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Askeri birlikte Covid-19 olanlarda gastrointestinal semptomlar ve karaciğer test bozukluğu sıklığının değerlendirilmesi: Tek merkezli pilot çalışma

Yıl 2021, Cilt: 20 Sayı: 2, 75 - 80, 26.08.2021
https://doi.org/10.17941/agd.981731

Öz

Giriş ve Amaç: Covid-19 çoğu zaman solunum yolu semptomları ile prezente olan bir hastalık olsa da gastrointestinal semptomlar da birçok hastada görülebilmektedir. Ayrıca hastalık süresince karaciğer testlerinde değişik oranlarda bozulmalar da olabilmektedir. Çalışmamızda Covid-19 salgını sürecinde ilimizde bulunan askeri birlikte salgının boyutunu ve hasta olanlarda gastrointestinal semptom ve karaciğer test bozukluğu sıklığını araştırmayı amaçladık. Gereç ve Yöntem: Mart 2020, 30 Mayıs 2020 tarihleri arası dönemde ilimizde bulunan askeri birlikte retrospektif olarak real time polimeraz zincir reaksiyonu pozitif Covid-19 tanılı askerlerin demografik, radyolojik, laboratuvar ve klinik açıdan analizi yapıldı. Bulgular: Askerlik görevini yapmak üzere ülkemizin değişik şehirlerinden gelen 2152 asker adayının ilk giriş muayenesi sonucu 17’sinde (%0.7), birliğe alındıktan sonra asker olanların takip eden günlerde 9’unda (%0.4) Covid-19 saptandı. Birlikte daimi bulunan 320 rütbeli askerden 1 (%0.3) kişi Covid-19 olurken başka birliklerden ilimizdeki birliğe gelen 56 askerden 2’si (%3.6) Covid-19 oldu. Hastaların yaş ortalaması 21.2 ± 1.8 idi. Toraks bilgisayarlı tomografide yalnızca 4 (%13.7) hastada pnömoni vardı. Hastaların tanı anında %6.8’inde gastrointestinal semptom, %13.7’sinde ise karaciğer test bozukluğu vardı. Hiçbir hastada solunum yetmezliği, yoğun bakıma alınma ve ölüm olmadı ve hastaların tümü komplikasyonsuz şekilde iyileşti. Sonuç: Çalışmamız literatürde görebildiğimiz kadarıyla Dünyada askeri ünitede yapılmış Covid-19 salgını ve bu hastalarda gastrointestinal semptom ve karaciğer test bozukluğu sıklığını araştıran ilk çalışma özelliği taşımaktadır. Çalışmamızda genç popülasyonda Covid-19’un daha hafif şiddette seyrettiğini, gastrointestinal semptom ve karaciğer test bozukluğunun daha az sıklıkta izlendiğini bulduk. Askeri birlik gibi çok fazla kişinin birarada yakın şekilde yaşayacağı ortamlarda yapılacak hızlı ve doğru triaj ve hastalık şüphesi olanlara uygun izolasyon ile Covid-19 salgını kontrol altına alınabilecektir. Ayrıca gastrointestinal semptomu olanlarda Covid-19 her zaman akılda tutulmalıdır ve hastaların erken izolasyonu ile bu tür ortamlarda salgının yayılması engellenebilecektir.

