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COVID-19 sonrası hastalarda akciğer sekelini baştan tahmin edebilir miyiz?

Year 2023, , 760 - 776, 30.12.2023
https://doi.org/10.18663/tjcl.1385126

Abstract

Amaç: COVID-19 pnömonisi ile hastaneye yatırılan hastalar, uzun süreli standart tedavi veya antienflamatuar rejim uygulansa bile enfeksiyon sonrası akciğer fibrozisine ilerleyebilir. Hangi hasta grubunun ilerleyici akciğer hastalığına sahip olacağını tahmin etmek zordur. Bu çalışma enfeksiyonun başlangıcından itibaren daha sonra akciğer fibrozisini öngörebilecek olası biyobelirteçleri tanımlamayı amaçlamaktadır.
Gereç ve Yöntemler: Ocak-Aralık 2020 tarihleri arasında COVID-19 pnömonisi nedeniyle yatan ve PCR pozitif olan hastalar çalışmaya alındı. COVID-19 sonrası semptomlar ve akciğer sekel oluşumu açısından hastalar 12 ay boyunca takip edildi.
Bulgular: Çalışmaya ortanca yaşı 62 (R: 17-93) olan toplam 64 hasta dahil edildi ve %42.2 kadındı (n=27). 35 hastada (%54.7) COVID sonrası semptomlar mevcuttu, 8 hasta (%12.5) kaybedildi ve 22’si (%34.4) yeniden hastaneye yatırıldı. Hastaların %76.6'sının klinik seyri iyiydi ancak hastaların %54.7'sinde enfeksiyon sonrası sekel gelişti. Pnömoni skoru, kan oksijen satürasyon düzeyi, CRP ve başvuru sırasındaki troponin düzeyleri sekel gelişimi ile anlamlı olarak ilişkiliydi (p<0.05). Erkek cinsiyet, ileri yaş, hastanede yatış süresi, kötü klinik prognoz ve yoğun bakım ünitesine yatış ile birlikte hipertansiyon varlığı ve post-COVID semptomları sekel oluşumu ile korelasyon gösterdi (p<0.05). Yaş 63.5'in üzerinde, CRP'nin 24.1'den yüksek olması ve pnömoni skorunun 0.15'in üzerinde olması akciğer sekel tahmini için anlamlı bulundu.
Sonuç: Bu çalışma, COVID-19 enfeksiyonu sonrası akciğer sekellerinin enfeksiyonun başlangıcından itibaren tahmin edilebileceğini ve sonrasında önlem alınabileceğini göstermektedir.

Ethical Statement

This study was performed in accordance with the Declaration of Helsinki. This human study was approved by the institutional review board on 18/02/2022 by No: KA22/92.

Supporting Institution

The authors declared that they did not receive any financial support during the research and authoring of this article.

Project Number

KA22/92.

Thanks

Thank you to Eylem Gül Ateş for giving a support to statistical analysis and interpretation.

