Türkiye’de bir üçüncü basamak sağlık merkezine başvuran COVID-19’lu hastaların klinik ve temel kardiyovasküler özellikleri

Year 2020, Volume: 4 Issue: 5, 367 - 370, 01.05.2020

Sabür Zengin Sema Avcı Seyhan Yılmaz

https://doi.org/10.28982/josam.727935

Cited By: 2

Abstract

Amaç: COVID-19 akut solunum yetmezliğine neden olabilen, ilk kez Aralık 2019’da Çin’in Wuhan şehrinde ortaya çıkan yeni zoonotik bir enfeksiyöz hastalıktır. Bu çalışmanın amacı Türkiye’de bir üçüncü basamak hastaneye başvuran COVID-19’lu hastaları analiz etmektir.
Yöntemler: Çalışmada, COVID-19 hastalık tanısı almış 49 hastanın (20 kadın, 29 erkek) demografik özellikleri, klinik semptom ve bulguları, komorbiditeleri, laboratuar sonuçları, toraks bilgisayarlı tomografi (BT) bulguları ve sağkalım, yoğun bakım ünitesine (YBÜ) ve servis yatışlarını değerlendirdik.
Bulgular: Vakaların 20’si (%40,9) kadın ve 29’u (%59,1) erkekti. Hastaların ortalama yaşı 56,20 (17,65) idi. En sık görülen semptom öksürüktü (%75,5). Hipertansiyon en sık eşlik eden hastalıktı (%26,5). 42 hastanın (%85,7) troponin I değeri negatifti (referans değer <0,1 ng/mL). 10 hasta YBÜ’ye başvurmuştu ve genel mortalite oranı %4,1 idi (n=2). Ölen iki hastanın önemli karakteristik özellikleri şöyleydi: i) 67 yaş erkek hasta, yüksek ateş (38,50C), sigara içici, diabetes mellitus (+), kronik obstrüktif akciğer hastalığı (KOAH) (+), konjestif kalp yetmezliği (+), ilk başvuru YBÜ’ye, toraks BT’de bilateral infiltrasyon ve troponin I (4,01 ng/L). ii) 38 yaş erkek hasta, sigara içici, KOAH (+), ilk başvuru YBÜ’ye ve yüksek c-reaktif protein (120,86 m/L).
Sonuç: Mevcut bilgilerimize göre COVID-19’da prognozu belirleyen klinik parametreler akut solunum yolu alevlenmesi ve hipertansiyon veya koroner arter hastalığı gibi kardiyovasküler hastalıkların eşlik etmesidir. Kardiyovasküler risk faktörleri olan hastalarda kardiyak enzim takibi önemlidir.

Keywords

COVID-19, Klinik profil, Üçüncü basamak merkez

Clinical and basic cardiovascular features of patients with COVID-19 admitted to a tertiary care center in Turkey

Abstract

Aim: COVID-19 is a new zoonotic infectious disease that can cause acute respiratory failure, which first occurred in Wuhan, China in December 2019. The aim of study was to analyze cases with COVID-19 admitted to a tertiary care center in Turkey.
Methods: We evaluated demographic characteristics, clinical symptoms or signs, comorbidities, laboratory results, chest computed tomography (CT) findings and outcomes including hospitalization, intensive care unit (ICU) admission and survival of 49 patients (20 females, 29 males) diagnosed with COVID-19 disease.
Results: Twenty (40.9%) of the cases were female and 29 (59.1%) were male. The mean age of the patients was 56.20 (17.65) years. The most common symptom was cough (75.5%). Hypertension (26.5%) was the most prevalent comorbid disease. Troponin I result of 42 (85.7%) patients were negative (reference value <0.1 ng/mL). Ten patients (18.4%) were admitted to the ICU and overall mortality rate was 4.1% (n=2). The important characteristics of two non-survivors were as follows: 1) A 67-year-old-man, high fever (38.50C), current smoker, diabetes mellitus (+), chronic obstructive pulmonary disease (COPD) (+), congestive heart failure (+), first admission to ICU, bilateral infiltration on chest CT, troponin I: 4.01 ng/L. 2) A 38-year-old-man, current smoker, COPD (+), first admission to ICU and high CRP (120.86 m/L).
Conclusion: The clinical parameters that determine the prognosis of COVID-19 are currently acute respiratory tract exacerbation and accompanying cardiovascular diseases such as hypertension and coronary artery disease. Cardiac enzyme monitoring is important in patients with cardiovascular risk factors.

