Tek Merkez Deneyimi: Bening ve Malign Hematolojik Hastalarda COVID-19

Year 2022, Volume: 7 Issue: Covid-19 Ek Sayısı, 108 - 115, 23.06.2022

Pınar Tığlıoğlu Murat Albayrak Hacer Berna Afacan Öztürk Mesut Tığlıoğlu Buğra Sağlam Merih Reis Aras Fatma Yılmaz Senem Maral Ümit Yavuz Malkan

https://doi.org/10.25279/sak.1061701

Abstract

Giriş
Coronavirus hastalığı 2019 (COVID-19), Dünya Sağlık Örgütü tarafından pandemi olarak ilan edildi. Bu çalışma ile malign veya benign hematolojik tanılarla takip edilen ve COVID-19 tanısı alan hastalarımızı analiz edip; bu enfeksiyonun hasta gruplarına göre dağılımını belirleyerek ve hematolojik hastalardaki seyrini inceleyerek tanımlayıcı istatistikler oluşturup literatüre katkı sağlamayı amaçladık.
Araç ve yöntemler
Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi Hematoloji Bölümü'nde bening ve malign hematolojik tanılarla takip edilen ve COVID-19 öyküsü olan hastalar retrospektif olarak incelenmiştir.
Bulgular:
Kliniğimizde hematolojik hastalıklar nedeniyle takip edilirken COVID-19 tanısı alan 88 hasta çalışmaya dahil edildi. 77 hasta hematolojik maligniteler, 11 hastayı da benign hematolojik tanılar ile takip ediyordu. Malign tanılarla izlenen grupta COVID en sık Philadelphia kromozomu negatif miyeloproliferatif neoplazm (%22), non-hodgkin lenfoma (%19) ve multipl miyelom (%16) tanılı hastalarda görüldü. Bening hastalık grubunda ise ITP (%64), COVID öyküsü olan hastalarda en sık görülen hastalıktı. Malign olguların 52'sinin (%67) ve bening olgularının 8'inin (%73) remisyonda hastalıkları remisyonda idi.
Hastaların COVID-19 tanısında en sık görülen semptomları ateş (%77), öksürük (%70) ve halsizlik (%65) idi. Hastaların %45'i evde izole edildi, %48'i hastaneye yatırıldı. Hastaların %49'u hafif; %27'si orta ve %24'ü şiddetli COVID-19 kliniğine sahipti. Orta ve ağır hastalık grubundaki hastaların tamamına yakını malign hematolojik hastalık grubunda idi. 16 (%18) hasta yoğun bakım ünitesine devredildi ve tümünün mekanik ventilasyon ihtiyacı oldu. Entübe edilen ve yoğun bakıma ihtiyacı olan hastaların tamamı malign hematolojik hastalık tanısı olan hastalardı. 17 hasta COVID-19 enfeksiyonu nedeniyle öldü. Mortalite oranı malign hematolojik hastalık grubunda %22, tüm hastalar (malign ve bening) dahil edildiğinde ise %19 idi.
Tartışma:
Sonuç olarak, COVID-19 pandemisi dünya genelinde sorun teşkil etmektedir. Belirli tanı gruplarında hastalığın seyrinin belirlenmesi hem ana hastalığın hem de COVID-19 enfeksiyonunun yönetiminde önemlidir. Bu nedenle bu tür kayıt çalışmalarının literatüre katkısı önemli ve değerlidir.