References

  • https://www.worldometers.info/coronavirus/ accessed at 3 August 2023
  • Mehta OP, Bhandari P, Raut A, et al. Coronavirus disease (COVID-19): comprehensive review of clinical presentation. Front. Public Health. 2021 15;8:582932.
  • Udwadia ZF, Koul PA, Richeldi L. Post-COVID lung fibrosis: The tsunami that will follow the earthquake. Lung India. 2021;38(Supplement): S41-S47.
  • Esendağlı D, Yılmaz A, AKÇAY MŞ, et al. Post-COVID syndrome: pulmonary complications. Turk. J. Med. Sci. 2021;51(7):3359-71.
  • Ponti G, Maccaferri M, Ruini C, et al. Biomarkers associated with COVID-19 disease progression. Critical reviews in clinical laboratory sciences. 2020;57(6):389-99.
  • Chen CH, Lin SW, Shen CF, et al. Biomarkers during COVID-19: Mechanisms of change and implications for patient outcomes. Diagnostics. 2022;12(2):509.
  • Samprathi Madhusudan, Muralidharan Jayashree. “Biomarkers in COVID-19: An Up-To- Date Review.” Front Pediatr, 2021;8:607647.
  • Aiello M, Marchi L, Calzetta L, et al. Coronavirus disease 2019: COSeSco–a risk assessment score to predict the risk of pulmonary sequelae in COVID-19 patients. Respir. 2022;101(3):272-80.
  • Ali RM, Ghonimy MB. Post-COVID-19 pneumonia lung fibrosis: a worrisome sequelae in surviving patients. EJRNM. 2021;52:1-8.
  • Solomon JJ, Heyman B, Ko JP, et al. CT of post-acute lung complications of COVID-19. Radiology. 2021;301(2):E383-95.
  • Alilou S, Zangiabadian M, Pouramini A, et al. Radiological Findings as Predictors of COVID-19 Lung Sequelae: A Systematic Review and Meta-Analysis. Acad. Radiol. 2023:1-10.
  • Froidure A, Mahsouli A, Liistro G, et al. Integrative respiratory follow-up of severe COVID-19 reveals common functional and lung imaging sequelae. Respir Med. 2021;181:106383.
  • Robey RC, Kemp K, Hayton P, et al. Pulmonary sequelae at 4 months after COVID-19 infection: a single-centre experience of a COVID follow-up service. Adv Ther. 2021;38:4505-19.
  • Caruso D, Guido G, Zerunian M, et al. Post-acute sequelae of COVID-19 pneumonia: six-month chest CT follow-up. Radiology. 2021;301(2):E396-405.
  • Liu M, Lv F, Huang Y, et al. Follow-up study of the chest CT characteristics of COVID-19 survivors seven months after recovery. Front. Med. 2021;8:636298.
  • Tarraso J, Safont B, Carbonell-Asins JA, et al. Lung function and radiological findings 1 year after COVID-19: a prospective follow-up. Respir Res. 2022;23(1):1-2.
  • Singh SJ, Baldwin MM, Daynes E, et al. Respiratory sequelae of COVID-19: pulmonary and extrapulmonary origins, and approaches to clinical care and rehabilitation. Lancet Respir Med. 2023 May 19.
  • Rogliani P, Calzetta L, Coppola A, et al. Are there pulmonary sequelae in patients recovering from COVID-19?. Respir Res. 2020;21(1):1-4.
  • Bazdyrev E, Rusina P, Panova M, et al. Lung fibrosis after COVID-19: treatment prospects. Pharm. J 2021;14(8):807.
  • Fraser E. Long term respiratory complications of covid-19. BMJ. 2020;370.
  • Siekacz K, Kumor-Kisielewska A, Miłkowska-Dymanowska J, et al. Oxidative Biomarkers Associated with the Pulmonary Manifestation of Post-COVID-19 Complications. J. Clin. Med. 2023;12(13):4253.
  • Myall KJ, Mukherjee B, Castanheira AM, et al. Persistent post–COVID-19 interstitial lung disease. An observational study of corticosteroid treatment. Ann. Am. Thorac. Soc. 2021;18(5):799-806.

Can we predict lung sequelae in post-COVID-19 patients?

Year 2023, , 760 - 776, 30.12.2023
https://doi.org/10.18663/tjcl.1385126

Abstract

Aim: Patients hospitalized with COVID-19 pneumonia can progress to lung fibrosis after the infection even though given the standard treatment or the anti-inflammatory regimen for the long term. It is hard to predict which group of patients is going to have a progressive lung disease thus this study aims to define possible biomarkers at the acute onset of infections that might predict lung fibrosis afterwards.
Material and Methods: Patients hospitalized between January - December 2020 with pneumonia and a positive PCR for COVID-19 infection were included in the study. They were followed up for 12 months for post-COVID-19 symptoms and lung sequelae formation.
Results: A total of 64 patients were included with a median age of 62 (R: 17-93) and 42.2% were women (n=27). 35 patients (54.7%) had post-COVID symptoms, 8 (12.5%) of them died and 22 (34.4%) were re-hospitalized. 76.6% had a good clinical course but 54.7% of the patients developed sequelae after infection. The pneumonia score, blood oxygen saturation level, CRP, and troponin levels at admission were significantly related to sequelae development (p<0.05). Male gender, elderly age, hospitalization period duration, bad clinical prognosis, and intensive care unit admission together with the presence of Hypertension and post-COVID symptoms were correlated with sequelae formation (p<0.05). Age above 63.5, CRP higher than 24.1 and pneumonia score greater than 0.15 were significant cut-off values for lung sequelae prediction.
Conclusion: This study shows that lung sequelae after COVID-19 infection can be predicted from the start of infection and measures might be taken afterwards.