Keywords

COVID-19, Clinical profile, Tertiary care center

References

• 1. Denniss AR, Chow CK, Kritharides L. Cardiovascular and logistic issues associated with COVID-19 pandemic. Heart Lung Circ. 2020. doi: 10.1016/j.hlc.2020.03.014.
• 2. Shao F, Xu S, Mad X, Xu Z, Lyu J, Ng M, et al. In-hospital cardiac arrest outcomes among patients with COVID-19 pneumonia in Wuhan, China. Resuscitation. 2020;151: 18-23.
• 3. https://www.who.int/emergencies/diseases/novelcoronavirus-2019/situation-reports/. Accessed 26 Apr 2020.
• 4. T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. COVID-19 (SARS-CoV-2 Enfeksiyon Rehberi) Bilim Kurulu Çalışması. 2020;9-89.
• 5. Atri D, Siddiqi HK, Lang J, Nauffal V, Morrow DA, Bohula EA. COVID-19 for the cardiologist: a current review of the virology, clinical epidemiology, cardiac and other clinical manifestations and potential therapeutic strategies. JACC. 2020. doi: 10.1016/j.jacbts.2020.04.002.
• 6. Perincek G, Avci S. A case series of patients with COVID-19 infection admitted to a secondary care center in Turkey. Adv J Emerg Med. 2020;4(2s). doi: 10.22114/ajem.v0i0.404.
• 7. https://www.worldometers.info/coronavirus/. Accessed 27 Apr 2020.
• 8. Vlachakis PK, Tentolouris A, Tousoulis D, Tentolouris N. Current data on the cardiovascular effects of the COVID-19. Hellen J Cardiol. 2020. doi: 10.1016/j.hjc.2020.04.001.
• 9. Denga Q, Hua B, Zhanga Y, Wanga H, Zhoub X, Hua W, et al. Suspected myocardial injury in patients with COVID-19: evidence from front-line clinical observation in Wuhan, China. Int J Cardiol. 2020. doi: 10.1016/j.ijcard.2020.03.087.
• 10. Zheng Y, Ma Y, Zhang J, Xie X. COVID-19 and the cardiovascular system. Nat Rev Cardiol. 2020. doi: 10.1038/s41569-020-0360-5.
• 11. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese center for disease control and prevention. JAMA. 2020. doi: 10.1001/jama.2020.2648.
• 12. Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F, et al. Association of cardiac injury with mortality in hospitalised patients with COVID-19 in Wuhan, China. JAMA Cardiol. 2020. doi: 10.1001/jamacardio.2020.0950.
• 13. Guo T, Fan Y, Chen M, Wu X, Zhang L, He T, et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). JAMA Cardiol 2020. doi: 10.1001/jamacardio.2020.1017.
• 14. Li B, Yang J, Zhao F, Zhi L, Wang X, Liu L, et al. Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clin Res Cardiol. 2020 ;109(5):531-38.
• 15. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-ınfected pneumonia in Wuhan, China. JAMA. 2020 Feb 7. doi: 10.1001/jama.2020.1585.
• 16. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395:1054-62.
• 17. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395:497-506.
• 18. Küçük U, Arslan M. Assessment of the white blood cell subtypes ratio in patients with supraventricular tachycardia: Retrospective cohort study. J Surg Med. 2019;3(4):297-9.