COVID-19'a Karşı Önde Gelen Hekimler Olarak Dermatologlar

Öz

Dear Editor, The COVID-19 pandemic has been such a nightmare for about a year. The COVID-19 is a disease that mainly concerns the specialties of infectious and chest diseases. However, there was such a global pandemic that the experts of these specialties could not bear the patient’s burden. Approximately 150 million people have been diagnosed with COVID-19 and more than 2 million patients have died (1). Physicians of all specialties in medicine have taken care of patients in the COVID-19 outpatient and inpatient clinics in many countries across the world including Turkey (2,3). As dermatologists, we took care and followed up 283 COVID-19 patients in our hospital between August 2020 and January 2021. The criteria for hospitalization were mainly severe involvement of lungs in computed tomography and shortness of breath that clinically required oxygen support. Patients were treated according to the guide by Turkey's Health Ministry Coronavirus Science Council. Favipravir and enoxaparine were given to all hospitalized patients while systemic antibiotics, systemic steroids, tocilizumab and other supportive agents were administered according to the patient's condition. Infection or chest diseases clinic was consulted if needed. The total number of patients with COVID-19 we followed up was 283 (141 women, 142 men). The age range of the patients was 21-95, the mean age was 63.33. 63 of the patients (22%) were under 60 years old. 24 patients (8.5%) were taken to intensive care during follow-up. 21 (7%) of the patients whose age range was between 60-95 years died. The average age of the patients who died due to COVID-19 was 74.6 years (3 male, 9 female). According to the most recent data from the Ministry of Health in Turkey, case-fatality rate is 1.5% (4). However, Çag and colleagues reported the death rate in patients who were hospitalized was 12% in their study that was performed in the first months of the outbreak. In that study, the average age of the patients who hospitalized was 61 years while the average age of patients who died was 74.5 years (5). Except death rate, other parameters are similar to each other. It can be suggested that in the later stages of the pandemic, the case-fatality rate decreased due to increased awareness of the diagnosis and administration of the diseases. Hospitalization time of the patients varied between 1-45 days. Average hospital stay was 8 days. A senior dermatologists say that dermatologists are not a doctor of the skin, in fact, they are a physician who deals with the skin (6). Dermatologists, who grew up with the concept that each skin disease may also be a reflection of an internal problem, did not experience difficulties in pandemic management. Further, they enrich their knowledge about infection and chest diseases. Dermatologists, who are the authors of this paper, were infected with the new coronavirus. After the recovery, they continued their duties in COVID-19 inpatient services.

Anahtar Kelimeler

• COVID-19
• dermatologists
• frontline

Dermatologists as Frontline Physicians Against the COVID-19

Öz

Dear Editor, The COVID-19 pandemic has been such a nightmare for about a year. The COVID-19 is a disease that mainly concerns the specialties of infectious and chest diseases. However, there was such a global pandemic that the experts of these specialties could not bear the patient’s burden. Approximately 150 million people have been diagnosed with COVID-19 and more than 2 million patients have died (1). Physicians of all specialties in medicine have taken care of patients in the COVID-19 outpatient and inpatient clinics in many countries across the world including Turkey (2,3). As dermatologists, we took care and followed up 283 COVID-19 patients in our hospital between August 2020 and January 2021. The criteria for hospitalization were mainly severe involvement of lungs in computed tomography and shortness of breath that clinically required oxygen support. Patients were treated according to the guide by Turkey's Health Ministry Coronavirus Science Council. Favipravir and enoxaparine were given to all hospitalized patients while systemic antibiotics, systemic steroids, tocilizumab and other supportive agents were administered according to the patient's condition. Infection or chest diseases clinic was consulted if needed. The total number of patients with COVID-19 we followed up was 283 (141 women, 142 men). The age range of the patients was 21-95, the mean age was 63.33. 63 of the patients (22%) were under 60 years old. 24 patients (8.5%) were taken to intensive care during follow-up. 21 (7%) of the patients whose age range was between 60-95 years died. The average age of the patients who died due to COVID-19 was 74.6 years (3 male, 9 female). According to the most recent data from the Ministry of Health in Turkey, case-fatality rate is 1.5% (4). However, Çag and colleagues reported the death rate in patients who were hospitalized was 12% in their study that was performed in the first months of the outbreak. In that study, the average age of the patients who hospitalized was 61 years while the average age of patients who died was 74.5 years (5). Except death rate, other parameters are similar to each other. It can be suggested that in the later stages of the pandemic, the case-fatality rate decreased due to increased awareness of the diagnosis and administration of the diseases. Hospitalization time of the patients varied between 1-45 days. Average hospital stay was 8 days. A senior dermatologists say that dermatologists are not a doctor of the skin, in fact, they are a physician who deals with the skin (6). Dermatologists, who grew up with the concept that each skin disease may also be a reflection of an internal problem, did not experience difficulties in pandemic management. Further, they enrich their knowledge about infection and chest diseases. Dermatologists, who are the authors of this paper, were infected with the new coronavirus. After the recovery, they continued their duties in COVID-19 inpatient services.

Anahtar Kelimeler

• COVID-19
• dermatologists
• frontline

Kaynakça

1. 1. World Health Organization. Coronavirus disease (COVID-19) pandemic. Available at:https://www.who.int/publications/m/item/weekly-epidemiological-update---19-january-2021
2. 2. Plachouri KM, Georgiou S. How well prepared are dermatologists redeployed to COVID-19 wards? Int J Dermatol. 2020 Jul;59(7):e247-e248
3. 3. Arsava EY, Cankurtaran M. Family medicine research
4. 4. assistants’ experiences during COVID-19 pandemic: A
5. 5. qualitative study. Int J Clin Pract. 2021;00:e13975.
6. 6. Aksoy H, Ayhan Başer D, Fidancı İ, Arsava EY, Cankurtaran M. Family medicine research assistants' experiences during COVID-19 pandemic: A qualitative study. Int J Clin Pract. 2020 Dec 30:e13975
7. 7. World Health Organization. Coronavirus disease (COVID-19) pandemic. Available at:https://covid19.who.int/region/euro/country/tr
8. 8. Cag Y, Icten S, Isik-Goren B, Baysal NB, Bektas B, Selvi E,et al. A novel approach to managing COVID-19 patients; results of lopinavir plus doxycycline cohort. Eur J Clin Microbiol Infect Dis. 2021 Feb;40(2):407-411

9. 9. Walsh S, Creamer D. A very peculiar practice: dermatology in the era of COVID-19. Br J Dermatol. 2020 Nov;183(5):940-941