COVID-19 Olan Çocuklarda İmmunoglobulin Seviyeleri ve Hastane Başvuruları Üzerine Etkisi

Abstract

Koronavirüs hastalığı-2019 (COVID-19) salgını tüm dünyada bir sağlık krizine dönüşmüştür. Çocukların da erişkinler kadar Şiddetli Akut Solunum Sendromu Coronavirüs 2 (SARS-CoV-2) ile enfekte olabildikleri belirlenmiştir. Bu çalışmada, COVID-19 saptanan çocuklarda bakılan immunoglobulin seviyelerini ve hastane başvurularındaki etkisini araştırmayı amaçladık. Ocak 2020 ve Aralık 2022 tarihleri arasında hastaneye başvuran COVID-19 saptanan, immunoglobulin seviyeleri bakılan 138 çocuk hastanın; demografik özellikleri, klinik belirtileri ve laboratuvar sonuçları retrospektif olarak tıbbi kayıtlardan elde edilerek analiz edildi. Olguların %53’ü kız, %47’si erkekti ve yaş ortancaları 9 yıl (0,6–17,8) idi. En sık başvuru semptomları ateş (%52), öksürük (%45) ve gastrointestinal belirtilerdi (%9). IgG %34.5’inde, IgA %14’ünde ve IgM %21.6’sında düşük seviyelerde bulundu. Düşük IgG bulunan hastalarda; IgA, IgM ve IgE seviyelerinde de azalma olduğu saptandı (p<0.001). Düşük IgG olanlarda hemoglobin, total kolesterol ve LDL seviyelerininde de düşüklük görüldü (p=0.015, p=0.036 ve p=0.006, sırasıyla). IgM düşüklüğü olan grupta, normal olan gruba kıyasla hastane yatış gereksinimi daha fazlaydı (p=0.045). Yatış durumu ile cinsiyet, IgG, IgA ve IgE arasında anlamlı ilişki yoktu (p>0,05). Düşük IgA ve IgM seviyeleri olanlarda anlamlı oranda çocuk yoğun bakım ihtiyacı oldugu saptandı (p=0.049, p=0.011, sırasıyla). Uzayan yatış durumu (>15 gün) ile cinsiyet, IgG, IgA, IgM ve IgE arasında istatistiksel olarak anlamlı ilişki yoktu (p>0,05). Hipogammaglobulinemi olan COVID-19 tanılı çocuk hastalarda, genel popülasyona göre mortalite ve yoğun bakım yatış oranlarının daha yüksek olduğu bilinmektedir. Bulgularımız, COVID-19 ile başvuran, hastane yatış gereksinimi olan çocuk hastaların rutin değerlendirmesinde immunoglobulin seviyelerinin değerlendirilmesinin önemini vurgulamaktadır.

Keywords

• COVID-19
• çocuk COVID-19
• hipogammaglobulinemi

Immunoglobulin Levels in Children with COVID-19 and Impact on Hospital Admissions

Abstract

The Coronavirus Disease 2019 (COVID-19) pandemic has become a global health crisis. It has been determined that children can be infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) as severely as adults. In this study, we aimed to investigate the levels of immunoglobulins and their impact on hospital admissions in children diagnosed with COVID-19. The demographic characteristics, clinical symptoms, and laboratory results of 138 children diagnosed with COVID-19 who visited the hospital between January 2020 and December 2022 and had their immunoglobulin levels checked were analyzed retrospectively using medical records. 53% of the cases were female, 47% were male, and the median age was 9 years (0.6–17.8). The most common presenting symptoms were fever (52%), cough (45%), and gastrointestinal symptoms (9%). Low levels of IgG were found in 34.5% of the cases, IgA in 14%, and IgM in 21.6%. In those with low IgG, a decrease in IgA, IgM, and IgE levels was also observed (p<0.001). Patients with low IgG also had lower levels of hemoglobin, total cholesterol, and LDL (p=0.015, p=0.036, and p=0.006, respectively). The group with low IgM had a higher need for hospitalization than the normal group (p=0.045). No significant relationship existed between hospitalization status and gender, IgG, IgA, and IgE (p>0.05). It was determined that children with low IgA and IgM levels had a significant need for pediatric intensive care (p=0.049, p=0.011, respectively). Prolonged hospitalization (>15 days) did not have a statistically significant relationship with gender, IgG, IgA, IgM, and IgE (p>0.05). Children with hypogammaglobulinemia diagnosed with COVID-19 have higher mortality and intensive care admission rates than the general population. Our findings emphasize the importance of immunoglobulin levels in the routine evaluation of children with COVID-19 who present with hospitalization needs, consistent with the literature.

Keywords

• COVID-19
• pediatric COVID-19
• hypogammaglobulinemia

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