Sakarya İli SARS-CoV-2 Olgularında İnme Sıklığının Araştırılması

Year 2020, Volume: 22 Issue: Special Issue, 51 - 55, 30.11.2020

Dilcan Kotan , Onur Taydaş , Ömer Faruk Ateş , Mehmet Halil Öztürk

https://doi.org/10.18678/dtfd.785531

Cited By: 1

Abstract

Amaç: Bu çalışmanın amacı Sakarya ilindeki şiddetli akut solunum yolu sendromu koronavirüsü 2 (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) olgularında inme sıklığını tespit etmek, inme tanısı almış olan hastaların klinik özelliklerini ortaya koyabilmek ve ulusal veri tabanına katkıda bulunmaktır.
Gereç ve Yöntemler: Bu çalışma, Sakarya ilindeki pandemi hastanesinde Nisan-Haziran 2020 tarihleri arasında SARS-CoV-2 tanısı alan 783 olgu ile geriye dönük olarak yürütüldü. Hastalar, yaş, Ulusal Sağlık Enstitüleri İnme Skalası (National Institute of Health Stroke Scale, NIHSS), risk faktörleri, radyolojik bulgular, yatarak tedavi, entübe olma durumları ve mortalite oranları bakımından karşılaştırıldı.
Bulgular: Yirmi altı iskemik inmeli olgunun 11 (%42,3)’i erkek ve 15 (%57,7)’i kadın idi. Enfarkt lokalizasyonu bakımından 26 hastanın 4 (%15,4)’ü orta serebral arter (medial cerebral artery, MCA), 2 (%7,7)’si baziller tepe, 1 (%3,8)’i baziller arter, 9 (%34,6)’u laküner, 10 (%38,5)’u arka sistemden kaynaklanmaktaydı. D-Dimer ve C-reaktif protein (C-reactive protein, CRP) düzeyleri bakımından hastalık şiddetine göre anlamlı bir farklılık yoktu (her iki p=0,262). Üç (%0,38) hasta inme bulgusuyla gelip SARS-CoV-2 tanısı almıştı. SARS-CoV-2 olgularının 8 (%30,8)’inde kriptojenik inme tespit edildi. Sakarya ilinde SARS-CoV-2 olgularında inme sıklığı %3,3 olarak hesaplandı.
Sonuç: Bu çalışma SARS-CoV-2 hastalarında inme sıklığını tespit etmeye yönelik Sakarya ilinde ve Türkiye’de yapılmış ilk çalışmadır. Çalışmamız, SARS-CoV-2 olgularında iskemik inmenin önlenebilmesi ve tedavi edilebilmesinin mortalitenin azalmasına belirgin katkı sunduğunu göstermesi bakımından önemlidir.

Keywords

Sakarya ili, SARS-CoV-2, inme, sıklık

Investigating the Frequency of Stroke in SARS-CoV-2 Cases in Sakarya City, Turkey

Abstract

Aim: The aim of this study is to identify the frequency of stroke among severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases in Sakarya city, to find out the clinical characteristics of patients diagnosed with stroke and to contribute to the national database.
Material and Methods: This retrospective study was carried out with 783 cases diagnosed with SARS-CoV-2 between April-June 2020 at the pandemic hospital in Sakarya city. Patients were compared in terms of age, National Institute of Health Stroke Scale (NIHSS), risk factors, radiological findings, inpatient treatment, intubation, and mortality rates.
Results: Out of 26 cases of ischemic stroke, 11 (42.3%) were male and 15 (57.7%) were female. In terms of infarction localization, the cause was medial cerebral artery (MCA) in 4 (15.4%) patients, top of the basilar in 2 (7.7%) patients, basilar artery in 1 (3.8%) patient, lacunar in 9 (34.6%) patients and anterior system in 10 (38.5%) patients. There was no significant difference in terms of D-dimer and C-reactive protein (CRP) levels according to disease severity (both p=0.262). Three (0.38%) patients presented with stroke findings and were diagnosed with SARS-CoV-2. Cryptogenic stroke was detected in 8 (30.8%) of the SARS-CoV-2 cases. Stroke frequency was calculated as 3.3% among the SARS-CoV-2 cases in Sakarya city.
Conclusion: This is the first study to identify the frequency of stroke among SARS-CoV-2 patients in Sakarya city and Turkey. Our study is important as it shows that preventing or treating ischemic stroke in SARS-CoV-2 cases contributes greatly to the reduction of mortality.

