Kovid-19 hastalarında eşlik eden kardiyo-metabolik hastalık sıklıkları ve klinik sonlanımlar üzerine etkileri

Year 2021, , 104 - 110, 31.12.2021

Mehmet Uzunlulu , Haluk Vahaboglu , Ayse Naciye Erbakan , Ümmügülsüm Durak , Lütfullah Caştur , Onur İncealtın , Özlem Aydın

https://doi.org/10.35514/mtd.2021.57

Abstract

Amaç: Kovid-19 tanısıyla hastaneye yatan hastalarda kardiyo-metabolik komorbidite (KMK) sıklıklarının ve özelliklerinin belirlenmesi amaçladık.
Gereç ve Yöntem: Retrospektif, gözlemsel, klinik çalışmaya kovid-19 şüphesi ile hastaneye yatan 313 hastadan, polimeraz zincir reaksiyonu (PCR) ile konfirme kovid-19 tanısı olan 159 hasta alındı. KMK sıklıkları, hastaların özellikleri, yatış süreleri ve klinik sonlanımları (taburcu, exitus, YBÜ ihtiyacı) değerlendirildi.
Bulgular: Kovid-19 hastalarında; hipertansiyon, diabetes mellitus, hiperlipidemi, koroner arter hastalığı, kronik böbrek hastalığı, konjestif kalp yetersizliği ve serebrovasküler hastalık sıklıkları sırasıyla; %39, %24,5, %24,5, %20,1, %11,9, %9,4 ve %8,2 idi. En az 1 KMK olan 79 olgu (%49,1), ≥3 KMK olan 42 (%26,1) olgu vardı. Medyan yatış süresi dört gün, mortalite sıklığı %1,3, YBÜ ihtiyacı sıklığı %2,5 idi. Yaş arttıkça tüm KMK sıklıklarının anlamlı arttığı görüldü (tümü için p<0.05). PCR negatif olgulara göre PCR pozitif kovid-19 hastalarında ortalama yatış süresi (p=0,001) uzun, hipertansiyon sıklığı (p=0,008) düşüktü.
Sonuç: Hastaneye yatan kovid-19 hastalarında KMK sıklıklarının kovid-19 PCR negatif olgulara ve ulusal epidemiyolojik çalışmalardaki benzer yaş gruplarına göre yüksek bulunmadığı görülmüştür. Bununla birlikte yaklaşık her dört olgudan birinde, exitus olanların tümünde ve YBÜ ihtiyacı gelişenlerin yarısında çoklu KMK varlığı, KMK’lerin tek başlarına varlıklarından ziyade bir arada bulunmalarının Kovid-19 ile ilişkili klinik sonlanımlar üzerinde kümülatif bir risk artışına neden olduklarını düşündürmektedir.

Keywords

Kovid-19, yatan hasta, kardiyo-metabolik komorbidite

The Frequency of Coexistent Cardio-metabolic Diseases in Covid-19 Patients and Their Effects On Clinical Outcomes

Abstract

Aim: We aimed to determine the frequency and characteristics of cardio-metabolic comorbidities (CMC) in patients hospitalized with the diagnosis of COVID-19 disease.
Materials and Methods: In this retrospective study, 159 patients with a confirmed diagnosis of COVID-19 with polymerase chain reaction (PCR) were included out of 313 patients hospitalized with suspected COVID-19. CMC frequencies, patients characteristics, duration of hospitalizations, and clinical outcomes (discharge, death, ICU need) were determined.
Results: In COVID-19 patients, the frequencies of hypertension, diabetes mellitus, hyperlipidemia, coronary artery disease, chronic kidney disease, congestive heart failure, and cerebrovascular disease were 39%, 24.5%, 24.5%, 20.1%, 11.9%, 9.4%, and 8.2%, respectively. There were 79 cases (49.1%) with at least 1 CMC and 42 (26.1%) cases with ≥3 CMC. The median duration of hospitalization was four days, the mortality rate was 1.3%, and the frequency of ICU need was 2.5%. All CMC frequencies increased significantly with advancing age (p<0.05 for all). Compared to PCR negative cases, the mean duration of hospitalization (p=0.001) was longer, and the frequency of hypertension (p=0.008) was lower in PCR-positive COVID-19 patients.
Conclusions: Cardio-metabolic comorbidity frequencies in hospitalized COVID-19 patients were not higher than COVID-19 PCR negative cases and similar age groups without COVID-19 infection in national epidemiological studies. However, the presence of multiple CMCs were approximately one of every 4 cases, in all of those who died and in half of those who developed ICU needs, suggests that the coexistence of CMCs rather than their presence alone causes a cumulative risk increase on clinical outcomes associated with COVID-19.

Keywords

COVID-19, inpatient, cardio-metabolic comorbidity

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