Kaynakça

  • 1. Richman DD, Whitley RJ, Hayden FG, eds. Clinical virology, 4th edn. Washington: ASM Press, 2016.
  • 2. Ksiazek TG, Erdman D, Goldsmith CS, et al; SARS Working Group. A novel coronavirus associated with severe acute respiratory syndrome. N Engl J Med 2003;348:1953-66.
  • 3. de Groot RJ, Baker SC, Baric RS, et al. Middle East respiratory syndrome coronavirus (MERS-CoV): announcement of the Coronavirus Study Group. J Virol 2013;87:7790-2.
  • 4. Wang L, Wang Y, Ye D, Liu Q. Review of the 2019 novel coronavirus (SARS-CoV-2) based on current evidence. Int J Antimicrob Agents 2020;55:105948.
  • 5. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395:507-13.
  • 6. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506.
  • 7. Liu Y, Gayle AA, Wilder-Smith A, Rocklöv J. The reproductive number of COVID−19 is higher compared to SARS coronavirus. J Travel Med 2020 [Epub ahead of print]. doi:10.1093/jtm/taaa021).
  • 8. Xiao F, Tang M, Zheng X, et al. Evidence for gastrointestinal infection of SARS-CoV-2. Gastroenterology 2020. [Epub ahead of print March 3, 2020.]
  • 9. Gu J, Han B, Wang J. COVID-19: Gastrointestinal manifestations and potential fecal-oral transmission. Gastroenterology 2020. [Epub ahead of print March3, 2020.]
  • 10. Pan L, Mu M, Yang P, et al. Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: A descriptive, cross-sectional, multicenter study. Am J Gastroenterol 2020;115:766-73.
  • 11. Holshue ML, DeBolt C, Lindquist S et al; Washington State 2019-nCoV Case Investigation Team. First case of 2019 novel coronavirus in the United States. N Engl J Med 2020;382:929-36.
  • 12. Wang H, Qui P, Liu J, Wang F, Zhao Q. The liver injury and gastrintestinal symptoms in patients coronavirus disease 19: A systematic rewiev and metanalysis. Clin Res Hepatol Gastroenterol 2020. Epub 2020 May 12.
  • 13. Yang X, Yu Y, Xu J et al. Clinical course and outcomes of criticallyill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020. Epub 2020 Feb 24.
  • 14. Xu XW, Wu XX, Jiang XG et al. Clinical findings in a group ofpatients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ 2020;368:m606.
  • 15. Opal SM, Girard TD, Ely EW. The immun patogenesis of sepsis in elderly patients. Clin Infect Dis 2005; 41(Suppl 7):S504-12.
  • 16. Leung WK, To KF, Chan PK, et al. Enteric involvement of severe acute respiratory syndrome associated coronavirus infection. Gastroenterology 2003;125:1011-7.
  • 17. Lee N, Hui D, Wu A, et al. A major outbreak of severe acute respiratory syndrome in Hong Kong. N Engl J Med 2003;348:1986-94.
  • 18. Chan JF, Lau SK, Tos K, et al. Middle East respiratory syndrome coronavirus: another zoonotic beta coronavirus causing SARS-like disease. Clin Microbiol Rev 2015;28:465-522.
  • 19. Zhang H, Kang ZJ, Gong HY, et al. The digestive system is a potential route of 2019-nCov infection: a bioinformatics analysis based on single-cell transcriptomes. Preprint. Posted online January 30, 2020. bioRxiv 927806.
  • 20. Liang W, Feng Z, Rao S, et al. Diarrhoea may be underestimated: a missing link in 2019 novel coronavirus. Gut 2020, Epub 2020 Feb 26.
  • 21. Han C, Duan C, Zhang S, et al. Digestive Symptoms in COVID-19 Patients With Mild Disease Severity: Clinical Presentation, Stool Viral RNA Testing, and Outcomes. Am J Gastroenterol 2020;115:916-23.
  • 22. Jin X, Lian JS, Hu JH, et al. Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms. Gut 2020;69:1002-9. Epub 2020 Mar 24.
  • 23. Chai X, Hu L, Zhang Y, et al. Specific ACE2 expression in cholangiocytes may cause liver damage after 2019-nCoV infection. bioRxiv 2020; published online Feb 4.
  • 24. Banales JM, Huebert RC, Karlsen T, et al. Cholangiocyte pathobiology. Nat Rev Gastroenterol Hepatol 2019;16:269-81.

Frequency evaluation of gastrointestinal symptoms and liver test disorder in patients during the Covid-19 outbreak in the military unit: A single-center pilot study

Yıl 2021, Cilt: 20 Sayı: 2, 75 - 80, 26.08.2021
https://doi.org/10.17941/agd.981731

Öz

Background and Aims: Coronavirus disease-2019 is a disease presenting with respiratory as well as gastrointestinal symptoms. In addition, the liver enzyme can be disrupted during the disease. This study aimed to investigate the extent of the military co-epidemic during the Coronavirus disease-2019 epidemic process and the frequency of gastrointestinal symptoms and liver test disorders. Materials and Methods: Demographic, radiological, laboratory, and clinical analysis of soldiers diagnosed with Coronavirus disease-2019 was carried out retrospectively in March, April, and May of 2020, using real-time polymerase chain reaction. Results: Coronavirus disease-2019 was detected in 17 (0.7%) of the 2,152 soldiers coming from different cities to perform their military services and 9 (0.4%) of the soldiers in the following days after recruitment. In addition, 1 (0.3%) of 320 senior militaries and 2 (3.6%) from 56 other soldiers who came to the unit from other units were also diagnosed with Coronavirus disease-2019. The mean age was 21.2 ± 1.8 years. In torax computed tomography, only 4 (13.7%) patients had pneumonia. At the time of diagnosis, 6.8% of the patients had gastrointestinal symptoms and 13.7% had liver enzyme disruption. None of the patients experienced respiratory failure, intensive care, and death; all the patients recovered. Conclusion: In the present literature, our study is the first to investigate the Coronavirus disease-2019 outbreak in the military unit in the world and the frequency of gastrointestinal symptoms and liver enzyme disruptions in these patients. Our study revealed that Coronavirus disease-2019 was milder in young populations and gastrointestinal symptoms and liver test disorder were less frequently observed. Coronavirus disease-2019 outbreak was taken under control by fast and accurate triage and suitable isolation for those with the suspected disease in environments where many people such as military units will live close together. Coronavirus disease-2019 should always be kept in mind, especially in patients with gastrointestinal symptoms, and early patient isolation prevents the spread of the epidemic in such crowded environments.

