YETİŞKİNLERDE COVID-19 ÖNCESİ SOLUNUM YOLU VİRAL ETKENLERİN EPİDEMİYOLOJİSİ VE MEVSİMSEL DAĞILIMI

Abstract

Amaç: Bu çalışmada COVID-19 pandemisi öncesi hastanemizde yatırılarak takip edilen hastalarda solunum yolu virüslerinin klinik ve epidemiyolojik özelliklerinin belirlenmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmada Ocak 2017-Aralık 2019 tarihleri arasında hastanemize solunum yolu enfeksiyonu bulguları ile başvuran, 18 yaş üzerindeki 193 hastanın kayıtları retrospektif olarak incelendi. Bulgular: Hastalardan alınan nazofarengeal sürüntü örneklerinde viral patojenlerden en sık influenza A/B virüs (n=143, %74.1), ikinci sıklıkta respiratuvar sinsisyal virüs (n=22, %11.4) ve üçüncü sıklıkta koronavirüs (n=9, %4.7) saptandı. Mevsimsel dağılımları incelendiğinde viral etkenlerin en sık kış aylarında saptandığı gözlendi. Hastaların hastaneye başvuru belirtileri arasında en sık gözlenenler boğaz ağrısı, miyalji, baş ağrısı ve halsizlik idi. Viral etkenler arasında servis yatış süreleri açısından anlamlı fark saptanmayıp (p=0.056), yoğun bakım gereksiniminin influenza dışı etkenlerde daha sık (p<0.001) olduğu tespit edildi. Sonuç: Çalışmamızın çeşitlilik gösteren solunum yolu enfeksiyonlarında virüslerin hızlı ve duyarlı tanısı ile hastalarda antibiyotiklerin gereksiz kullanımını azaltma konusunda ve virüslerin mevsimsel dağılımı nedeniyle doğru testin uygun zaman dilimi aralıklarında kullanılması konusunda yardımcı olacağını düşünmekteyiz.

Keywords

• Solunum yolu enfeksiyonları
• solunum yolu virüsleri
• mevsimler

Epidemiology and Seasonal Distribution of Respiratory Viral Agents in the Pre-COVID-19 Period in Adults

Abstract

Objective: In this study, it was aimed to determine the clinical and epidemiological characteristics of respiratory tract viruses in hospitalized and followed-up patients in our hospital before the COVID-19 pandemic. Material and Methods: The records of 193 patients aged over 18 years, who admitted to our hospital with respiratory tract infection findings between January 2017 and December 2019, were retrospectively analyzed. Results: In the nasopharyngeal swab samples taken from the patients, influenza A/B virus (n=143, 74.1%) was the most common viral pathogen, respiratory syncytial virus was the second most common (n=22, 11.4%) and coronavirus was the third most common (n=9, 4.7%) was detected. When their seasonal distributions were examined, it was observed that viral agents were most frequently detected in winter months. The most common symptoms at admission to hospital were sore throat, myalgia, headache, and fatigue. There was no significant difference between the lengths of hospitalization for viral agents (p=0.056), and the need for intensive care was found to be more frequent in non-influenza agents (p<0.001). Conclusion: We think that our study will help in reducing the use of unnecessary antibiotics in patients with rapid and sensitive diagnosis of viruses in various respiratory tract infections, and in using the right test at appropriate time intervals due to seasonal distribution of viruses.