Keywords

Koronavirüs, Pandemi, Şiddetli akut solunum sendromu koronavirüsü 2

Single Centre Experience: Bening and Malign Hematological Patients with COVID-19

Abstract

Introduction
Coronavirus disease 2019 (COVID-19) were declared as pandemic by World Health Organization. With this study, we aimed to define our patients who were followed up with malign or benign hematological diagnoses and diagnosed with COVID-19; determine the distribution of this infection in patient groups and contribute to the literature by creating descriptive statistics with its clinical and demographic features.
Patients and methods:
It is planned to retrospectively examine patients with a history of COVID-19 who were followed up in Hematology Department of Dışkapı Yıldırım Beyazıt Training and Research Hospital with benign and malignant diagnoses.
Results:
88 patients who had COVID-19 infection while being followed in our clinic due to hematological diseases were included in the study. 77 patients had been followed by hematologic malignancies and 11 patients had been followed by benign hematological disease.In the group with malignancy, COVID was found most frequently in patients diagnosed with Philadelphia chromosome negative myeloproliferative neoplasms (22%), nonhodgkin lymphoma (19%) and multiple myeloma (16%). ITP (64%) was the most common disease in patients with benign hematological disorder who had COVID history. 52 (67%) of the malignant cases and 8 (73%) of the bening cases were found to be followed up with the disease in remission.
The all patient's most common symptoms at COVID-19 diagnosis were fever (77%), cough (70%) and weakness (65%). 45% of the patients were isolated at home, 48% were required hospitalization. 49% of patients had mild; 27% had moderate and 24% had severe COVID-19 infection. Almost all of the patients in the moderate and severe disease group were followed up in patients diagnosed with malignant hematological disease. 16 (18%) patients received mechanical ventilation and 16 (18%) patients was transferred intensive care unit. All of the patients who were intubated and needed intensive care were diagnosed with malignant hematological disease. 17 patients died due to COVID-19 infection. The mortality rate was 22% in patients with diagnosis of malignant hematological diseases, and 19% when all patients (malignant and bening) were included.
Conclusion:
In conclusion, the COVID-19 pandemic is a problem all over the world. Determining the course of the disease in certain diagnostic groups is important in the management of both the main disease and the COVID-19 infection. Therefore, the contribution of such recording studies to the literature is important and valuable.

Keywords

Coronavirus, Pandemic, Severe acute respiratory syndrome coronavirus 2

References

• Referans1: García-Suárez, J., De La Cruz, J., Cedillo, Á., Llamas, P., Duarte, R., Jiménez-Yuste, V., . . . Sánchez-Godoy, P. (2020). Impact of hematologic malignancy and type of cancer therapy on COVID-19 severity and mortality: lessons from a large population-based registry study. Journal of hematology & oncology, 13(1), 1-12.
• Referans2: Hirsch, H. H., Martino, R., Ward, K. N., Boeckh, M., Einsele, H., & Ljungman, P. (2013). Fourth European Conference on Infections in Leukaemia (ECIL-4): guidelines for diagnosis and treatment of human respiratory syncytial virus, parainfluenza virus, metapneumovirus, rhinovirus, and coronavirus. Clin Infect Dis, 56(2), 258-266. doi: 10.1093/cid/cis844
• Referans3: Mehta, V., Goel, S., Kabarriti, R., Cole, D., Goldfinger, M., Acuna-Villaorduna, A., . . . Verma, A. (2020). Case Fatality Rate of Cancer Patients with COVID-19 in a New York Hospital System. Cancer Discov, 10(7), 935-941. doi: 10.1158/2159-8290.cd-20-0516
• Referans4: Meng, Y., Lu, W., Guo, E., Liu, J., Yang, B., Wu, P., . . . Li, F. (2020). Cancer history is an independent risk factor for mortality in hospitalized COVID-19 patients: a propensity score-matched analysis. Journal of hematology & oncology, 13(1), 1-11.
• Referans5: Passamonti, F., Cattaneo, C., Arcaini, L., Bruna, R., Cavo, M., Merli, F., . . . Della Porta, M. G. (2020). Clinical characteristics and risk factors associated with COVID-19 severity in patients with haematological malignancies in Italy: a retrospective, multicentre, cohort study. The Lancet Haematology, 7(10), e737-e745.
• Referans6: Rate, C.-F. (2020). Characteristics of Patients Dying in Relation to COVID-19 in Italy Onder G, Rezza G, Brusaferro S. JAMA. Published online March, 23. Wang, C., Horby, P. W., Hayden, F. G., & Gao, G. F. (2020). A novel coronavirus outbreak of global health concern. The lancet, 395(10223), 470-473.
• Referans7: Wiersinga, W. J., Rhodes, A., Cheng, A. C., Peacock, S. J., & Prescott, H. C. (2020). Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review. Jama, 324(8), 782-793.
• Referans8: Wood, W. A., Neuberg, D. S., Thompson, J. C., Tallman, M. S., Sekeres, M. A., Sehn, L. H., . . . Niemeyer, C. M. (2020). Outcomes of patients with hematologic malignancies and COVID-19: a report from the ASH Research Collaborative Data Hub. Blood advances, 4(23), 5966-5975.
• Referans9: Yang, J., Zheng, Y., Gou, X., Pu, K., Chen, Z., Guo, Q., . . . Zhou, Y. (2020). Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. International Journal of Infectious Diseases, 94, 91-95.
• Referans10: Zhu, N., Zhang, D., Wang, W., Li, X., Yang, B., Song, J., . . . Lu, R. (2020). A novel coronavirus from patients with pneumonia in China, 2019. New England journal of medicine.