COVID-19 Ön Tanısı Olan Çocuk Hastaların Klinik Özellikleri ile Tedavi Sonuçlarının Değerlendirilmesi

Abstract

Amaç: Çocuklarda koronavirüs hastalığı 2019 (coronavirus disease 2019, COVID-19)'un epidemiyolojik özellikleri ve bulaşma yolları henüz tam olarak anlaşılamamıştır. Bu çalışmada, COVID-19 şüphesiyle takip edilen PCR testi negatif ve pozitif olan hastalarda klinik, laboratuvar ve radyolojik bulgular ve tedavi yaklaşımlarının geriye dönük olarak değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Bu çalışma, COVID-19 ön tanısı ile ayaktan veya yatarak tedavi gören 18 yaş altı 317 hasta ile yapılmıştır. Tüm hastalar klinik seyir, hastalık şiddeti, ek hastalıkları, demografik özellikler, laboratuvar ve radyodiagnostik testler, tedavi özellikleri ve sonuçları açısından değerlendirildi. Bulgular: COVID-19 şüphesi olan hastaların 133’ünde (%42) PCR testi pozitif ve 184’ünde (%58) negatifti. PCR pozitif ve negatif hastaların sırasıyla 78’inde (%58,6) ve 51’inde (%27,7) temas öyküsü vardı (p<0,001). PCR-negatif grupta hastaneye yatış oranı daha yüksek iken (p=0,020), PCR-pozitif grupta hastanede kalış süresi daha uzundu (p=0,037). Beyaz kan hücresi sayısı (p=0,001), trombosit sayısı (p=0,037), nötrofil sayısı (p=0,015) ve laktat düzeyi (p=0,025) PCR pozitif grupta anlamlı düzeyde düşüktü. Sonuç: COVID-19'u düşündüren semptomları olan çocukların erken tespiti ve izolasyonu, hastalığın yayılmasını sınırlamak için önemlidir. Özellikle pediatrik hastalarda vakanın COVID-19 olup olmadığını klinik olarak anlamak başlangıçta zor olabilir. PCR testi COVID- 19 tanısında altın standarttır. Salgının yaygınlığı, şiddeti ve komplikasyonları göz önüne alındığında şüpheli hastaları başlangıçta COVID-19 hastası gibi değerlendirmek uygun bir yaklaşım olacaktır.

Keywords

• COVID-19
• SARS-CoV-2
• çocukluk çağı

Evaluation of Clinical Features and Treatment Results of Pediatric Patients With Pre-Diagnosis of COVID-19

Abstract

Aim: The epidemiological characteristics and modes of transmission of coronavirus disease 2019 (COVID-19) in children are not yet fully understood. In this study, it was aimed to evaluate clinical, laboratory, and radiological findings and treatment approaches in patients with negative and positive PCR tests among those with suspected COVID-19 retrospectively. Material and Methods: This study was conducted with 317 patients under 18 years of age, who received outpatient or inpatient treatment with a pre-diagnosis of COVID-19. All patients were assessed for clinical course, disease severity, comorbidity, demographic characteristics, laboratory and radiodiagnostic tests, treatment characteristics, and outcomes. Results: The PCR test was positive in 133 (42%) and negative in 184 (58%) of the patients with suspected COVID-19. There was a history of contact in 78 (58.6%) and 51 (27.7%) of the PCR-positive and negative patients, respectively (p<0.001). While the PCR-negative group had a higher rate of hospitalization (p=0.020), hospital stay was longer in PCR-positive cases (p=0.037). The white blood cell count (p=0.001), platelet count (p=0.037), neutrophil count (p=0.015), and lactate level (p=0.025) were significantly lower in the PCR-positive group. Conclusion: Early detection and isolation of children with symptoms suggestive of COVID-19 are important to limit the spread of the disease. It can be challenging initially to clinically understand whether the case has COVID-19, especially in pediatric patients. PCR test is the gold standard in the diagnosis of COVID-19. Considering the prevalence, severity, and complications of the outbreak, it would be a proper approach to initially evaluate suspected patients as COVID-19 patients.

Keywords

• COVID-19
• childhood
• SARS-CoV-2

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