Project Number

KA22/92.

References

  • https://www.worldometers.info/coronavirus/ accessed at 3 August 2023
  • Mehta OP, Bhandari P, Raut A, et al. Coronavirus disease (COVID-19): comprehensive review of clinical presentation. Front. Public Health. 2021 15;8:582932.
  • Udwadia ZF, Koul PA, Richeldi L. Post-COVID lung fibrosis: The tsunami that will follow the earthquake. Lung India. 2021;38(Supplement): S41-S47.
  • Esendağlı D, Yılmaz A, AKÇAY MŞ, et al. Post-COVID syndrome: pulmonary complications. Turk. J. Med. Sci. 2021;51(7):3359-71.
  • Ponti G, Maccaferri M, Ruini C, et al. Biomarkers associated with COVID-19 disease progression. Critical reviews in clinical laboratory sciences. 2020;57(6):389-99.
  • Chen CH, Lin SW, Shen CF, et al. Biomarkers during COVID-19: Mechanisms of change and implications for patient outcomes. Diagnostics. 2022;12(2):509.
  • Samprathi Madhusudan, Muralidharan Jayashree. “Biomarkers in COVID-19: An Up-To- Date Review.” Front Pediatr, 2021;8:607647.
  • Aiello M, Marchi L, Calzetta L, et al. Coronavirus disease 2019: COSeSco–a risk assessment score to predict the risk of pulmonary sequelae in COVID-19 patients. Respir. 2022;101(3):272-80.
  • Ali RM, Ghonimy MB. Post-COVID-19 pneumonia lung fibrosis: a worrisome sequelae in surviving patients. EJRNM. 2021;52:1-8.
  • Solomon JJ, Heyman B, Ko JP, et al. CT of post-acute lung complications of COVID-19. Radiology. 2021;301(2):E383-95.
  • Alilou S, Zangiabadian M, Pouramini A, et al. Radiological Findings as Predictors of COVID-19 Lung Sequelae: A Systematic Review and Meta-Analysis. Acad. Radiol. 2023:1-10.
  • Froidure A, Mahsouli A, Liistro G, et al. Integrative respiratory follow-up of severe COVID-19 reveals common functional and lung imaging sequelae. Respir Med. 2021;181:106383.
  • Robey RC, Kemp K, Hayton P, et al. Pulmonary sequelae at 4 months after COVID-19 infection: a single-centre experience of a COVID follow-up service. Adv Ther. 2021;38:4505-19.
  • Caruso D, Guido G, Zerunian M, et al. Post-acute sequelae of COVID-19 pneumonia: six-month chest CT follow-up. Radiology. 2021;301(2):E396-405.
  • Liu M, Lv F, Huang Y, et al. Follow-up study of the chest CT characteristics of COVID-19 survivors seven months after recovery. Front. Med. 2021;8:636298.
  • Tarraso J, Safont B, Carbonell-Asins JA, et al. Lung function and radiological findings 1 year after COVID-19: a prospective follow-up. Respir Res. 2022;23(1):1-2.
  • Singh SJ, Baldwin MM, Daynes E, et al. Respiratory sequelae of COVID-19: pulmonary and extrapulmonary origins, and approaches to clinical care and rehabilitation. Lancet Respir Med. 2023 May 19.
  • Rogliani P, Calzetta L, Coppola A, et al. Are there pulmonary sequelae in patients recovering from COVID-19?. Respir Res. 2020;21(1):1-4.
  • Bazdyrev E, Rusina P, Panova M, et al. Lung fibrosis after COVID-19: treatment prospects. Pharm. J 2021;14(8):807.
  • Fraser E. Long term respiratory complications of covid-19. BMJ. 2020;370.
  • Siekacz K, Kumor-Kisielewska A, Miłkowska-Dymanowska J, et al. Oxidative Biomarkers Associated with the Pulmonary Manifestation of Post-COVID-19 Complications. J. Clin. Med. 2023;12(13):4253.
  • Myall KJ, Mukherjee B, Castanheira AM, et al. Persistent post–COVID-19 interstitial lung disease. An observational study of corticosteroid treatment. Ann. Am. Thorac. Soc. 2021;18(5):799-806.
There are 22 citations in total.

