Telehelath Monitoring in Renal Transplantat Recipients with Diagnosis COVID-19: Retrospective Study

Öz

Objective: To retrospectively examine the characteristics, hospitalization need, clinical course, severity of the condition and information about treatment management of kidney transplant recipients who were found to be COVID-19 positive and followed up through Telehealth services, through a questionnaire. Methods: The population of this descriptive and retrospective study consisted of kidney transplant recipients over the age of 18 who were followed up through Telehealth services, who were positive for COVID-19 in the Organ Transplant Center of a university hospital between March 2020 and March 2021. In the study, all patients followed up via Telehealth service between the data collection dates without using the sample selection method were included in the study. The sample of the study consisted of 63 kidney transplant recipients over the age of 18 who were found to be positive for COVID-19. The data were obtained by retrospective examination of medical records with a questionnaire prepared by the researchers and telephone interviews with patients. The data obtained from the study were evaluated by descriptive statistical methods. Approval for the study was obtained from the Clinical Research Ethics Committee of the institution where the study was conducted. Results: The mean age of kidney transplant recipients who were found to be positive for COVID-19 was 50.70±10.89, the mean body mass index was 27.71±6.20, and 23.8% of the patients were obese, 52.4% were male. It was determined that 60.3% of them were primary school graduates, 81% had comorbidities (84.1% hypertension, 22.2% diabetes), 52.4% of them were transplanted from a living donor. It was determined that 52.4% got the disease in autumn, 49.2% had cough, 42.9% had pneumonia, 42.9% had general body pain/fatigue, 22.2% dyspnea, 22.2% loss of taste and smell, 11.1% headache, 15.9% diarrhea, 9.5% nausea and vomiting symptoms were found. 42.9% had thorax CT involvement, 44.4% of the patients were hospitalized, 17.5% were treated in the intensive care unit, 6.3% were intubated, 15.9% experienced rejection risk, 7.9% died, 1.6% started hemodialysis. Conclusion: Although the diagnosis of COVID-19 in organ transplant patients was similar to the general population, it was observed that the symptoms were mild and the disease progressed rapidly, and the morbidity and mortality were high. For this reason, it is necessary to be careful and attentive in the diagnosis, treatment and nursing care of organ transplant patients.

Anahtar Kelimeler

• Covid-19
• Kidney Transplantation
• Tele health

COVİD-19 Geçiren Böbrek Nakli Alıcılarında Telesağlık İzlemi: Retrospektif Çalışma

Öz

Amaç: COVID-19 pozitif saptanan ve tele sağlık hizmetleri aracılığıyla takip edilen böbrek nakli alıcılarının özelliklerini, hospitalizasyon ihtiyacını, klinik seyrini, durumun ciddiyetini, tedavi yönetimi hakkında bilgileri anket yolu ile retrospektif olarak incelemektir. Gereç Yöntem: Tanımlayıcı ve retrospektif türde olan bu çalışmanın evrenini bir üniversite hastanesinin Organ Nakli Merkezinde Mart 2020 – Mart 2021 tarihleri arasında COVID-19 pozitif olan, telesağlık hizmetleri aracılığıyla takip edilen 18 yaş üstü böbrek nakli alıcıları oluşturdu. Araştırmada örneklem seçim yöntemi kullanılmadan veri toplama tarihleri arasında telesağlık hizmeti aracılığıyla takip edilen tüm hastalar araştırma kapsamına alındı. Araştırmanın örneklemini 18 yaşını doldurmuş, COVID-19 pozitif saptanan 63 böbrek nakli alıcısı oluşturdu. Veriler, araştırmacılar tarafından hazırlanan anket formu ile tıbbi kayıtların retrospektif olarak incelenmesiyle ve hastalar ile gerçekleştirilen telefon görüşmeleri ile elde edildi. Araştırmadan elde edilen veriler tanımlayıcı istatistiksel yöntemlerle değerlendirildi. Araştırma için araştırmanın yapıldığı kurumun Klinik Araştırmalar Etik Kurulundan onay alındı. Bulgular: COVID-19 pozitif saptanan böbrek nakli alıcılarının yaş ortalamasının 50,70±10,89 olduğu, beden kitle indeksi ortalamasının 27,71±6,20 olduğu ve hastaların %23,8’inin obes olduğu, %52,4’ünün erkek olduğu, %60,3’ünün ilköğretim mezunu olduğu, %81’inin ek hastalığının olduğu (%84,1’inde hipertansiyon, %22,2’sinde diyabet), %52,4’ünün canlıdan nakil olduğu belirlendi. Böbrek nakli alıcılarının %52,4’ünün sonbaharda hastalığa yakalandığı, %49,2’sinde öksürük, %42,9’unda pnömoni, %42,9’unda genel vücut ağrısı/yorgunluk, %22,2’sinde dispne, %22,2’sinde tat ve koku kaybı, %11,1’inde baş ağrısı, %15,9’unda ishal, %9,5’inde bulantı kusma belirtileri olduğu saptandı. %42,9’unda torax CT tutulumu vardı, hastaların %44,4’ü hastaneye yatarak tedavi olduğu, %17,5’i yoğun bakımda tedavi aldığı, %6,3’ünün entübe edildiği, %15,9’u rejeksiyon riski yaşadığı, %7,9’unun ex olduğu, %1,6’sının hemodiyalize başladığı belirlendi. Sonuç: Organ nakli hastalarında COVID-19 teşhisi genel popülasyona benzer olmasına rağmen, semptomların hafif seyredip hastalığın hızlı ilerleyebildiği ve sağlıklı popülasyona göre mortalitenin yüksek seyrettiği görüldü.

Anahtar Kelimeler

• Covid 19
• Böbrek Nakli
• Tele sağlık

Kaynakça

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