Kaynakça

  • 1. Richman DD, Whitley RJ, Hayden FG, eds. Clinical virology, 4th edn. Washington: ASM Press, 2016.
  • 2. Ksiazek TG, Erdman D, Goldsmith CS, et al; SARS Working Group. A novel coronavirus associated with severe acute respiratory syndrome. N Engl J Med 2003;348:1953-66.
  • 3. de Groot RJ, Baker SC, Baric RS, et al. Middle East respiratory syndrome coronavirus (MERS-CoV): announcement of the Coronavirus Study Group. J Virol 2013;87:7790-2.
  • 4. Wang L, Wang Y, Ye D, Liu Q. Review of the 2019 novel coronavirus (SARS-CoV-2) based on current evidence. Int J Antimicrob Agents 2020;55:105948.
  • 5. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395:507-13.
  • 6. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506.
  • 7. Liu Y, Gayle AA, Wilder-Smith A, Rocklöv J. The reproductive number of COVID−19 is higher compared to SARS coronavirus. J Travel Med 2020 [Epub ahead of print]. doi:10.1093/jtm/taaa021).
  • 8. Xiao F, Tang M, Zheng X, et al. Evidence for gastrointestinal infection of SARS-CoV-2. Gastroenterology 2020. [Epub ahead of print March 3, 2020.]
  • 9. Gu J, Han B, Wang J. COVID-19: Gastrointestinal manifestations and potential fecal-oral transmission. Gastroenterology 2020. [Epub ahead of print March3, 2020.]
  • 10. Pan L, Mu M, Yang P, et al. Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: A descriptive, cross-sectional, multicenter study. Am J Gastroenterol 2020;115:766-73.
  • 11. Holshue ML, DeBolt C, Lindquist S et al; Washington State 2019-nCoV Case Investigation Team. First case of 2019 novel coronavirus in the United States. N Engl J Med 2020;382:929-36.
  • 12. Wang H, Qui P, Liu J, Wang F, Zhao Q. The liver injury and gastrintestinal symptoms in patients coronavirus disease 19: A systematic rewiev and metanalysis. Clin Res Hepatol Gastroenterol 2020. Epub 2020 May 12.
  • 13. Yang X, Yu Y, Xu J et al. Clinical course and outcomes of criticallyill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020. Epub 2020 Feb 24.
  • 14. Xu XW, Wu XX, Jiang XG et al. Clinical findings in a group ofpatients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ 2020;368:m606.
  • 15. Opal SM, Girard TD, Ely EW. The immun patogenesis of sepsis in elderly patients. Clin Infect Dis 2005; 41(Suppl 7):S504-12.
  • 16. Leung WK, To KF, Chan PK, et al. Enteric involvement of severe acute respiratory syndrome associated coronavirus infection. Gastroenterology 2003;125:1011-7.
  • 17. Lee N, Hui D, Wu A, et al. A major outbreak of severe acute respiratory syndrome in Hong Kong. N Engl J Med 2003;348:1986-94.
  • 18. Chan JF, Lau SK, Tos K, et al. Middle East respiratory syndrome coronavirus: another zoonotic beta coronavirus causing SARS-like disease. Clin Microbiol Rev 2015;28:465-522.
  • 19. Zhang H, Kang ZJ, Gong HY, et al. The digestive system is a potential route of 2019-nCov infection: a bioinformatics analysis based on single-cell transcriptomes. Preprint. Posted online January 30, 2020. bioRxiv 927806.
  • 20. Liang W, Feng Z, Rao S, et al. Diarrhoea may be underestimated: a missing link in 2019 novel coronavirus. Gut 2020, Epub 2020 Feb 26.
  • 21. Han C, Duan C, Zhang S, et al. Digestive Symptoms in COVID-19 Patients With Mild Disease Severity: Clinical Presentation, Stool Viral RNA Testing, and Outcomes. Am J Gastroenterol 2020;115:916-23.
  • 22. Jin X, Lian JS, Hu JH, et al. Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms. Gut 2020;69:1002-9. Epub 2020 Mar 24.
  • 23. Chai X, Hu L, Zhang Y, et al. Specific ACE2 expression in cholangiocytes may cause liver damage after 2019-nCoV infection. bioRxiv 2020; published online Feb 4.
  • 24. Banales JM, Huebert RC, Karlsen T, et al. Cholangiocyte pathobiology. Nat Rev Gastroenterol Hepatol 2019;16:269-81.
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Enver Avcı Bu kişi benim 0000-0002-3065-2419

Onur Akhan Bu kişi benim 0000-0003-4440-9599

Erkin Öztaş Bu kişi benim 0000-0002-3160-7492

Selçuk Dişibeyaz Bu kişi benim 0000-0002-1637-7684

Yayımlanma Tarihi 26 Ağustos 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 20 Sayı: 2

Kaynak Göster

APA Avcı, E., Akhan, O., Öztaş, E., Dişibeyaz, S. (2021). Frequency evaluation of gastrointestinal symptoms and liver test disorder in patients during the Covid-19 outbreak in the military unit: A single-center pilot study. Akademik Gastroenteroloji Dergisi, 20(2), 75-80. https://doi.org/10.17941/agd.981731

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