the course of infection and the course of BD postCOVID diagnosis, assessed by Behçet’s Disease Activity Index (BDAI). Result: Among 449 BD patients, 68 (15.1%) had contracted COVID-19. The mean age of the patients was 42.7±11.8 years of whom 63.2% (n=43) were female. While most (n=48, 70.6%) had only mucocutaneous symptoms, others also had systemic symptoms (n=20, 29.4%) during their BD course; 86.8% (n=59) had received colchicine only at the time of infection. Prior to infection, 85.3% (n=58) had been in remission (BDAI score of 0), while 14.7% (n=10) already had active BD (BDAI score between 1-3). Post-COVID-19 diagnosis, activation or exacerbation of activation was seen in 39.7% (n=27) of BD patients, as characterized by increased BDAI scores (BDAI score between 1-4). No change was recorded in 60.3% (n=41) of the patients. Disease activation in the BD patients was mostly mucocutaneous (n=21, 30.9%). Comparison of the BD patients’ BDAI scores pre- and post-COVID-19 diagnosis revealed the scores to be significantly elevated (p<0.001; z=-4.691), demonstrating the possible effects of COVID-19 on BD severity. Conclusion: COVID-19 infection may lead to activation of BD symptoms, with new organs being involved in some patients, which should be confirmed by prospective large series.

Keywords

• Behcet’s disease
• COVID-19
• disease activity

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