İSTANBUL’DA ÜÇÜNCÜ BASAMAK BİR MERKEZİN COVID-19 PANDEMİSİNDE ÇOCUKLARDAKİ DENEYİMİ

Abstract

Amaç: Beklenmedik bir anda tüm dünyayı etkileyen SARS-CoV-2 virüsü milyonlarca insanı enfekte etmeye ve yüzbinlerce insanın da ölüme neden olmaya devam etmektedir. Pediyatrik yaş grubuna dair görüş birliği henüz sağlanamamıştır. Bu nedenle merkezimize ait pediyatrik grup deneyiminin paylaşılması amaçlanmıştır. Gereç ve Yöntem: Pandemi ilanından sonra merkezimize COVID-19 hastalığı şüphesiyle başvuran 1076 çocuk olgu ele alındı. SARS-CoV-2 polimeraz zincir reaksiyon testinde pozitif olan 85 çocuk, epidemiyolojik, klinik, laboratuvar ve görüntüleme verileri ile retrospektif olarak değerlendirildi. Bulgular: Hastaların yarısı erkek ve yaklaşık yarısı 60-179 ay arasındaydı. Hastaların %80’inde ev içi temas/maruziyet mevcuttu. En sık şikayetler sırasıyla %51,8 ve %47,1 oranlarıyla öksürük ve ateşti. Hastaların %72,9’unda daha hafif klinik tablo ve sadece %2,4’ünde kritik hastalık vardı. En çarpıcı laboratuvar bulgusu lenfopeniydi. Görüntüleme sonuçları, anormal toraks BT oranının %10,6 olduğunu gösterdi. Hastaların %80’ine evde izolasyon uygulandı. Hastanede yatan hastaların sadece %4,7’sinde çeşitli spesifik tedaviler uygulandı. Hidroksiklorokin, intravenöz immünglobulin ve tosilizumab alan bu hastalardan biri öldü. Mortalite oranı %1,5 idi. Sonuç: Güvenilir tanısal testlerin ve çocuklar için uygun spesifik antiviral tedavilerin yokluğunda, COVID-19 enfeksiyonunu daha iyi anlamak ve yönetmek için daha virolojik, epidemiyolojik, klinik, laboratuvar ve görüntüleme çalışmalarına ihtiyaç olduğu fikrine varıldı.

Keywords

• COVID-19
• çocuk
• yönetim
• tedavi

EXPERIENCE IN CHILDREN IN THE COVID-19 PANDEMIC OF A TERTIARY CENTER, IN ISTANBUL

Abstract

Objective: The SARS-CoV-2 virus, which unexpectedly has affected the whole world, continues to infect millions of people and causes the death of hundreds of thousands of people. There has been no consensus on the pediatric age group yet. For this reason, it was aimed to share the pediatric group experience of our center. Material and Method: After the pandemic announcement, 1076 pediatric cases admitted to our center with suspected COVID-19 disease were discussed. Eighty-five children who were positive in the SARS-CoV-2 polymerase chain reaction test, were evaluated retrospectively with epidemiological, clinical, laboratory and imaging data. Results: Half of the patients were male and about half of them were between 60-179 months. The household contact/exposure was 80% of the patients. The most common complaints were cough and fever, with the rates of 51.8% and 47.1%, respectively. There was a milder clinic 72.9% of patients and critical illness only 2.4% of the patients. The most striking laboratory finding was lymphopenia. Imaging results showed that abnormal thorax CT rate was 10.6%. Isolation at home was administered on 80% of the patients. Various specific treatments were used only in 4.7% of the hospitalized patients. One of these patients who received hydroxychloroquine, intravenous immunglobuline and tocilizumab died. The mortality rate was 1.5%. Conclusion: In the absence of reliable diagnostic tests and specific antiviral treatments appropriate for children, it was concluded that we need more virological, epidemiological, clinical, laboratory and imaging studies to better understand and manage COVID-19 infection.

Keywords

• COVID-19
• child
• management
• treatment

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