Keywords

• Respiratory tract infections
• respiratory system viruses
• seasons

References

1. Lieberman D, Shvartzman P, Ben-Yaakov M, Lazarovich Z, Hoffman S, Mosckovitz R et al. Etiology of respiratory tract infection in adults in a general practice setting. European Journal of Clinical Microbiology and Infectious Diseases. 1998;17(10):685-9.
2. Wu X, Wang Q, Wang M, Su X, Xing Z, Zhang W et al. Incidence of respiratory viral infections detected by PCR and real-time PCR in adult patients with community-acquired pneumonia: a meta-analysis. Respiration. 2015;89(4):343-52.
3. Tregoning JS, Schwarze J. Respiratory viral infections in infants: causes, clinical symptoms, virology, and immunology. Clin Microbiol Rev. 2010;23(1):74-98.
4. Vallières E, Renaud C. Clinical and economical impact of multiplex respiratory virus assays. Diagnostic microbiology and infectious disease. 2013;76(3):255-61.
5. Sloots T, Whiley D, Lambert S, Nissen M. Emerging respiratory agents: new viruses for old diseases? Journal of Clinical Virology. 2008;42(3):233-43.
6. Yeolekar LR, Damle RG, Kamat AN, Khude MR, Simha V, Pandit AN. Respiratory viruses in acute respiratory tract infections in Western India. The Indian Journal of Pediatrics.008;75(4):341-5.
7. Allander T, Jartti T, Gupta S, Niesters HG, Lehtinen P, Osterback Ret al. Human bocavirus and acute wheezing in children. Clinical Infectious Diseases. 2007;44(7):904-10.
8. Semret M, Schiller I, Jardin BA, Frenette C, Loo VG, Papenburg J et al. Multiplex respiratory virus testing for antimicrobial stewardship: a prospective assessment of antimicrobial use and clinical outcomes among hospitalized adults. The Journal of infectious diseases. 2017;216(8):936-44.

9. Kuşkucu MA, Mete B, Tabak F, Midilli K. Yetişkinlerde Solunum Yolu Viral Etkenlerinin 2010-2018 Yılları Arasındaki Prevalansı ve Mevsimsel Dağılımı. Turk Mikrobiyol Cem Derg. 2020;50(1):21-6.
10. Johansson N, Kalin M, Tiveljung-Lindell A, Giske CG, Hedlund J. Etiology of community-acquired pneumonia: increased microbiological yield with new diagnostic methods. Clinical infectious diseases. 2010;50(2):202-9.
11. Karadag‐Oncel E, Ciblak MA, Ozsurekci Y, Badur S, Ceyhan M. Viral etiology of influenza‐like illnesses during the influenza season between December 2011 and April 2012. Journal of medical virology. 2014;86(5):865-71.
12. Mengelle C, Mansuy J, Pierre A, Claudet I, Grouteau E, Micheau P et al. The use of a multiplex real-time PCR assay for diagnosing acute respiratory viral infections in children attending an emergency unit. Journal of Clinical Virology. 2014;61(3):411-7.
13. Byington CL, Ampofo K, Stockmann C, Adler FR, Herbener A, Miller T et al. Community surveillance of respiratory viruses among families in the Utah Better Identification of Germs-Longitudinal Viral Epidemiology (BIG-LoVE) study. Clinical Infectious Diseases. 2015;61(8):1217-24.
14. Heikkinen T, Järvinen A. The common cold. The Lancet. 2003;361(9351):51-9.
15. Karron RA, Wright PF, Belshe RB, Thumar B, Casey R, Newman F et al. Identification of a recombinant live attenuated respiratory syncytial virus vaccine candidate that is highly attenuated in infants. The Journal of infectious diseases. 2005;191(7):1093-104.
16. Zhang D, He Z, Xu L, Zhu X, Wu J, Wen W et al. Epidemiology characteristics of respiratory viruses found in children and adults with respiratory tract infections in southern China. International Journal of Infectious Diseases. 2014;25:159-64.
17. Eccles R. An explanation for the seasonality of acute upper respiratory tract viral infections. Acta oto-laryngologica. 2002;122(2):183-91.
18. Bayrakdar F, Altaş AB, Korukluoğlu G. Solunum Yolu Virüslerinin 2009-2012 Yılları Arasında Ülkemizdeki Mevsimsel Dağılımı. Türk Mikrobiyol Cem Derg. 2013;43:56-66.