Covid 19 Pandemisinde Akciğer ve Göğüs Hastalıkları

Abstract

Çin Wuhan şehrinde canlı hayvan pazarı ile ilişkilendirilen ve etkeni belli olmayan bazı pnömoni vakaları ile başlayan süreç; sebep olan etkenin (SARS-CoV-2) tanımlaması ve Dünya Sağlık Örgütünün (DSÖ) pandemi ilan etmesine kadar hızlıca gerçekleşti. Hastalığın damlacık, temas yoluyla bulaşmasıyla, üst solunum yolları mukoza epitelinde ve alt solunum yollarında anjiyotensin dönüştürücü enzimi (ACE-2) reseptörleri vasıtasıyla hücereye giriş yaptığı ve replikasyonun devam ettiği kabul edilmektedir. Böylelikle hastalığın klinik seyrinde üst solunum yolları ve pnömoni bulguları ön planda ve belirleyici oldu.Tanı ve takip aşamasında radyolojik tetkikler akciğer grafisi ve toraks bilgisayarlı tomografi (BT)etkin olarak kullanılmıştır. Toplam sayı içinde %81 hafif vakalar, %14 ağır vakalar %5 hastada kritik vakalar görüldü. COVID-19’ da solunum sistemi bulguları klinik ve radyolojik olarak; Komplike olmayan hafif hastalık, orta şiddette pnömoni, ağır şiddette pnömoni ve ARDS olmak üzere 4 grupta değerlendirilmiştir The process, which is associated with the livestock market in Wuhan, China, started with some cases of pneumonia whose cause was unknown. From the diagnosis of the causative agent (SARS-CoV-2) to World Health Organization’s declaration of pandemic, the process happened quite quickly. The disease is transmitted through droplets and contact, and it is accepted that it enters the cell through angiotensin converting enzyme (ACE-2) receptors in the upper respiratory tract mucosa epithelium and in the lower respiratory tract. It continues replication after entering. Thus, upper respiratory and pneumonia findings during the clinical course were at the forefront and determinant. Radiological examinations, chest radiography and thorax computed tomography (CT) were used effectively at the stages of diagnosis and patient follow-up. There were 81% of mild cases, 14% of severe cases, and 5% of critical cases. The respiratory system findings in COVID-19 were evaluated in 4 groups by clinically and radiologically: uncomplicated ailment, moderate pneumonia, severe pneumonia, and ARDS.

Keywords

• covid 19
• pnömoni
• solunum yetmezliği
• pandemi

References

1. 1. Zhu N, Zhang D, Wang W, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-733.
2. 2. Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. (2020) J.Autoimmun. 109:102433. doi: 10.1016/j.jaut.2020.102433.
3. 3. Jin, Y., Yang, H., Ji, W., et al. (2020). Virology, Epidemiology, Pathogenesis, and Control of COVID-19. Viruses, 12(4). doi:10.3390/v12040372
4. 4. Zhou M, Zhang X, Qu J. Coronavirus disease 2019 (COVID-19): A clinical update.(2020) Front Med. 2020 Apr 2. doi: 10.1007/ s11684-020-0767-8.
5. 5. Ufuk F, Savas R. Chest CT features of the novel coronavirus disease (COVID-19). Turk J Med Sci 2020 May 12. Doi: 10.3906/sag-2004-331.
6. 6. Hosseiny M, Kooraki S, Gholamrezanezhad A, et al. Radiology Perspective of Coronavirus Disease 2019 (COVID-19):Lessons From Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome. AJR Am J Roentgenol.2020 May;214(5):1078-1082.
7. 7. Çinkooğlu A, Bayraktaroğlu S, Savaş R. Lung Changes on Chest CT During 2019 Novel Coronavirus (COVID-19) Pneumonia. Eur J Breast Health. 2020 Apr1;16(2):89-90.
8. 8. Li, K., Wu, J., Wu, F., et al. (2020). The Clinical and Chest CT Features Associated with Severe and Critical COVID-19 Pneumonia. Invest Radiol. doi:10.1097/RLI.0672

9. 9. Halacli, B., Kaya, A., & Topeli, A. (2020). Critically-ill COVID-19 patient. Turk J Med Sci. doi:10.3906/sag-2004-122
10. 10. ZheXu, LeiShi, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med 2020;8:420-22.
11. 11. T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü COVID-19 (SARS-CoV-2 Enfeksiyonu) Rehberi 19 Haziran 2020
12. 12. McGonagle D, Sharif K, O'Regan A, Bridgewood C.The Role of Cytokines including Interleukin-6 in COVID-19 induced Pneumonia and Macrophage Activation Syndrome-Like Disease.AutoimmunRev. 2020 ;19(6):102537.
13. 13. Rotzinger, D. C., Beigelman-Aubry, C., von Garnier, C., et al. (2020). Pulmonary embolism in patients with COVID-19: Time to change the paradigm of computed tomography. Thromb Res, 190, 58-59. doi:10.1016/j.thromres.2020.04.011