Details

Primary Language English
Subjects Chest Diseases
Journal Section Orıgınal Artıcle
Authors

Dorina Esendağlı 0000-0002-6619-2952

Ece Koç 0000-0001-6638-7357

Nilsu Buket Ercan 0009-0008-3148-266X

Buse Tekşam 0009-0004-4263-3110

Begüm Eda Türkay 0009-0001-0502-9748

Zehra Dilek Yağcı 0009-0000-2679-7087

Project Number KA22/92.
Publication Date December 30, 2023
Submission Date November 2, 2023
Acceptance Date December 4, 2023
Published in Issue Year 2023

Cite

APA Esendağlı, D., Koç, E., Ercan, N. B., Tekşam, B., et al. (2023). COVID-19 sonrası hastalarda akciğer sekelini baştan tahmin edebilir miyiz?. Turkish Journal of Clinics and Laboratory, 14(4), 760-776. https://doi.org/10.18663/tjcl.1385126
AMA Esendağlı D, Koç E, Ercan NB, Tekşam B, Türkay BE, Yağcı ZD. COVID-19 sonrası hastalarda akciğer sekelini baştan tahmin edebilir miyiz?. TJCL. December 2023;14(4):760-776. doi:10.18663/tjcl.1385126
Chicago Esendağlı, Dorina, Ece Koç, Nilsu Buket Ercan, Buse Tekşam, Begüm Eda Türkay, and Zehra Dilek Yağcı. “COVID-19 Sonrası Hastalarda akciğer Sekelini baştan Tahmin Edebilir Miyiz?”. Turkish Journal of Clinics and Laboratory 14, no. 4 (December 2023): 760-76. https://doi.org/10.18663/tjcl.1385126.
EndNote Esendağlı D, Koç E, Ercan NB, Tekşam B, Türkay BE, Yağcı ZD (December 1, 2023) COVID-19 sonrası hastalarda akciğer sekelini baştan tahmin edebilir miyiz?. Turkish Journal of Clinics and Laboratory 14 4 760–776.
IEEE D. Esendağlı, E. Koç, N. B. Ercan, B. Tekşam, B. E. Türkay, and Z. D. Yağcı, “COVID-19 sonrası hastalarda akciğer sekelini baştan tahmin edebilir miyiz?”, TJCL, vol. 14, no. 4, pp. 760–776, 2023, doi: 10.18663/tjcl.1385126.
ISNAD Esendağlı, Dorina et al. “COVID-19 Sonrası Hastalarda akciğer Sekelini baştan Tahmin Edebilir Miyiz?”. Turkish Journal of Clinics and Laboratory 14/4 (December 2023), 760-776. https://doi.org/10.18663/tjcl.1385126.
JAMA Esendağlı D, Koç E, Ercan NB, Tekşam B, Türkay BE, Yağcı ZD. COVID-19 sonrası hastalarda akciğer sekelini baştan tahmin edebilir miyiz?. TJCL. 2023;14:760–776.
MLA Esendağlı, Dorina et al. “COVID-19 Sonrası Hastalarda akciğer Sekelini baştan Tahmin Edebilir Miyiz?”. Turkish Journal of Clinics and Laboratory, vol. 14, no. 4, 2023, pp. 760-76, doi:10.18663/tjcl.1385126.
Vancouver Esendağlı D, Koç E, Ercan NB, Tekşam B, Türkay BE, Yağcı ZD. COVID-19 sonrası hastalarda akciğer sekelini baştan tahmin edebilir miyiz?. TJCL. 2023;14(4):760-76.


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