Keywords

Sakarya city, SARS-CoV-2, stroke, frequency

References

• Wu Y, Xu X, Chen Z, Duan J, Hashimoto K, Yang L, et al. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav Immun. 2020;87:18-22.
• Jin H, Hong C, Chen S, Zhou Y, Wang Y, Mao L, et al. Consensus for prevention and management of coronavirus disease 2019 (COVID-19) for neurologists. Stroke Vasc Neurol. 2020;5(2):146-51.
• Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13.
• Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurological manifestations of hospitalized patients with coronavirus disease 2019 (COVID-19) in Wuhan, China. JAMA Neurol. 2020;77(6):683-90.
• Aggarwal G, Lippi G, Michael Henry B. Cerebrovascular disease is associated with an increased disease severity in patients with coronavirus disease 2019 (SARS-COV-2): A pooled analysis of published literature. Int J Stroke. 2020;15(4):385-9.
• Shahjouei S, Naderi S, Li J, Khan A, Chaudhary D, Farahmand G, et al. Risk of stroke in hospitalized SARS-CoV-2 infected patients: A multinational study. EBioMedicine. 2020;59:102939.
• Li Y, Li M, Wang M, Zhou Y, Chang J, Xian Y, et al. Acute cerebrovascular disease following COVID-19: a single center, retrospective, observational study. Stroke Vasc Neurol. 2020;5(3):279-84.
• Avula A, Nalleballe K, Narula N, Sapozhnikov S, Dandu V, Toom S, et al. COVID-19 presenting as stroke. Brain Behav Immun. 2020;87:115-9.
• Siniscalchi A, Gallelli L. Could COVID-19 represent a negative prognostic factor in patients with stroke? Infect Control Hosp Epidemiol. 2020;41(9):1115-6.
• Helms J, Tacquard C, Severac F, Leonard-Lorant I, Ohana M, Delabranche X, et al. High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study. Intensive Care Med. 2020;46(6):1089-98.
• Klok FA, Kruip MJHA, van der Meer NJM, Arbous MS, Gommers DAMPJ, Kant KM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res. 2020;191:145-7.
• Violi F, Pastori D, Cangemi R, Pignatelli P, Loffredo L. Hypercoagulation and antithrombotic treatment in coronavirus 2019: A new challenge. Thromb Haemost. 2020;120(6):949-56.
• hsgm.saglik.gov.tr [Internet]. T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. COVID-19 (SARS-CoV-2 Enfeksiyonu) Rehberi [Cited: 2020 August 25]. Available from: https://dosyamerkez.saglik.gov.tr/ Eklenti/37044,covid-19rehberipdf.pdf?0.
• Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9.
• Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20.
• AHA/ASA Stroke Council Leadership. Temporary emergency guidance to US stroke centers during the coronavirus disease 2019 (COVID-19) pandemic: On Behalf of the American Heart Association/American Stroke Association Stroke Council Leadership. Stroke. 2020;51(6):1910-2.
• Li YC, Bai WZ, Hashikawa T. The neuroinvasive potential of SARS‐CoV-2 may play a role in the respiratory failure of COVID‐19 patients. J Med Virol. 2020;92(6):552-5.
• Lodigiani C, Iapichino G, Carenzo L, Cecconi M, Ferrazzi P, Sebastian T, et al. Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thromb Res. 2020;191:9-14.
• Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020;323(13):1239-42.
• Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 2020;180(7):934-43.
• Goyal P, Choi JJ, Pinheiro LC, Schenck EJ, Chen R, Jabri A, et al. Clinical characteristics of COVID-19 in New York City. N Engl J Med. 2020;382(24):2372-4.
• Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18(4):844-7.
• Khosravani H, Rajendram P, Notario L, Chapman MG, Menon BK. Protected code stroke: hyperacute stroke management during the coronavirus disease 2019 (COVID-19) pandemic. Stroke. 2020;51(6):1891-5.
• Baracchini C, Pieroni A, Viaro F, Cianci V, Cattelan AM, Tiberio I, et al. Acute stroke management pathway during coronavirus-19 pandemic. Neurol Sci. 2020;41(5):1003-5.