COVID-19 Hastalarının Prognozunu Etkileyen Faktörler: Tek Merkez Deneyimi

Year 2024, , 71 - 79, 16.08.2024

Yekta Özkılıç , Esma Eryılmaz Eren , Zeynep Türe , İhami Çelik

https://doi.org/10.55694/jamer.1444875

Abstract

Amaç: COVID-19 pandemisi tüm dünyada milyonlarca insanı etkiledi. Bu çalışmada, merkezimizde takip edilen COVID-19 tanılı
hastaların klinik özellikleri ve tedavileri ele alınarak prognozu etkileyen faktörlerin tanımlanması amaçlanmıştır.
Gereç ve Yöntemler: Bu çalışma retrospektif gözlemsel bir kohort çalışma olarak yapıldı. Eylül 2020 - Şubat 2021 tarihleri
arasında COVID-19 tanısı konmuş hastanemizde yatarak takip ve tedavi edilen hastaların demografik ve klinik özellikleri, labo -
ratuvar ve radyolojik bulguları ile aldıkları tedaviler kaydedildi. Hastaların klinik ağırlıkları ve 28. gün mortalite gelişimi kayıt
altına alındı. Hafif-orta ve şiddetli-kritik seyir gösteren hastalar ile ölen ve sağ kalan hastalar arasında demografik veriler, altta
yatan hastalıklar, laboratuvar bulguları, akciğer tutulum yüzdeleri ve tedaviler karşılaştırıldı. Bu parametrelerden hastalık seyri
ve mortalite açısından yüksek risk faktörü olanlar belirlendi.
Bulgular: Çalışmaya 500 hasta dahil edildi. Hastaların yaş ortalaması 63.01±14.25 yıl olup çoğunluğunu %63.8 (n=319) erkek -
ler oluşturmaktaydı. En sık saptanan semptom nefes darlığı %68.2 (n=341), en sık altta yatan hastalık diabetes mellitus %43.6
(n=218) idi. İleri yaş mortaliteyi arttırıcı risk faktörü olarak bulundu (OR: 1.048, %95 CI, 1.026-1.070, p<0.001). Akciğer tutulum
derecesi ortanca %40 (10-90) olan hastalar, %30 (5-90) olanlara göre mortalite açısından artmış riske sahipti (OR: 1.036, %95
CI, 1.024-1.049, p<0.001). Kortikosteroid tedavisi mortaliteyi azaltıcı faktör olarak saptandı (OR: 0.484, %95 CI, 0.270-0.870,
p=0.015).
Sonuç: İleri yaş ve akciğer tutulum oranı yüksekliği mortalite artışı ile ilişkilidir. Antiviral tedaviler ile mortalite arasında anlam-
lı bir ilişki bulunmazken, kortikosteroid tedavisinin mortaliteyi azaltıcı etkisi olduğu gözlendi.idir

Keywords

COVID-19, klinik seyir, mortalite, SARS-CoV-2

Factors Affecting the Prognosis of COVID-19 Patients: Single-Center Experience

Abstract

Abstract
Aim: The COVID-19 pandemic has affected million people all over the world. This study aimed to describe the factors affecting the clinical characteristics, treatments and prognosis of patients with COVID-19 followed in our center.

Methods: This study was conducted as a retrospective observational cohort study. The demographic and clinical characteristics, laboratory and radiological findings, and treatments given of the patients diagnosed with COVID-19 and treated in our hospital between September 2020 and February 2021 were recorded. The clinical weights of the patients and the development of mortality on the 28th day were recorded. Demographic data, underlying diseases, laboratory findings, lung involvement percentages and treatments were compared between mild-moderate and severe-critical patients and between deceased and surviving patients. From these parameters, those with risk factors for disease course and mortality were determined.

Results: 500 patients were included in the study. The average age of the patients was 63.01±14.25 years and the majority [63.8% (n=319)] were men. The most common symptom was shortness of breath [68.2% (n=341)], and the most common underlying disease was diabetes mellitus (DM) [ 43.6% (n=218) ].
Advanced age was found to be a risk factor increasing mortality (OR: 1.048, 95% CI, 1.026-1.070, p<0.001). Patients with a median degree of lung involvement of 40% (10-90) had an increased risk of mortality compared to those with a median degree of lung involvement of 30% (5-90) (OR: 1.036, 95% CI, 1.024-1.049, p<0.001). Corticosteroid treatment was found to be a factor reducing mortality (OR: 0.484, 95% CI, 0.270-0.870, p = 0.015).

Conclusions: In this study, advanced age and high lung involvement rate were found to be associated with increased mortality. While there was no significant relationship between antiviral treatments and mortality, it was observed that corticosteroid treatment had a mortality-reducing effect. It is important to closely monitor patients with these parameters in terms of severe-critical course and mortality.

Keywords

COVID-19, clinical course, mortality, SARS-CoV-2

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